Case Presentation: A four month-old boy presented with abdominal distension.  His parents had noted increasing abdominal size over several weeks.  They also reported a diaper rash for two months and nasal congestion for one month. They denied fever, cough, emesis or diarrhea.  The patient was adopted, born full term in another state.  Birth mother had […]

Case Presentation: Few spider bites are medically significant. A 24-year-old African American woman presented with malaise, fever, nausea, and myalgias. She reported a sharp pain on her lower back the night prior that at first felt like burning before progressing to pain. Her initial vitals were T 101, HR 120, BP 141/117. Physical exam revealed […]