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 76-year-old Chinese woman with history of cryptogenic cirrhosis (MELD-Na 25) presented to our hospital with 1 week of worsening jaundice, abdominal distension, and right upper quadrant pain. Cirrhosis was diagnosed by imaging on admission 2 months previously and presumed to be secondary to Hepatitis C infection due to antibody positivity. CT of [...]

Case Presentation: Few spider bites are medically significant. A 24-year-old African American woman presented with malaise, fever, nausea, and myalgias. She reported a sharp pain on her lower back the night prior that at first felt like burning before progressing to pain. Her initial vitals were T 101, HR 120, BP 141/117. Physical exam revealed [...]

Case Presentation: A 52-year-old African American male with a past medical history of gastric ulcer presented to the emergency department with progressively worsening exertional dyspnea and fatigue over the past two months. Physical examination was significant for a heart rate of 105 bpm and icteric sclera. Pinprick and vibratory sensations over bilateral lower extremity were [...]

Case Presentation: A 60-year-old female with hypertension and hyperlipidemia presented with 8 days of generalized weakness, fatigue, and myalgia. She reported headaches and shortness of breath but denied fever, chills or hematochezia. Vitals were stable and physical exam was unremarkable except for splenomegaly, scleral icterus, and mucosal pallor. Hemoglobin was 4.0 on admission, down from [...]

Case Presentation: A 60-year-old male with history of diabetes mellitus, right foot osteomyelitis, psoriasis, and multiple medication allergies (including vancomycin, levofloxacin, daptomycin, ertapenem, ampicillin-sulbactam, and infliximab) presented to the hospital with complaint of jaundice, abdominal pain, and vomiting. He had been diagnosed one week prior with methicillin sensitive Staphylococcus aureus septic arthritis and was being [...]

Case Presentation: A 20 year old woman with a history of astrocytoma of thoracic and lumbar spine status post resection with subsequent neurogenic bladder and bowel presented with acute encephalopathy following a viral illness. Initial workup showed acute kidney injury (creatinine 2.21 mg/dL), normal hemoglobin (12 g/dL), new thrombocytopenia (platelet 60 K/uL), and urinalysis suggestive [...]

Case Presentation: A 68 year old female patient presented to the emergency department after being found down at her house. On exam she was found to be confused and disoriented. Lab work showed severe pancytopenia, and elevated bilirubin with no associated elevation of LFTs. She was transfused with 2 units of packed red blood cells [...]

Case Presentation: A 59-year-old female with a history of type 2 diabetes, hypertension, dyslipidemia, bipolar disorder, and daily alcohol use, presented with acute onset epigastric abdominal pain radiating to the back, nausea and vomiting. Physical examination was notable only for epigastric tenderness. Pertinent labs include neutrophilic leukocytosis, elevated lipase (2353 units/L) and lactic acidosis (2.4 [...]

Case Presentation: 60-year-old gentleman with a history of autoimmune hemolytic anemia presented to emergency department with acute onset of severe left leg pain, edema, and cyanosis. On examination of his left leg, pulses were not palpable distal to posterior tibialis but motor functions remained intact. There were no blebs or bullae noted. He was requiring [...]