Case Presentation: A 57-year-old man with stable ischemic heart disease presented to the emergency department with stable exertional chest pain. On arrival, the patient was chest pain free and vital signs were within normal limits. Electrocardiogram revealed ST elevation in aVR with ST depressions in leads I, II, and V4 – V6. The patient received [...]

Case Presentation: A 74 year old female with history of atrial flutter on warfarin presented to the emergency department with altered mental status and bilateral leg pain. She was found to have a leukocytosis (WBC 14.7), pre-renal azotemia and an elevated INR of 8.2. Exam was notable for bilateral lower extremity ulcers. She was treated [...]

Case Presentation: A 24-year-old man with no significant past medical history presented with a petechial perifollicular rash, polyarthralgia of his large joints (hips, spine, knees), 20-pound weight loss, myalgia, and fatigue, all of two months duration. For prior six months, the patient had been homeless, living in his car which he scrupulously cleaned with Lysol [...]

Case Presentation: A 30-year-old morbidly obese woman with a history of Lynch syndrome (hereditary non‐polyposis colorectal cancer), who presented with complaints of lower back pain and subjective fevers. Six months before this presentation she was diagnosed with a large lower paraspinal hematoma treated with embolization and gel foam implantation. Upon presentation, the patient was vitally [...]

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: An 18-year-old woman who presented with a year history of recurrent painless gross hematuria and a 3-year history of anemia requiring continuous oral iron replacement therapy and subsequent blood transfusions. On further evaluation, she was also found to have significant proteinuria with preserved renal excretion function and a negative autoimmune panel. A renal [...]

Case Presentation: A 47- year-old man with a history of hypothyroidism presented to the emergency room (ER) for the evaluation of generalized body weakness and jaundice of a week duration. There was also associated intense generalized pruritus of about 6 months; subjective weight loss, recurrent fevers, nausea and vomiting. Physical examination was significant for an [...]

Case Presentation: A 56-year-old man with a medical history of nicotine dependence, gastroesophageal disease (GERD) and chronic obstructive pulmonary disease (COPD) emphysema sub-type presented to the outpatient clinic for the evaluation of cough and shortness of breath. Cough was said to be productive of light-yellow sputum and he denied any associated fevers or chest pain. [...]

Case Presentation: A 45 y/o Asian Male from Vietnam with PMH of treated pulmonary tuberculosis 10 years ago upon immigration to the US, presented to the ED with 3-day history of fever, abdominal pain, nausea and vomiting. He denied recent travel or use of antibiotics. On exam he had fever 102.2, tachycardia, scleral icterus and [...]

Case Presentation: A 54-year-old female presented with acute kidney injury and nephrotic syndrome secondary to diabetic nephropathy requiring initiation of hemodialysis. She has a past medical history of chronic kidney disease stage III, diabetes mellitus, and chronic eczematous non-bullous rash for two years. The hospital course was complicated by a marked worsening of her chronic [...]