Case Presentation: 72 year old Caucasian man who presented to the emergency department with sudden onset severe upper abdominal pain. Pain radiated to the back, with associated vomiting. No history of alcohol use. Past medical history includes acute pancreatitis, cholecystectomy for acute cholecystitis, hypertension and hyperlipidemia. There was no recent change in his medications. On […]

Case Presentation: A 60-year-old female with metastatic breast cancer presented with involuntary irregular forceful and painful contractions of facial muscles and dystonic posturing of her hands and feet lasting 5 to 30 minutes. Episodes sporadically occurred up to 20 times daily. MRI brain and spinal cord showed no evidence of metastatic disease or dural enhancement. […]

Case Presentation: We present a case of a 65 year old female with a recent diagnosis of small cell lung cancer (SCLC) who had completed four cycles of carboplatin and etoposide. She was subsequently initiated on maintenance program cell death ligands (PD-L1) inhibitor, atezolizumab every three weeks since January 2019. Seven months after initiation, she […]

Case Presentation: Patient is a previously healthy 11-year old Hispanic female who presented to an emergency department with altered mental status, opus-myoclonus movements, aphasia, hallucinations and slurred speech. Six weeks prior to presentation, patient had been treated for an acute tonsillitis infection with Penicillin therapy. Soon after, she developed involuntary movements with progression to neurological […]

Case Presentation: RM is a 7-year-old African American male seen twice in 2 days in the emergency department. He had a 3 day history of fever to 39.7°C, right neck pain and swelling, vomiting, and diarrhea. He was diagnosed with cervical lymphadenitis and sent home with oral clindamycin, but he had persistent emesis, worsening neck […]

Case Presentation: A 69 year old man with history of Stage IV Mantle cell lymphoma on maintenance Rituximab presented to the emergency department with acute confusion and expressive aphasia. Patient was at his behavioral and functional baseline prior to this episode and there had not been any recent illnesses, medication changes or inciting events. Initial […]

Case Presentation: A 76-year-old man with history of diabetes mellitus, atrial fibrillation, colonic adenoma, and recent self-reported bed bug infestation presents with one month of pruritic rash. On interview, he also endorses progressive edema, dyspnea on exertion, orthopnea, as well as 5 days of melena. Admission exam is notable for anasarca and diffuse, tense fluid-filled […]

Case Presentation: 37 year old Hispanic male with Hyperlipidemia presented with diffuse abdominal pain and cramping for 2 days duration. Physical exam showed facial hyper pigmentation, soft palate – 2×2 mm hyper pigmented macules, hyper pigmentation on nails of all extremities. Patient had stocky neck without Goiter and scant axillary hair. Significant laboratory findings were: […]

Case Presentation: A 32-year-old female with a history of untreated sarcoidosis and gastric bypass surgery with partially treated B12 deficiency in the past, was admitted for shortness of breath with a primary diagnosis of pancytopenia. Patient had not taken B12 injections for close to 2 years. Her labs were consistent with severe pancytopenia (Hemoglobin 5.4, […]

Case Presentation: A 61-year-old woman with no pertinent past medical history presented to the hospital with two months of progressive numbness that began with her left foot and hands and eventually extended to her forearms. She developed clumsiness in her hands, gait unsteadiness, and had a 20-pound weight loss. A CT scan of the chest […]