Case Presentation: A 60 year‐old woman presents with a 3 day history of weakness and shortness of breath. Associated symptoms include pain in her back, occiput, and chest, as well as subjective fevers and presyncope. Her medical history was significant for remote intravenous drug use, current opiate abuse, and a chronic pain syndrome that had […]

Case Presentation: A 79-year-old woman was found minimally responsive in her home and brought to the hospital for evaluation. On arrival, she was bradycardic (32/min) and hypotensive (75/40) without fever, tachypnea (16/min), or oxygen needs (98% room air). Her initial exam was notable for somnolence, conjunctival injection with normal pupils, dry oral mucosa, slightly cool […]

Case Presentation: A 25-year-old man with a past medical history of sickle cell disease was transferred to our hospital for seizure-like activity and acute renal failure. Computed tomography (CT) head was unremarkable, urine drug screen was negative, and triage labs were significant for white blood cell count (WBC) of 20.7 cells/liter and an elevated creatine […]

Case Presentation: 17 year old female with history of severe persistent asthma, allergies, and chronic marijuana use presents with one month of worsening dyspnea, cough, and chest pain, after treatment for left lower lobe pneumonia and asthma exacerbation.She was afebrile, tachycardic, tachypneic, but saturating well on room air. Lung exam had diminished breath sounds at […]

Case Presentation: A 69-year-old male with prostate cancer in remission developed diplopia 2 weeks prior to presentation. Workup at the referring hospital included a normal ophthalmologic exam and an MRI brain with possible mastoiditis and/or otitis media. A course of unknown oral antibiotics was completed. He had no improvement of his diplopia and progressed to […]