Case Presentation: A 20 year-old, asymptomatic Caucasian man presented to the Emergency Department while vacationing in New Orleans. His home physician instructed him to self-present to the nearest hospital after receiving the patient’s Holter monitor data, which noted third-degree AV block and heart rate nadir of 21. The patient was wearing a Holter monitor due […]

Case Presentation: A 43 year old female with no significant past medical history presented to the emergency department after developing subjective fevers, myalgias, arthralgias, and malaise one week after a hiking trip in northern Minnesota. She had a fever of 39.2℃ and splenomegaly with no rash. Pertinent labs showed a hemoglobin of 12.1 g/dL (11.6-15.0 […]

Case Presentation: A 73-year-old male presented to the ER with right-sided facial droop for 2 days. He had a recent history of multiple insect bites and had noticed a bull’s eye rash about 4 weeks back. He did not have any GI or GU symptoms. No history of recent surgery or trauma. His diet was […]

Case Presentation: A 16 y/o male presented with an acute onset of palpitations, generalized chest pain, and rash (Figure 1). In light of recent camping exposure and targetoid lesions compatible with erythema chronicum migrans (ECM), Lyme disease was suspected. An EKG demonstrated 1st degree AV block with a PR interval of 384 msec. Echocardiogram and […]