Case Presentation: A 73 year-old man with type 2 diabetes mellitus (hemoglobin A1c 7.5), hypertension, hyperlipidemia, chronic renal failure stage 3a, and a distant 10 pack year smoking history presented with 2 weeks of substernal chest tightness and dyspnea on exertion. He was hemodynamically stable without tachypnea at rest. Examination revealed a grade 2/6 holosystolic […]

Case Presentation: A 26-year-old female with lymphangiomatosis presented to the emergency department with fever and malaise of one day duration. She denied headache, cough, nausea, dysuria, or rash. Vitals were notable for elevated heart and respiratory rate. Initial lab work revealed a WBC of 5.9 with a neutrophilic predominance of 99%. This neutrophilia led to […]

Case Presentation: The patient is a 51 year old female with a history of acute cholecystitis status post cholecystectomy who presented to the hospital for acute on chronic abdominal pain. Since her cholecystectomy five months prior, she had recurrent episodes of nausea, vomiting, and abdominal pain with persistently elevated LFTs and bilirubin. Liver biopsy and […]

Case Presentation: A 3-year-old previously healthy male was admitted with a five-day history of fevers up to 104 F, decreased oral intake, and decreased activity. He had been seen by his pediatrician on day three of illness, at which time he was noted to have leukocytosis with a white blood cell count of 30,200/µL and […]