Case Presentation: A 14 y.o. male with acne presented to dermatology for follow up. Having failed multiple acne treatments he was started on isotretinoin. Approximately 6 weeks later he developed fatigue, non-purulent conjunctivitis, retrosternal chest pain associated with dyspnea, joint pains, and bilateral lower extremity muscle aches. He was evaluated by cardiology with normal cardiac [...]

Case Presentation: A 34 year old male with a history of CVID subclass 2 and 4, with low IgG level, absent IgA, liver nodular regenerative hyperplasia with portal hypertension, and immune thrombocytopenic purpura status post splenectomy presented with a month of nonproductive cough, mild episodes of hemoptysis, and shortness of breath. Physical exam revealed peripheral [...]

Case Presentation: A 40-year-old male of Hispanic/Asian origin with a history of diabetes mellitus type II, hypertension, dyslipidemia, recurrent sinusitis and bilateral otitis media presented to the emergency department complaining of acute hand joints pain, nasal congestion and left ear pain. On physical examination, he appeared fatigued with no acute distress. He had prominent sinus [...]

Case Presentation: A 60-year-old man presented with progressive fatigue, 30-pound weight loss, and arthralgias over six months. He also noted more recent onset of left upper quadrant abdominal discomfort and nonproductive cough. Past medical history was notable for idiopathic thrombocytopenic purpura (ITP) and nephrolithiasis requiring lithotripsy. He had never smoked cigarettes. Examination revealed tender splenomegaly [...]

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 27-year-old white male with adult-onset asthma and recurrent pneumonia presented to a rural hospital with a one month history of ascending lower extremity numbness. He also reported fever, fatigue, night sweats, and a twenty-pound weight loss over three weeks. Initial workup revealed leukocytosis and eosinophilia, prompting transfer to our facility for further [...]

Case Presentation: A 25 year-old white man with no significant past medical history presented with gradually progressive dyspnea on exertion and dry cough for approximately two months. He was treated for community-acquired pneumonia with various oral antibiotics and corticosteroids without resolution of symptoms. Importantly, during a particularly severe coughing spell, he noted sharp right-sided chest [...]