Case Presentation: A 73 year old man with a history of prostate cancer and transient ischemic attack presented to the emergency room of a community hospital with 25 days of extreme fatigue, fever, and shaking chills. The fatigue had developed during a vacation to British Columbia, and had worsened over the last several weeks such […]

Case Presentation: A 62-year-old man with history of end-stage renal disease and poorly controlled type 2 diabetes mellitus presents to the hospital after a fall due to unsteady gait and was noted to have facial movements similar to tardive dyskinesia, whole body chorea, and hyperkinesis of torso and bilateral extremities. On admission, he had an […]

Case Presentation: An 82 year old usually high functioning male with a history of hypothyroidism, hypertension and depression presented with failure to thrive and confusion for 6 weeks. EMS was called when the patient began having suicidal thoughts. The patient was seen in the ER two weeks prior for depression, where a TSH was noted […]

Case Presentation: A 79-year-old male with type 2 diabetes mellitus presented after being found down by a neighbor. Patient reported generalized fatigue. On exam, he was not alert or oriented, but otherwise had a non-focal neurological exam. Glucose was 742 mg/dL, bicarb 15 mmol/L, anion gap 22.8 mmol/L, and beta-hydroxybutyrate 3.92 mmol/L. CT head was […]