Case Presentation: A 42 Y/O AAM with PMH of polysubstance abuse presented to ED with 2 weeks of worsening vertigo, headache, left facial weakness, blurred vision and new onset dysphagia. Physical exam was notable for complete left facial (VII) palsy, left abducence (VI) palsy and umbilicated facial rash. MRI of head revealed a 2.6×2.6×3.9 cm progressive brain lesion at [...]

Case Presentation: A 28 year old Nepali female presented with convulsive activity and one week of progressive changes in behavior and mental acuity. She had polyarthralgia, painful cervical lymph nodes, malar rash, subjective fever, headaches, and fatigue for 2 months. Previous workup revealed positive antinuclear antibody (ANA), anti-ribonuclearprotein (RNP), and anti-Ro antibodies with no formal [...]

Case Presentation: A previously healthy 48 year-old Guatemalan male presented with malaise, anorexia, 20-pound weight loss. Three weeks prior, he had fever, chills, emesis and diarrhea. A thorough history revealed that the patient was having intermittent confusion with labile, tearful mood swings. Lab-work confirmed pancytopenia, hyponatremia and mild transaminitis. Abdominal ultrasound showed hepatosplenomegaly. MRI brain [...]

Case Presentation: A 37 year-old man with a history of alcohol abuse presented to the emergency department with a chief complaint of abdominal pain and jaundice. The patient stated that 3 days prior to presentation, he awoke with severe intermittent right upper quadrant abdominal pain associated with a yellow discoloration of his skin and sclera. [...]

Case Presentation: This is a 38 year old male with a past medical history of hypertension, hyperlipidemia, bipolar disorder and alcohol abuse who was brought to the emergency room after he collapsed on the subway in May 2018. Several days prior to this episode, he reported cyclical fevers to a maximum of 102F, myalgias and [...]

Case Presentation: A 40-year-old male presented to the emergency department with complaints of back pain for 3 weeks. He described the pain as aching and circumferential involving the sternum, right ribs, shoulders, and back. His previous medical history was unremarkable and he never had any prior imaging studies. Plain radiographs of the spine did not [...]

Case Presentation: Patient is a 71 year old female with hypertension and chronic obstructive pulmonary disease who presented after syncopal episodes and falls. She denied chest pain but did have lightheadedness and shortness of breath (SOB). She was started on transcutaneous pacing by EMS due to severe bradycardia. Admission EKG (fig 1) showed 3rd degree [...]

Case Presentation: A 22 year-old G1P1000 pregnant woman at 24 weeks presented with hypertensive urgency and newly diagnosed intrauterine growth restriction in the setting of pre-eclampsia. On admission her physical exam and laboratory data were unremarkable. The patient was admitted to maternal fetal medicine for closer fetal monitoring. On hospital day (HD) 9 she began [...]

Case Presentation: A 49-year-old male with past medical history of anxiety, chronic diarrhea and alcohol dependency presented with blood-tinged emesis. The patient endorsed a three-week history of non-bilious, blood-streaked emesis after ingestion of both solids and liquids. He also endorsed a cough productive of blood-streaked sputum and easy bruising. He was a retired librarian. He [...]

Case Presentation: Patient is an 85-year-old woman with a history of CAD, AS s/p TAVR, HFrEF, HTN, HLD, hypothyroidism, LV thrombus, and COPD who presented with worsening dyspnea on minimal exertion for 1 week. Previously independent, her SOB had made it impossible to complete her ADLs. She was never a smoker and had no recent [...]