Case Presentation: A 14-year-old previously healthy male presented to a community hospital for sudden repeated episodes of initially non-bloody, and then grossly bloody, emesis. He denied sick contacts, travel, significant NSAID use, alcohol consumption, and caustic ingestions. On presentation, he had normal vital signs, mild epigastric tenderness, and heme-positive dark stool. His labs were notable [...]

Case Presentation: A 79-year-old African American male patient with a past medical history of prostate cancer presented with progressive weakness, headache, and confusion. Free and total PSA levels were within normal limits. Brain MRI showed a 4.1×3.3×4.1 cm left frontal lesion at the surface of the left lateral ventricle with vasogenic edema and midline shift. [...]

Case Presentation: The patient is a 58-year-old male with a past medical history of end-stage liver cirrhosis status post-liver transplantation in 1991 who was on tacrolimus (TAC) 1 mg twice a day. He was admitted for altered mental status, fever and respiratory distress. He was found to have bilateral pneumonia treated as community-acquired pneumonia. The [...]

Case Presentation: A 20-year-old male with past history of asthma presented initially with bloody diarrhea and subjective fever of one day’s duration. Upon evaluation vital signs revealed temperature of 103 F, and tachycardia. On physical examination there was generalized abdominal tenderness with normal bowel sounds. Thrombocytopenia was present with platelet count of 46 k/ul. Antibiotics [...]

Case Presentation: A 74-year-old female, with no significant past medical or travel history, developed sepsis 2 days after undergoing debulking surgery for stage IIIc ovarian carcinoma. Blood cultures were positive for gram-negative bacilli and the organisms identified as Enterobacter spp. with blaIMP MBL (Verigene). Antimicrobial susceptibility testing demonstrated high-level resistance to all penicillins, ureidopenicillins, cephalosporins, [...]

Case Presentation: A 59-year-old woman presented with acute worsening of chronic abdominal pain and nausea. Her past medical history included a stable type-B aortic dissection. Over the previous year, she had multiple hospitalizations for postprandial abdominal pain associated with nausea and vomiting. The pain had been increasing in severity and had led to a 10-pound [...]

Case Presentation: 78 year old woman with persistent non valvular atrial fibrillation was admitted with palpitation and dyspnea. She was in atrial fibrillation with rapid ventricular rate. Given symptomatic atrial fibrillation after rate control, decision was made for transesophageal echocardiogram (TEE) and elective direct current cardioversion (DCCV). She was successfully converted to sinus rhythm with [...]

Case Presentation: A 35-year-old black male presented to the emergency department (ED) with acute onset diffuse abdominal pain, along with nausea and vomiting. Review of systems was positive for polyuria and polydipsia. The examination was unremarkable apart from a sizeable fungating lesion of the left lower extremity by the ankle measuring 12 x 8 cm. [...]

Case Presentation: A 40-year-old white male who had noticed a nodule over the extensor surface of his right forearm, which then grew to a size of 3 cm tumor and ulcerated over six months. At one point, he was assumed to have an infection and treated with antibiotics with no improvement. Around the same time, [...]

Case Presentation: A 24-year-old black male with a history of generalized epilepsy first diagnosed one year ago presented to the Emergency Department (ED) after one episode of a witnessed generalized tonic-clonic seizure. Upon arrival at the ED, he was at his baseline mental state. However, just moments later, he had another refractory generalized tonic-clonic seizure [...]