Case Presentation: A 70 year-old woman with hyperthyroidism, hypertension and diabetes presented with subacute progressive altered mental status and frequent falls. History obtained from family revealed a previously independently functioning woman until 4 months prior, when she began to demonstrate symptoms of forgetfulness and micrographia. Symptoms progressed rapidly requiring an inpatient psychiatric admission, a month [...]

Case Presentation: A 36yo M with PMH of alcohol abuse presented with intermittent atypical chest pain, worsening exertional shortness of breath, chills, and right (R) upper quadrant abdominal pain for the past three weeks. On physical exam, he was noted to be tachycardic and tachypneic; respiratory exam was significant for decreased breath sounds in R [...]

Case Presentation: A 58-year-old Caucasian man with Stage I pancreatic cancer, who underwent Whipple procedure, now presents with 50 pound weight loss over 11 months, abdominal pain, diarrhea, and failure to thrive. The patient’s symptoms started 6 weeks after the Whipple procedure and progressively worsened. His intermittent nausea and vomiting was occasionally feculent and foul-smelling. [...]

Case Presentation: A 63-year old woman presented with progressive, severe bilateral hearing loss over the course of two months with complete loss of hearing over the week prior to presentation. She had associated imbalance and mild generalized fatigue. She had not received medical care for many years prior to this admission. She denied head trauma, [...]

Case Presentation: A 21-year-old otherwise healthy female army recruit undergoing basic training was admitted to an outside hospital with severe abdominal pain, nausea, and vomiting. An abdominal CT was unremarkable. Laboratory results revealed hyponatremia (Na 117mmol/L) and polycythemia (Hgb 17mg/dL). Patient then developed severe chest pain associated with tachycardia, hypertension and a mild troponin elevation. [...]

Case Presentation: A 69-year-old man presented with acute onset abdominal pain during hemodialysis. He had a history of end stage renal disease and extensive vascular disease, including coronary artery disease, peripheral arterial disease, and an abdominal aortic aneurysm. One hour into dialysis, he developed epigastric, burning, ten-out-of-ten abdominal pain that radiated to his back. He [...]

Case Presentation: A 68 year-old woman with a past medical history of paroxysmal atrial fibrillation, recurrent Clostridium difficile infection and intra-abdominal abscess for which she was treated with ceftriaxone and metronidazole for six weeks, presented to the emergency department with slurred speech and ataxia. CT head showed no acute hemorrhage, infarction or other intracranial disease [...]

Case Presentation: A 65 year-old Mexican man had presented to an outside hospital with 2 weeks of cough and dyspnea and was found to have a new apical pulmonary infiltrate. He underwent lung biopsy and was treated for pneumonia for several days without resolution of his symptoms. He was transferred to our medicine service and [...]

Case Presentation: A 54-year-old male with hereditary spherocytosis, status-post splenectomy presented to the emergency room complaining of acute onset neck pain for 2 days. This was localized on the left side of his neck and associated with odynophagia. The patient endorsed mild headache but no photophobia or fever. His vital signs were stable with a [...]

Case Presentation: A 63-year-old woman woman presented after multiple episodes of seizure. She had no prior history of seizures or alcoholism. The patient had a deceased donor renal transplant 6 months prior complicated by persistent right perinephric fluid collection treated with long term piperacillin-tazobactam therapy. Attempts to obtain microbiology were unsuccessful and patient was started [...]