Case Presentation: A 21-year-old man with no previous medical history presented to the emergency department with nausea, vomiting and diarrhea for one week. Labs were significant for white blood cell (WBC) count 3.4 k/ul with decreased lymphocytes along with mild elevation of transaminases and lipase. He was thought to have viral gastroenteritis and was discharged. [...]

Case Presentation: A 70-year-old male with a medical history significant for transurethral resection of bladder tumor and lung adenocarcinoma presented with diaphoresis and subjective fever 4 days after undergoing an uncomplicated aortic extension cuff placement for an abdominal aortic aneurysm. The patient was hemodynamically stable. Labs notable for leukocytosis of 18.4X10E9 cells/liter. CT abdomen demonstrated [...]

Case Presentation: 66 year old man with a history of eosinophilic granulomastosis with polyangiitis presented with ascending numbness and unsteadiness that worsened over two days and finally manifested as paraesthesia and weakness in all extremities, gait imbalance, and diplopia. Three weeks prior to presentation, the patient had received the flu vaccine. Neurology was consulted upon [...]

Case Presentation: This patient was a 44-year-old female with a past medical history of localized scleroderma (morphea) of the breast diagnosed by punch biopsy. She presented to the emergency department with right upper quadrant pain and nausea. At that time, a CT scan showed a heterogeneous liver without a definitive underlying mass. Her workup revealed [...]

Case Presentation: A 41-year-old female presented with a three-day history of nausea, vomiting, and diffuse abdominal pain radiating to her back. The day prior to admission, the patient started having hematemesis, characterized as “streaks” of blood in her emesis. The patient had recently been in a motor vehicular accident leading to a tibial plateau fracture [...]

Case Presentation: A 63- year-old man with a history of seizures, hepatitis C infection and multiple spinal fusion surgeries presented to the emergency room (ER) for the evaluation of back pain. Back pain was said to have commenced 3 days prior to presentation. Pain was mainly located in the lumbar region, dull in nature, rated [...]

Case Presentation: The patient is 67-year-old man with prior metastatic renal cell carcinoma (status post right nephrectomy), on long term pazopanib therapy, who presented with dyspnea and pleurisy. He was found to be in hypoxemic respiratory distress out of proportion to the mild pulmonary vascular congestion seen on his initial chest x-ray (CXR). He improved [...]

Case Presentation: A 65 year old male with no significant medical history presented to an outside facility complaining of fatigue, weakness, nausea and vomiting. He had moderate alcohol history and significant weight loss over the past 6 months. Initial lab workup was notable for elevated liver transaminases with a hepatocellular pattern, Maddrey score of 53.6 [...]

Case Presentation: A 68-year-old Caucasian male with a history of stage IV follicular lymphoma treated with rituximab and bendamustine presented with generalized malaise, weakness, and acute encephalopathy of two weeks.He was hypotensive and his exam showed dry mucous membranes and poor skin turgor. Laboratory examination was remarkable for: creatinine 7.6 mg/dL, AST and ALT 691 [...]

Case Presentation: A 21-year-old male with end-stage renal disease for 3 years (cause unknown) presented to the hospital with a 19lb weight loss (10% of body weight) over 2 months. Exam was notable for jaundice, diffuse abdominal tenderness, and innumerable purple, papular lesions covering his body, which he had noticed for 8 months. Labs revealed [...]