Case Presentation: A 74 year old female with history of atrial flutter on warfarin presented to the emergency department with altered mental status and bilateral leg pain. She was found to have a leukocytosis (WBC 14.7), pre-renal azotemia and an elevated INR of 8.2. Exam was notable for bilateral lower extremity ulcers. She was treated […]

Case Presentation: A 47-year-old female with ESRD, chronic hypotension, anemia of chronic disease, depression and anxiety presented with painful chronic non-healing bilateral lower extremity wounds. Her wounds started about 3 months prior as superficial hyperpigmented painful areas which had gradually become indurated and subsequently ulcerated. Her wounds were extremely painful, limiting her ability to move […]

Case Presentation: A 60-year-old female presented to the emergency department with shortness of breath, worsening edema, and a tender, non-purulent, erythematous rash on her medial thighs bilaterally. Her medical history was significant for atrial fibrillation, heart failure with reduced ejection fraction, and chronic myelomonocytic leukemia. The patient had been recently discharged after an admission for […]

Case Presentation: An 80-year-old female with a history of atrial fibrillation on warfarin, type 2 diabetes mellitus, vitamin D deficiency, and CKD stage III presented as a transfer for further management of a worsening left lower extremity ulceration. Onset was 2 weeks prior without any concordant symptoms of infection and was initially evaluated by her […]