Background: Up to 12% of hospitalized patients require high dose parenteral thiamine treatment to prevent Wernicke’s Encephalopathy, a devastating and easily preventable neurologic disorder that can lead to death. Despite the fact that it is as simple and relatively inexpensive therapy with no known side effects, high dose thiamine continues to be underutilized. Attempts to […]

Case Presentation: An 82‐year‐old woman came to the emergency department with pleuritic chest pain, cough, and fever. On arrival, she was found to have aphasia and right‐sided hemiparesis. Her family noted that she was normal just hours before. CT scan and MRI of her brain demonstrated only chronic ischemic changes consistent with her previous lacunar […]

Case Presentation: 2A 19 year old Bulgarian G2 P1 at 35 weeks by last menstrual period confirmed by ultrasound was found to have a platelet count of 40,000/µL during an admission for pyelonephritis. Past medical history was significant only for idiopathic thrombocytopenic purpura (ITP) diagnosed at age 12. She was followed by an oncologist at […]

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: This is a case of a 53 year old female with past medical history of hypertension, anxiety and gastric bypass surgery in 2001. She presented to the hospital acutely ill, complaining of inability to ambulate along with leg weakness that had started two years ago and was associated with progressive numbness and tingling. […]

Case Presentation: A 19-year-old African-American woman with history of neonatal meningitis with baseline mental retardation, left hemiparesis and seizure disorder presented with altered mental status, decreased responsiveness, new right hemiparesis and aphasia. Brain and spine MRI revealed demyelination representing an acute inflammatory myelopathy. MR spectroscopy revealed findings of necrosis and anoxia. Mental status change was […]

Case Presentation: 36-year-old female is admitted to our hospital with acute-onset chest pain and found to have bilateral segmental pulmonary embolism.  Her medical history was pertinent for juvenile idiopathic arthritis diagnosed at age of 15. Despite being on chronic steroids and rituximab for maintenance therapy, she had been having intermittent fever for the past two […]

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 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 58-year-old Caucasian woman with HIV on HAART, hyperthyroidism with radioiodine ablation, Hepatitis B and C, past IV drug use, former smoker, HTN, and HLD, initially presented with chest pain and was found to have NSTEMI. She underwent cardiac catheterization, which revealed 90% stenosis of mid-LAD and had a drug-eluting stent (DES) placed. […]