Case Presentation: A 69-year-old female with no prior past medical history who presented to the ED with complaints of shortness of breath. Chest-x-ray was found to be positive for right sided pleural effusion. A thoracentesis was performed and pleural fluid found to be exudative per Light’s criteria. Fluid cytology and cell count were within normal [...]

Case Presentation: A 48-year-old male from North Carolina with a history of rheumatoid arthritis presented to the ED with complaints of black tarry melena, nausea, vomiting, and nose bleeds. The patient was found to have stomatitis and severe pancytopenia. He eventually admitted to not understanding his methotrexate dose and stated he accidentally took three times [...]

Case Presentation: 57-year-old male with type II Diabetes on insulin therapy and depression, with prior suicidal attempts on opioids presented to the Emergency Department (ED) after an intentional injection of 320 Units of glargine. His home medications were glargine 20 U daily and metformin 500 mg twice a day. On arrival to the ED, he [...]

Case Presentation: A 68-year-old female presented to the emergency department with altered mental status. A few weeks prior to presentation, she was found to have a viral influenza infection which was managed supportively. Approximately one week prior to presentation, she had started developing a productive cough associated with body aches and fatigue, and eventually developed [...]

Case Presentation: A 70-year-old gentleman with no known medical issues was brought in to the emergency department after experiencing sudden onset unresponsiveness and respiratory arrest. He had been intubated by paramedics on arrival. Upon transfer to the emergency department, he was found to have unstable atrial fibrillation with rapid ventricular response necessitating cardioversion. Initial labs [...]

Case Presentation: Ms. C was a 44 yo female with a past history of IV methamphetamine and heroin use. She was involved in a motor vehicle collision in 2016, in which she sustained a right femoral neck fracture. At that time, she was transferred to our tertiary care medical center and underwent open reduction and [...]

Case Presentation: A 36 year old female presented to our hospital with septic shock following an elective laparoscopic sleeve gastrectomy performed in Mexico. She had undergone the procedure four months earlier, which she tolerated well, returning to her home in the United States four days later. Her post-operative course had been characterized by numerous complications, [...]

Case Presentation: 90-year-old female presented with generalized weakness, nausea, vomiting, and diarrhea of 3 days duration. She also reported anorexia but denied any fever, chills, abdominal pain, chest pain, shortness of breath and cough. Vital signs were unremarkable. Physical exam was remarkable for dry oral mucous membranes, the presence of bilateral nephrostomy tubes and costovertebral [...]

Case Presentation: A 71-year-old male with no known past medical history presented with chief complaint of fatigue associated with generalized weakness, malaise, slurring of speech and body aches specifically upper and lower back pain for 3 weeks. He reported working in the woods. Vital signs were unremarkable. Physical exam was remarkable for a faint erythematous [...]

Case Presentation: A 72-year-old-female presented to the ED with an 8-month history of intermittent, progressive, substernal chest pain. EKG showed normal sinus rhythm without ischemic changes and troponin was negative. CT Angiogram showed a moderate pericardial effusion and mild wall thickening of the thoracic aorta concerning for vasculitis. Cardiac MRI showed aortitis with mild pericarditis [...]