Case Presentation: A 54-year old female was hospitalized for 3-week history of abdominal pain, chills, nausea and diarrhea. Her past medical history was significant for multiple self-reported antibiotic allergies, Roux-en-Y gastric bypass complicated by gastrojejunostomy leak, and prior perisplenic abscess requiring percutaneous drainage. On admission, blood pressure was 137/79, heart rate of 80, respirations 20, [...]

Case Presentation: A 37 year old female with a past medical history of Hypertension, Ischemic Cardiomyopathy (EF=40-45%), Systemic Lupus Erythematosus, and Antiphospholipid Antibody Syndrome presented to the Emergency Department with complaints of pleuritic chest pain that had been persistent for two days duration which radiated down her left arm. Initial laboratory workup noted a normal [...]

Case Presentation: A 79-year-old woman with well-controlled hypertension and diabetes mellitus presented to her primary care physician’s office with two weeks of constant, right-sided clear nasal discharge that began one week after discharge from recent hospitalization for septic shock secondary to E. coli urinary tract infection with associated bacteremia. Her physician recommended therapies for allergic [...]

Case Presentation: A 61-year-old woman was admitted to our internal medicine teaching service with 5 days of epigastric pain accompanied by nausea and vomiting. She did not drink alcohol and did not take any home medications. Physical exam revealed epigastric abdominal tenderness. Laboratory tests revealed normal triglycerides and calcium with an elevated lipase of 173 [...]

Case Presentation: A 26-year-old man from Haiti with no past medical history was hospitalized with a four month history of intermittent fevers, weight loss, and dyspnea. In the ED, he was found to be febrile, tachycardic, and tachypneic with an oxygen saturation of 88% on room air. Physical exam was significant for bilateral rales on [...]

Case Presentation: 75-year-old female with past medical history of obesity (BMI 31.7 kg/m2), paroxysmal atrial fibrillation, hypertension, hypothyroidism, was admitted to the hospital for elective laparoscopic cholecystectomy. Patient tolerated the procedure without complications, however, post operatively, she was difficult to extubate due to hypercapnia of pCO2 of 100 mmHg in arterial blood gas. She was [...]

Case Presentation: A 69 year-old male with widely metastatic melanoma presenting seven weeks into his treatment with ipilimumab and nivolumab with five days of progressive lightheadedness, headache, nausea, non-bloody emesis, and generalized malaise. The patient had witnessed syncope in the clinic and was sent to the emergency room where he was febrile to 100.8 and [...]

Case Presentation: A 47-year-old woman with migraines, bipolar disorder, and hypothyroidism presented with a 2-day headache that was not improving with sumatriptan. She also complained of generalized weakness, dizziness, nausea, and vomiting. Workup revealed diabetic ketoacidosis, with blood glucose 530 mg/dL, venous pH 7.02, bicarbonate of 8 mmol/L, and anion gap 29. The patient had [...]

Case Presentation: A 22 year-old African American male college student presented with acute abdominal pain radiating to the right flank with associated fever, dark urine, and nonbilious nonbloody vomiting. There was no dysuria or change in bowel habits. Medical history was notable for nephrotic syndrome due to biopsy-proven minimal change disease diagnosed at age 17, [...]

Case Presentation: A 71-year-old woman presented to the hospital after her granddaughter noticed two days of worsening jaundice. The patient reported a one-week history of fatigue, early satiety, poor appetite, nausea, and vomiting. She also noted having tea-colored urine and a 30-pound unintentional weight loss during the previous eight months. She denied history of trauma, [...]