Case Presentation: A 63-year-old woman with multiple sclerosis, hypertension, and venous insufficiency was admitted with shock and diffuse rash. Two months earlier, she had a confluent, erythematous, pruritic, painful, bilateral foot rash that spread from the dorsi to the ankles with associated swelling. Clotrimazole resulted in mild improvement. Two weeks prior to admission, she developed [...]

Case Presentation: 30-year-old male with no previous medical history presented with acute abdominal pain of 3 days duration. He noted abdominal distention for several years that was more prominent secondary to recent intentional weight loss. He denied periorbital edema, leg edema, dyspnea, orthopnea or PND. Examination revealed a protuberant abdomen with dull percussion note in [...]

Case Presentation: A 51 y/o male active smoker, presented with sudden onset of dizziness, confusion, right arm weakness, and numbness. He also reported left-sided chest pain and mild headache five days ago. The examination revealed decreased sensation and strength (3/5) in the right upper extremity. Labs notable for leukocytosis=22k/uL (60% eosinophils), high sensitivity troponin 440ng/L, [...]

Case Presentation: An 86 years old male with a history of pulmonary fibrosis, HTN, CHF, RA, valve replacement presented after left eye transient visual loss and exertional dyspnea. He reported an episode of painless vision loss in the left eye, felt like a grey curtain was pulled down over his left eye and lasted about 30 seconds. He [...]

Case Presentation: 47-year-old African American incarcerated male presented with headache, new seizures, and blurry vision. Spinal fluid showed high protein, lymphocytes, mildly elevated adenosine deaminase, and low glucose. AFB, bacterial, fungal and viral studies were negative. MRI revealed severe basilar meningitis with enhancing nodular density. RIPE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol) was started, followed by RI [...]

Case Presentation: A 62-year-old man with history of end-stage renal disease and poorly controlled type 2 diabetes mellitus presents to the hospital after a fall due to unsteady gait and was noted to have facial movements similar to tardive dyskinesia, whole body chorea, and hyperkinesis of torso and bilateral extremities. On admission, he had an [...]

Case Presentation: An 80-year-old female presented with several months of progressive dysphagia and weight loss. On physical exam she had diffuse cervical lymphadenopathy. Computed tomography (CT) of her neck revealed a 3.0 x 1.8-centimeter mass originating from the upper third of the esophagus and cervical LAD. Core needle biopsy of a cervical lymph node revealed [...]

Case Presentation: A 53-year-old woman with a history of metabolic syndrome and necrotizing pancreatitis presented with new onset ascites. Her story began nine months earlier, when she developed abdominal pain. CT at that time revealed pancreatitis and cholelithiasis without biliary dilation. Lab values were notable for: lipase 55000, total bilirubin (TBIL) 5.3, AST 660, ALT [...]

Case Presentation: A 52 year old African American male with past medical history of hereditary hemorrhagic telangiectasia (HHT) on aminocaproic acid presents with epistaxis and hematochezia with a hemoglobin of 6.7 g/dL. Patient was diagnosed with HHT in his mid-30s when found to be profoundly anemic with reported hemoglobin of below 3 g/dL during incarceration. [...]

Case Presentation: A 77-year-old female with atrial fibrillation (AF) on flecainide, sinus node dysfunction (SND), and permanent pacemaker presents with frequent palpitations. EKG showed regular, wide-complex tachycardia with ventricular rate of 137 BPM. Device interrogation revealed atrial flutter with 1:1 AV conduction (AL11AV). Rhythm terminated with overdrive atrial pacing along with resolution of symptoms. Troponins [...]