Case Presentation: A 44 year old African American man presented to the hospital for evaluation and treatment following generalized tonic-clonic seizures. He denied recent and remote travel, fever, chills, sick contacts, constitutional symptoms, and felt relatively well at time of interview. He was on maintenance immunosuppression with prednisone 20 mg daily for sarcoidosis. MRI demonstrated [...]

Case Presentation: A 58 year old man, who has sex with men, presented with three weeks of blurred vision. During this period he also noted fevers, malaise, and headache. Physical exam revealed a patchy erythematous scalp rash with associated alopecia. Fundoscopic examination revealed anterior uveitis bilaterally. Serum RPR was positive, with a titer of 1:64, [...]

Case Presentation: A 62 YO woman with PMHx significant for type 2 DM, HTN, CAD with a previous MI, and OSA was recovering as expected from elective decompressive laminectomy. On POD 4 she developed nausea, confusion, and lethargy. The hospitalist service was consulted, prompting a metabolic work-up that suggested anion gap metabolic acidosis. There were [...]

Case Presentation: A 44-year-old Caucasian man presented with rectal bleeding following an episode of constipation. He reported a two-year history of cachexia, peripheral neuropathy generalized weakness, urinary retention, and chronic constipation. His father had similar issues including chronic constipation and bilateral carpal tunnel syndrome. The patient was consistently hypotensive with orthostasis. A soft cardiac murmur [...]

Case Presentation: A 60-year-old man with no comorbidities presented with multiple episodes of substernal chest pressure and reduced exercise tolerance. Cardiac catheterization was notable for severe systolic dysfunction with left ventricular dilatation without coronary disease. Echocardiography was significant for an ejection fraction (EF) of 20% with global hypokinesis and extensive left ventricular (LV) trabeculations consistentwith [...]

Case Presentation: A 59-year-old male patient with no significant past medical history presented to our hospital with left foot swelling that started almost four weeks prior to presentation. The swelling was progressive, ascending, and associated with erythema. The patient was initially evaluated by his primary care physician who requested a venous Doppler of his lower [...]

Case Presentation: A 56 year old female smoker with history of progressive weight loss in the past 6-9 months and changes in urinary frequency for about a month, presented with confusion, generalized weakness, lower extremity edema and dysphagia. Physical examination revealed blood pressure 112/53 mmHg, hear rate 81 bpm, temperature 96.1 F, and 1+ bilateral [...]

Case Presentation: A 44-year-old male with a medical history of active injection drug use (IDU) and three prior admissions for native mitral valve endocarditis was admitted to the hospital for sepsis. On physical examination, the patient had JVP elevated to 10cm, bibasilar crackles and 2+ pitting peripheral edema. Transesophageal echocardiogram (TEE) revealed a large vegetation on the mitral [...]

Case Presentation: A 57 year old Caucasian man with history of  porphyria cutanea tarda- recently started on therapeutic phlebotomy, COPD, alcohol abuse, hypertension was admitted to the hospital with recurrent syncopal spells of one day duration. He also endorsed bilateral hand pain and weakness, weight loss, dyspnea and headache. Vital signs were stable on arrival. [...]

Case Presentation: Mononeuritis multiplex (MM) was first described in 1960 as a hereditable neuropathy favoring the brachial nerve. MM is now known as the painful, asymmetrical destruction of at least two separate peripheral nerves caused by an array of disorders including diabetes mellitus, systemic lupus erythematous, rheumatoid arthritis, and various vasculitides. This clinical case describes [...]