Case Presentation: A 60-year-old male presented with one week of new onset fevers and fatigue. Past medical history included primary sclerosing cholangitis, orthotopic liver transplant 12 years ago and Epstein-Barr virus (EBV) negative post transplant lymphoproliferative disease (PTLD) with partial response to single-agent Rituximab treatment one-year prior.The patient reported debilitating fatigue, daily low-grade fevers, night [...]

Case Presentation: A 79 year old male presented after having recurrent falls. He was extremely weak, and reported that he had lost about 20 lbs in the past month. The patient’s family reported a significant decrease in his appetite. Past medical history included COPD, CAD status post CABG, and CVA. In the Emergency Room the [...]

Case Presentation: A 41-year old male with history of alcohol abuse and polysubstance abuse, presented after being found unresponsive on the floor. He had been complaining of nausea, vomiting and abdominal pain. The patient was noted to have blood around his mouth, was cyanotic appearing with dilated unresponsive pupils. He was emergently intubated and started [...]

Case Presentation: We present a 48-year-old Caucasian female with a past medical history of breast cancer, status post-mastectomy, admitted for a month of abnormal uterine bleeding, secondary to fibroids; continued blood loss led to acute kidney injury. Retroperitoneal ultrasound showed multiple cysts of various sizes throughout both kidneys with left renal enlargement consistent with ADPKD; [...]

Case Presentation: A 26-year-old female with lymphangiomatosis presented to the emergency department with fever and malaise of one day duration. She denied headache, cough, nausea, dysuria, or rash. Vitals were notable for elevated heart and respiratory rate. Initial lab work revealed a WBC of 5.9 with a neutrophilic predominance of 99%. This neutrophilia led to [...]

Case Presentation: A 29 year-old-woman was found to have proteinuria on routine labs that later progressed over the next few months to nephrotic syndrome with worsening lower extremity edema. Her work up revealed a positive (antinuclear antibody) ANA titer of 1:640. However, her anti-dsDNA and serum complement levels were normal, and she did not meet [...]

Case Presentation: A 45 year-old gentleman with a history of recurrent alcoholic pancreatitis complicated by pancreatic pseudocyst presented to the hospital after three episodes of hematochezia. Ten days prior, he had undergone endoscopic transgastric metal stent placement between his pseudocyst and stomach, followed 6 days later by pseudocyst drainage with necrosectomy. After 3 days, he [...]

Case Presentation: A 60-year-old female presented to the emergency department with shortness of breath, worsening edema, and a tender, non-purulent, erythematous rash on her medial thighs bilaterally. Her medical history was significant for atrial fibrillation, heart failure with reduced ejection fraction, and chronic myelomonocytic leukemia. The patient had been recently discharged after an admission for [...]

Case Presentation: A 31 yo male bodybuilder with a history (> 10 yrs) of testosterone and aromatase inhibitor (AI) use presented to the ED after a focal seizure. He reported recent difficulty with fine motor function, unintentional weight loss, and growth of multiple painless nodules over the past 3 to 6 months.Physical exam revealed inguinal [...]

Case Presentation: A 79-year-old woman was found minimally responsive in her home and brought to the hospital for evaluation. On arrival, she was bradycardic (32/min) and hypotensive (75/40) without fever, tachypnea (16/min), or oxygen needs (98% room air). Her initial exam was notable for somnolence, conjunctival injection with normal pupils, dry oral mucosa, slightly cool [...]