Case Presentation: A 36-year-old female with a history of morbid obesity and hypertension presented with three weeks of progressive dyspnea and productive cough. She was previously diagnosed with community-acquired pneumonia and completed two five-day courses of azithromycin, without improvement in her symptoms. She denied smoking but reported increased smoke inhalation due to local forest fires. [...]

Case Presentation: A 32 yo male presented after 1 week of high spiking fevers and a pruritic rash. Sulfamethoxazole-trimethoprim had been started 5 weeks prior. Treatment was started with antihistamines, topical steroids, and prednisone 60mg daily without improvement. Exam revealed facial edema, conjunctival injection, and diffuse erythematous papules. No vesicles or bulla and Nikolsky sign [...]

Case Presentation: A 32 year old Caucasian female with a fourteen year history of relapsing-remitting MS was admitted to the hospital for evaluation of severe headache, fatigue and dizziness. On physical exam she was tachycardic and very pale. Pertinent labs were as follows: hemoglobin (Hb) 4.1 mg/dL (baseline Hb 10.5 mg/dL), red cell distribution width [...]

Case Presentation: A fifty year old female with no significant past medical history presented with one year of acute on chronic bilateral periorbital swelling and twenty pound unintentional weight loss. She also complained of xerostomia and keratoconjunctivitis sicca. Review of systems was positive for intermittent nausea, vomiting, abdominal pain, pruritis, and neck swelling. The patient [...]

Case Presentation: The patient was a 57 year old male with IgG lambda MM (Multiple Myeloma) without remission after autologous hematopoietic stem cell transplant. One month after transplantation, he developed erythematous right flank swelling, high fever, fatigue and anorexia. CT scan revealed inflammatory stranding of right medial gluteal musculature and pre sacral space which was [...]

Case Presentation: Statin-induced necrotizing autoimmune myopathy (SINAM) is an immune mediated myopathy characterized by proximal muscle weakness and necrosis in the presence of autoantibodies to hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase. It is a rare side effect of statin use that must be recognized quickly in order to prevent the development of irreversible muscle weakness. Most cases occur [...]

Case Presentation: The patient is a 29-year-old female with the history of acute pancreatitis and gastric bypass surgery, who initially presented with lower extremity swelling in the setting of hypoalbuminemia and protein-calorie malnutrition. She was started on high calorie/protein diet and was discharged on furosemide. Three weeks after discharge, she noticed peri-oral rash, which extended [...]

Case Presentation: A 75-year-old Caucasian female with a history of hyperlipidemia treated with statin presented to the emergency room for generalized weakness. She became completely bedbound over the course of 5 days. Examination showed symmetric muscle weakness with power 2/5 at proximal muscles but normal strength in distal muscles. Deep tendon reflexes were decreased. She [...]