Case Presentation: A 63 year old female with metastatic melanoma to brain and breast presented to the emergency department with altered mental status. She was disoriented to time and place and unable to follow commands. She had received two doses of immunotherapy with ipilimumab and nivolumab. Her last dose was administered two weeks prior. She [...]

Case Presentation: A 55 year old male with metastatic lung cancer presented to the emergency department with right arm pain, weakness and right hand numbness. Patient had brain metastasis previously treated surgically and with radiotherapy. His last treatment with radiation was to the left cerebellum, 3 months prior. Patient was started on pembrolizumab and vorinostat [...]

Case Presentation: A 20-year-old male with a family history of Hepatoblastoma in his brother, presented with a two-week history of intermittent left lower quadrant abdominal pain. He was afebrile and initial work-up showed a normal White blood cell count (WBC), Hemoglobin (Hg) 7.1 g/dl, Mean corpuscular volume (MCV) 71 femtoliters and a positive stool occult [...]

Case Presentation: We report a case of vancomycin-induced DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome in a 48-year-old female presenting 6 days after discontinuation of IV vancomycin for the treatment of MRSA bacteremia secondary to right foot cellulitis. She presented with 2 days of painful, diffuse, blanchable, morbiliform rash with palmar petechiae. The [...]

Case Presentation: A 41-year-old male with past medical history of ulcerative colitis (UC) currently on vedolizumab infusions every 8 weeks presented to the hospital with right lower quadrant abdominal pain. The patient endorsed nausea, vomiting, and 15-20 loose, bloody bowel movements per day. Upon admission, the patient was afebrile, normotensive, and non-tachycardic. Physical exam revealed [...]

Case Presentation: An 18-year-old female with past medical history of benign primary hypergammaglobulinemic purpura of Waldenstrom presented with an acute kidney injury, nausea, and vomiting. On admission vital signs were significant for blood pressure elevated to 154/96. Physical exam was grossly normal. Notable laboratory studies included Hgb 8.7, Plt 393, BUN 16, creatinine 1.3 (baseline [...]

Case Presentation: A 42 year old gentleman with past medical history of anxiety and depression presented with acute psychosis, hypertensive urgency, tachycardia and worsening agitation ultimately needing sedation and intubation. He was found to be oliguric with an elevated creatinine of 6.69 with a baseline normal kidney function. After failing a diuretic challenge, the patient [...]

Case Presentation: 50 year old male with past medical history of multiple myeloma status post bone marrow transplant, on tacrilomus presented with 2 day history of worsening abdominal pain, bloating and right-sided flank pain. Physical examination was remarkable for involuntary guarding of the abdomen and absent bowel sounds. CT of the abdomen/pelvis showed pneumatosis involving [...]

Case Presentation: Microangiopathic hemolytic anemia (MAHA) refers to mechanical hemolytic anemia characterized by schistocytes on peripheral smear (PS). It is seen in various conditions such as thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), disseminated intravascular coagulation (DIC), infections and immune disorders. Rarely, it can occur in malignant tumors as a paraneoplastic syndrome. We describe [...]

Case Presentation: We present a 22 y.o. female with a history significant for nephrolithiasis and a hormonal Intra Uterine contraceptive Device, who was admitted to the medicine Service for 6-7 days of odynophagia and dysphagia. She was being worked up along the lines of foreign body impaction and esophageal abrasion. Gastroenterology was consulted and had [...]