Case Presentation: A 76-year-old man with seropositive RA treated with MTX 15-20mg weekly for at least four years presented to the hospital with worsening fatigue, generalized weakness, poor appetite, and dyspnea. Contrast-enhanced computed tomography of chest abdomen and pelvis (CT CAP) demonstrated numerous pulmonary nodules, centrally hypodense left retroperitoneal soft tissue masses which may represent [...]

Case Presentation: A 40-year-old white male who had noticed a nodule over the extensor surface of his right forearm, which then grew to a size of 3 cm tumor and ulcerated over six months. At one point, he was assumed to have an infection and treated with antibiotics with no improvement. Around the same time, [...]

Case Presentation: A 73-year-old female with PMH of iron deficiency anemia, laparoscopic cholecystectomy, and hernia repair had received iron transfusions as well as blood transfusion. Despite which, her hemoglobin remained low, 7.3gm/dl. She was fatigued, but denied abdominal pain, black stool, vomiting blood, fevers or chills. She had an upper endoscopy that was unremarkable as [...]

Case Presentation: Our patient was a 70-year-old male with a past medical history of HTN, HLD, COPD, and CAD status-post CABG. He originally presented with hypotension, new onset weakness, dyspnea, orthopnea and bilateral lower extremity pitting edema. As part of his work-up, a CT scan of the abdomen and pelvis was ordered, which revealed an [...]

Case Presentation: A 47- year-old man with a history of hypothyroidism presented to the emergency room (ER) for the evaluation of generalized body weakness and jaundice of a week duration. There was also associated intense generalized pruritus of about 6 months; subjective weight loss, recurrent fevers, nausea and vomiting. Physical examination was significant for an [...]

Case Presentation: 73 year old male with solitary kidney due to prior renal cell carcinoma and splenic marginal zone lymphoma currently treated with chlorambucil presented to the emergency department with acute kidney injury. He complained of red “kool-aid” urine and lower extremity rash. The rash was non-blanching, erythematous, papular and present on his ankles and [...]

Case Presentation: A 39-year-old male with a history of primary refractory T-cell lymphoblastic leukemia/lymphoma (T-ALL) complicated by superior vena cava (SVC) syndrome, and Guillain Barre Syndrome secondary to chemotherapy presented with worsening right-sided pleuritic chest pain. He denied dyspnea or difficulty during exertion. On exam, blood pressure was 106/74 mmHg, heart rate was 123 bpm [...]

Case Presentation: A 60-year-old male presented with one week of new onset fevers and fatigue. Past medical history included primary sclerosing cholangitis, orthotopic liver transplant 12 years ago and Epstein-Barr virus (EBV) negative post transplant lymphoproliferative disease (PTLD) with partial response to single-agent Rituximab treatment one-year prior.The patient reported debilitating fatigue, daily low-grade fevers, night [...]

Case Presentation: A healthy 38 yo woman presented to hospital with 3 weeks of fatigue. She was recently treated for a urinary tract infection but continued to feel unwell. She complained of mild LUQ abdominal pain. On review of systems she endorsed weight loss, fever and night sweats but denied chest pain, dyspnea, easy bleeding, [...]

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 [...]