Case Presentation: Mr. A is a 53-year-old male who presented with a painful thigh. The patient was released from prison one week prior and had been living under a bridge next to a creek ever since. On the day of admission, Mr. A decided to bathed himself in the creek. As he was wading through [...]

Case Presentation: A 50-year-old male with a past medical history of type 2 diabetes mellitus presented with gangrene of his left foot. The foot was erythematous with pustular eruptions. His symptoms included fevers, chills, and the inability to move his fourth and fifth digits. He was afebrile, with a leukocytosis of 19.6, erythrocyte sedimentation rate [...]

Case Presentation: A 79-year-old male with type 2 diabetes mellitus presented after being found down by a neighbor. Patient reported generalized fatigue. On exam, he was not alert or oriented, but otherwise had a non-focal neurological exam. Glucose was 742 mg/dL, bicarb 15 mmol/L, anion gap 22.8 mmol/L, and beta-hydroxybutyrate 3.92 mmol/L. CT head was [...]

Case Presentation: This is a 58 year old male with a past medical history of MDD, GAD, history of polysubstance abuse, history of enterococcus bacteremia complicated by aortic valve endocarditis status post valvular replacement and hemorrhagic stroke who was admitted to the hospital for urosepsis. Of note, this patient was previously hospitalized for Lactobacillus bacteremia [...]

Case Presentation: A 48-year-old woman presented with a history of intermittent abdominal pain for eight years, with an extensive workup that had been negative. She ended up being labeled as having irritable bowel syndrome. The pain was localized to the epigastrium, was present during most of the day, but was aggravated by large meals. Upon [...]

Case Presentation: A 24 year-old man with past medical history significant for tobacco, marijuana, and e-cigarette use presented to the emergency department for hemoptysis, dyspnea, cough with pleuritic chest pain, and subjective fevers. Twenty-four hours prior to presentation, the patient endorsed first-time use of a street-purchased e-cigarette cartridge containing tetrahydrocannabinol (THC). The patient had acute [...]

Case Presentation: A 38-year-old woman with well-controlled Crohn’s disease on immunosuppression presented to the emergency department with a three- day history of rash and fevers following antimicrobial treatment at an outside urgent care facility for presumed bacterial sinusitis. At the urgent care facility, she had received intramuscular ceftriaxone, oral azithromycin, and oral prednisone. The following [...]

Case Presentation: The patient is a 64-year-old male, history of ischemic cardiomyopathy, chronic right ventricular failure, arrhythmia, and new infarcts, status post cardiac transplant. While recovering in the cardiac ICU, the patient started experiencing confusion and personality changes, and was unable to recognize his mom. On CT scan, the patient was shown to have a [...]

Case Presentation: The patient is a 50 year-old unvaccinated Amish male who presented with progressive jaw pain and tightness after stepping on a nail 9 days prior. Initial management in the emergency department was wound debridement, Tdap vaccination, tetanus immune globulin intravenously (IV) and locally in the wound, as well as IV antibiotics.He was started [...]

Case Presentation: Pancreaticopleural fistula is a rare and serious complication of acute and chronic pancreatitis. This phenomenon develops due to a leak from an incompletely formed or disrupted pseudocyst, though it can also result from direct pancreatic duct leak. Although few case reports identify pancreaticopleural fistula causing recurrent pleural effusion and empyema, we describe the [...]