Case Presentation: An 11-year-old obese male of Micronesian descent presented with a pruritic bullous rash and bilateral lower extremity pain. Scattered non-blanching purpura started on both ankles 10 days prior and spread to his legs, back and arms accompanied by bilateral leg pain and intense pruritus. Four days prior to presentation, blisters to legs and [...]

Case Presentation: A previously healthy sixteen-year old Japanese-American female presented to her primary care provider following one week of frontal headache, dizziness, and a feeling of “floating while walking.” Exam revealed upper extremity blood pressure of 148/93 and a loud bruit across her left lower back. A renal ultrasound ruled out renal artery stenosis, but [...]

Case Presentation: A 43 year-old-woman with no known medical history presented with two months intermittent fever, cough, pleurisy, hematuria, and weight loss. On exam she had diffuse crackles and lower extremity edema. The patient was intubated for respiratory distress. Laboratory workup revealed acute anemia and urinalysis consistent with nephritic syndrome. Chest x-ray showed bilateral diffuse [...]

Case Presentation: A 54-year old man with active cocaine use and untreated hepatitis C presented with fever and rash. He last smoked cocaine 4 days prior to admission. In the next several days, tender enlarging rashes appeared on the left arm and legs. On admission he was febrile (100.5 F) with HR of 101 and [...]

Case Presentation: A 60 year old woman with a history of substance abuse and unclassified dementia presented to the emergency department following 2 weeks of acute functional decline and being found unresponsive at home. She had experienced progressive cognitive decline over the prior 2 years, becoming increasingly forgetful and less talkative. She was diagnosed with [...]

Case Presentation: 29 y.o. female with a history of autoimmune hepatitis presented with worsening lower extremities ulceration. The onset of rash was four months ago during which she visited dermatology clinic. Vitals signs were within normal limits, physical examination was consistent with large deep necrotic painful ulceration with violaceous erythema, retiform purpura on bilateral lower [...]

Case Presentation: A 72-year-old man presented with several months of progressive weakness and dysphagia with a 70-pound weight loss. He was diagnosed with rheumatoid arthritis (RA) 4 months prior based on serology and synovial biopsy and was started on hydroxychloroquine. Previous work up for weight loss and dysphagia revealed a mild stricture versus delay in [...]

Case Presentation: IgA Vasculitis, formerly known as Henoch-Shönlein Purpura, is a systemic vasculitis most often seen in children. We present a case of a 28 yo obese man who presented to his primary care physician with complaints of fever, chills, nausea, vomiting, and sore throat for twelve hours. He was diagnosed with viral gastroenteritis and [...]

Case Presentation: A 71 year old Caucasian man with uncontrolled diabetes mellitus, stage III chronic kidney disease, hypertension, hyperlipidemia, sick sinus syndrome, and osteomyelitis of the right 2nd metatarsal s/p amputation, was transferred from an outside hospital for evaluation of rash and acute on chronic kidney injury. He first presented to the outside hospital for [...]

Case Presentation: A 73-year-old woman with a history of coronary artery disease and remote cervical cancer presented to the hospital with a two-month history of progressive leg weakness and confusion. Over the course of six weeks, symptoms progressed to flaccid paralysis and loss of sensation in both legs. Magnetic resonance imaging (MRI) demonstrated enhancing hemorrhagic [...]