Case Presentation: High anion gap metabolic acidosis is a frequently encountered problem with a very specific workup based on history and physical. This case brings to light a possible rare cause of anion gap metabolic acidosis. 49-year-old female with Asperger’s disorder and seizures who was brought to the emergency department by her caregiver because of [...]

Case Presentation: An 84 year-old female with metastatic bladder cancer was admitted for a one month history of progressively worsening fatigue, bilateral ptosis, dysphagia, dyspnea, and lower extremity weakness. She was previously diagnosed with localized urothelial carcinoma in 2005 with recurrence in 2017 with pelvic metastases seen on surveillance imaging. She underwent chemotherapy, cystectomy, and [...]

Case Presentation: A 25 year old male with no past medical history was admitted for progressively worsening burning chest pain and shortness of breath associated with diaphoresis, nausea, vomiting, and left arm numbness. Initial electrocardiogram showed STEMI in the inferior and antero-lateral leads, and a troponin of 2.15. Emergent cardiac catheterization revealed a mid left [...]

Case Presentation: A 78-year-old female was referred to the ED from clinic for elevated creatinine and hyperkalemia after recent treatment of right lower extremity cellulitis with sulfamethoxazole/trimethoprim. Physical exam showed improving cellulitis and large area of ecchymosis on right wrist. The patient reports developing frequent large bruises without trauma for the previous two months. During [...]

Case Presentation: 60-year-old gentleman with a history of autoimmune hemolytic anemia presented to emergency department with acute onset of severe left leg pain, edema, and cyanosis. On examination of his left leg, pulses were not palpable distal to posterior tibialis but motor functions remained intact. There were no blebs or bullae noted. He was requiring [...]

Case Presentation: A 33-year-old male presented to the emergency department (ED) after abrupt onset left anterior chest pain with associated diaphoresis, nausea, and abdominal pain one hour prior to arrival. He denied aggravating or relieving factors. Vital signs were stable and physical exam, including cardiac and respiratory exam, were unremarkable. Patient denied a history of [...]

Case Presentation: The patient is a 20-year-old male without past medical history. He began to feel depressed about 3 weeks prior to admission, and his dietary intake decreased. Concomitantly, he experienced diarrhea once to twice per day. He noticed pain in both the thighs when waking up the day before the admission. The pain persisted [...]

Case Presentation: Our patient is 56-year-old gentlemen with a history of non-ischemic cardiomyopathy related to prior alcohol use, hypertension and atrial fibrillation who presented to the emergency department complaining of shortness of breath, pleuritic chest pain and subjective feeling of fever and chills of 3 days’ duration. He was found to be hypotensive (86/60 mmHg) [...]

Case Presentation: A 62-year-old male from a major urban city in Northeast US with history of hypertension and type II diabetes mellitus presented with fevers and thigh pain for three days. He had no recent travel history, sick contacts, or bug bites. Physical examination was notable for injected conjunctiva. Lab work revealed leukocytosis, thrombocytopenia, acute [...]

Case Presentation: A 64 year old female with a past medical history of coronary artery disease and coronary artery bypass graft, heart failure with reduced ejection fraction, diabetes mellitus, peripheral arterial disease, hyperlipidemia and a strong smoking history presented to the emergency department with exertional dyspnea worsening over the past 1 month and substernal chest [...]