Case Presentation: An 18 year old male in Florida with a history of asthma developed frontal headaches three months ago. He was diagnosed with sinusitis, and was prescribed oral amoxicillin/clavulanic acid. However, within two weeks his headaches worsened, fevers developed, and his family observed him walking into walls. At an outside hospital, his lumbar puncture [...]

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: An 84-year-old man from China with a history of remote gastric cancer with prior subtotal gastrectomy, chronic hepatitis B virus infection on antivirals (without cirrhosis, normal liver function tests) was brought to the hospital after his family found him to be obtunded. At baseline he was independent in all iADLs. Physical exam showed [...]

Case Presentation: A 65-year-old man presents with five days of altered mental status, ataxia, and headaches. Four months prior, he traveled to Arizona. Soon after, he sought care for sinus pain, cough, weight loss, and diplopia. Lumbar puncture (LP) at the time showed 492 white blood cells (WBCs)/μl (80% lymphocytes), protein 509 mg/dL, and glucose [...]

Case Presentation: A 28-year-old man with ulcerative colitis treated with adalimumab presented with headache, fever and sinus symptoms that progressed over two weeks to neck stiffness, “clouded” thinking, and intermittent left arm and facial numbness. On physical examination, he had normal cardiorespiratory findings. He had mild nuchal rigidity but an otherwise normal neurologic examination. CT [...]