Case Presentation: A 47-year-old woman presented with two days of shortness of breath and hemoptysis following two weeks of nonproductive cough. Associated symptoms included bilateral lower extremity edema and malaise. She was a nursing home resident and former smoker, but had no other risk factors for tuberculosis. Medical history included systolic heart failure, ESRD, COPD, [...]

Case Presentation: A 78-year-man with a high-grade-T1-urothelial carcinoma status post transurethral resection of the prostate (TURBT), on weekly intravesical-BCG for past 2-months, presented a day following his last instillation with fever, chills and altered mental state. In the ED, he was febrile (102.8), tachypnoeic (42/min) & hypotensive (SBP in 70s). Initial labs showed elevated WBC (27.2) [...]

Case Presentation: A 41-year-old female presented with symptoms of abdominal pain, nausea, and vomiting one week after starting Methimazole 10 mg daily for Graves’ disease. She had no prior history of alcohol use or cholelithiasis. Her physical examination was significant for tenderness to superficial and deep palpation in her epigastrium. Her labs revealed a lipase [...]

Case Presentation: A healthy 35-year-old female from eastern Arizona presented in February with two weeks of fever, headache, epigastric pain, decreased appetite, two episodes of non-bloody emesis, dyspnea, and with orthopnea. She was cleaning out a trailer with rodent droppings inside a few days prior to the onset of her symptoms. Her vitals were notable [...]

Case Presentation: A 68 year-old male with hypertension and bipolar disorder presented with a 3-week history of memory deficits, weight loss, and increasing irritability. Exam revealed disorientation, dysarthria, and left sided weakness. MRI was suggestive of a right basal ganglia infarction. Patient was treated for a stroke and discharged. He was readmitted 30 days post-discharge [...]

Case Presentation: A 69-year-old female with a medical history of morbid obesity presented to a rural hospital with a one-week history of extreme fatigue, malaise, jaundice, and anorexia. Her initial vital signs were unremarkable. Physical exam revealed a distressed-appearing woman with diaphoresis, scleral icterus, jaundice, and lower extremity edema. Laboratory findings revealed significant elevation of [...]

Case Presentation: The patient is a 20-year-old male with no past medical history who presented with a 6 day history of 6/10 constant sharp abdominal pain focused in the right upper quadrant (RUQ). The pain was worsened by eating, and associated with one episode of yellow, non-bloody vomiting. The patient denied any diarrhea, bloody stool, [...]

Case Presentation: A 46-year-old female presented for evaluation of two days of nausea and vomiting. She also described swelling in her legs and decreased urination over that time. Exam revealed blood pressure of 150/100 (baseline blood pressure 90/50), pitting lower extremity edema, taut skin of both hands, and bibasilar crackles. Labs revealed creatinine of 3.2 [...]

Case Presentation: Hashimoto encephalopathy is a poorly understood and rare complication of Hashimoto thyroiditis. Patients can present with seizures, movement disorders, or cognitive decline that improves with steroid therapy. The disease is a diagnosis of exclusion, but delay in recognition and treatment can lead to increased morbidity and mortality. A twenty-one year old white female [...]

Case Presentation: A 19-year old female with history of atopic dermatitis and herpes simplex virus (HSV) labialis presented with a 3 day complaint of facial rash. The rash was preceded by two days of sore throat, fever, and body aches. She was initially evaluated at an urgent care clinic where she was prescribed cephalexin for [...]