Case Presentation: A 53-year-old gentleman with metastatic adrenocortical carcinoma with liver and lung metastases, was recently started on pazopanib, a non-specific tyrosine kinase inhibitor. He was brought to the hospital by family for increasing confusion and decreased oral intake. He was hemodynamically stable and afebrile on presentation. Initial labs were significant for low platelet count […]

Case Presentation: 74-year-old male with history of NASH cirrhosis with Grade I esophageal variceal bleeding history, SDH s/p burr hole drainage with course complicated by seizures on Keppra and Vimpat, type 2 diabetes mellitus, and coronary artery disease status post 1 drug eluting stent who presented with worsening confusion, fatigue and difficulty walking x 3-4 […]

Case Presentation: A 76 year old male with a history of hypertension and hyperlipidemia presented with acute onset ascending weakness, perioral tingling, and loss of temperature sensation. The patient’s profound weakness progressed over the course of a few days, with subsequent diplopia, hallucinations, and confusion. He received the influenza vaccine a few weeks prior, and […]

Case Presentation: A 67 year old female patient with diffuse large B-cell Lymphoma with extensive nodal disease involving the lower thorax, abdomen, pelvis and central nervous system (CNS) presented with generalized weakness, acute confusion and fevers. Her recent treatment history included systemic chemotherapy with dose adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, rituximab (DA-EPOCH-R) and intrathecal […]

Case Presentation: A 23 year-old woman presented with blurry vision and difficulty walking for two weeks. Her family also reported two weeks of progressive memory changes and a 52-pound weight loss over four months. One month prior to presentation, while pregnant at 18 weeks gestation, she was admitted with three months of vomiting and five […]

Case Presentation: A 46 year old African American woman presented with one week of worsening hearing loss along with 3 days of vision changes, confusion, visual hallucinations, and difficulty ambulating. She had history of invasive ductal cell carcinoma status-post mastectomy and chemotherapy. Additional history included hemorrhoids for which she underwent hemorrhoidectomy due to excessive bleeding […]

Case Presentation: A 27 y/o M presented after an episode of confusion and abnormal behavior. Patient reported 1 week of intermittent headaches, nausea, emesis, and dizziness. He had no sick contacts or recent travel. Family history was significant for SLE. On exam he had diffuse weakness but was otherwise neurologically intact without meningeal signs. Initial […]

Case Presentation: A 29 year old female presents with one week of sudden onset double vision. She reports accompanying dark spots in her vision, photosensitivity, and some unsteadiness with walking. The patient’s friend noted that her eyes were “crossed” the morning of admission. Past medical history is significant for alcohol abuse and anxiety with a […]

Case Presentation: A 63-year-old male presented with altered mental status of one day duration. The patient’s history was significant for CAD, CKD Stage 3, and a recent whipple procedure for cholangiocarcinoma complicated by abdominal abscess requiring percutaneous drainage and prolonged course of ertapenem (renally dosed). He was admitted to the hospital with encephalopathy after having […]

Case Presentation: 33-year-old male with metastatic germ cell testicular cancer to the lungs initially presented with worsening headaches. Imaging showed significant disease progression with new intracranial metastases in the right parietal and occipital lobes. He underwent autologous stem cell transplant complicated by pancytopenia. Three days later developed sudden onset typical chest pain at rest associated […]