Case Presentation: A 48-year-old female with spina bifida was admitted for sepsis secondary to sacral osteomyelitis. She improved with broad-spectrum antibiotics, and her antibiotic regimen was narrowed to Zosyn (piperacillin + tazobactam) to complete a 6-week course. On hospital day 12, discharge was delayed pending insurance approval of an air mattress for home. Three days […]

Case Presentation: A 48-year-old female with spina bifida was admitted for sepsis secondary to sacral osteomyelitis. She improved with broad-spectrum antibiotics, and her antibiotic regimen was narrowed to Zosyn (piperacillin + tazobactam) to complete a 6-week course. On hospital day 12, discharge was delayed pending insurance approval of an air mattress for home. Three days […]

Case Presentation: A 32 year‐old man presented with worsening exertional dyspnea. Medical history was notable for asthma; diagnosed at age 8. His only medication was an albuterol inhaler which he had not used for >5 years because it “didn’t work well.” He denied allergies, smoking or drug use. Vital signs were normal and examination was […]

Case Presentation: A previously healthy 38-year-old man presented with 8 days of intermittent colicky RUQ pain and jaundice. He denied any OTC or illicit drug use but did report daily alcohol use. On admission HAV, HBV, HCV, and HIV 1 & 2 screening, urine drug screen, and autoimmune workup were negative. Ceruloplasmin, serum copper, serum […]

Case Presentation: A 40 year old previously healthy female was incidentally found to have elevated transaminases on routine lab work. She was sent to our hospital for further evaluation. On admission, she complained of fatigue, right sided abdominal discomfort, and jaundice of a few weeks. She denied taking prescription medications but reported taking a supplement […]

Case Presentation:                A 24-year-old man with no past medical history was brought to the emergency department after being struck in the chest by a post while docking a water taxi. On arrival, he complained of shortness of breath and chest pain. Physical exam revealed an alert man with […]

Case Presentation: A 43 year old male to female transgender patient with a history of AIDS on HAART, ESRD on hemodialysis, pulmonary embolism, heart failure with reduced ejection fraction with AICD in place, history of recurrent ventricular and supraventricular tachycardia with prior ablation presented to our hospital reporting dizziness and several episodes of non-bloody non-bilious […]

Case Presentation: A 40-year-old female with adult-onset Still’s disease (AoSD) refractory to methylprednisolone and who had been recently started on anakinra 2 months prior to hospitalization was admitted with 2 weeks of fatigue, nausea, diffuse pruritis, jaundice, and intermittent fevers and rash. Exam was notable for jaundice and salmon-colored rashes on her trunk and back. […]

Case Presentation: A 46-year-old woman with no past medical history presented with right upper quadrant pain, jaundice, and pruritus after undergoing a liver biopsy at an outside hospital. At the outside hospital, she had these same symptoms with hyperbilirubinemia and transaminitis. HIDA scan was negative. The liver biopsy showed marked portal and pan-lobular inflammatory infiltration […]

Case Presentation: A 37-year old male with PMH of HIV on HAART presented with episodes of seizure, syncope and altered mental status. Vital signs and physical examination were unremarkable. Laboratory results revealed sodium level 113, serum osmolarity 243, urine osmolarity 429 and urine sodium 113. Lab findings along with patient appearing euvolemic on exam suggested […]