Case Presentation: A 57-year-old man presented with three weeks of palpable petechial rash, abdominal pain, polyarthralgia and edema. The rash started as “red dots” on his abdomen and spread throughout his body. On exam, he exhibited diffuse palpable purpura with blistering to his bilateral feet. Initial work up was notable for creatinine (Cr) 3.30 from [...]

Case Presentation: A 39-year-old male with no known history presented with complaints of back pain and shortness of breath for four days. Work up initially revealed pyelonephritis. The patient was treated with Amoxicillin-Clavunate. After a month, patient was re-evaluated for increased shortness of breath, fatigue, abdominal pain, diffuse arthralgia, and a new rash. The shortness [...]

Case Presentation: A 48-year-old man with a history of gastroesophageal reflux disease and obstructive sleep apnea presented with one week of pain, warmth, and rash over the right foot accompanied by episodic fever and headaches. He was a landscaper. Six weeks ago, he fell from a ladder with resultant right nondisplaced medial malleolar and comminuted [...]

Case Presentation: A-28-year-old male with history of asthma and bipolar disorder presented to our hospital with a 10-day old, painful rash on bilateral lower extremities. History was significant for flea bites that occurred a day before the rash started. The rash started off as 3/10 petichae on both legs, but over 2 days it rapidly [...]

Case Presentation: A 41-year old-woman with history of Hashimoto’s thyroiditis was transferred from referring hospital (OSH) for persistent thrombocytopenia. Patient was well until one month prior to presentation, when she presented for right upper quadrant (RUQ) pain. The patient was diagnosed with gallstone cholecystitis and underwent laparoscopic cholecystectomy. At the time of her surgery, she [...]

Case Presentation: A 49-year-old man presented to the Emergency Department with a two-day history of worsening chills. He was afebrile with HR 115 beats/minute, RR 22 breaths/minute, BP 120/93 mmhg. Pertinent findings on physical exam revealed an ill appearing male with a new facial rash and a new systolic murmur. Labs were significant for WBC [...]

Case Presentation: A 50-year-old man without significant medical history presented with two months of purpura over his lower extremities and abdomen, ankle pain, and two days of severe abdominal pain associated with vomiting and melena. His symptoms started following a respiratory infection. On presentation, he was afebrile with normal vital signs. Physical exam was notable [...]

Case Presentation: An 8-year-old HIV-negative boy presented to a hospital in Malawi in septic shock secondary to typhoid fever with ileocecal perforation. He underwent repair and peritoneal washout without bowel resection. He was treated with ceftriaxone, metronidazole and supportive care. Initial labs were notable for hemoglobin of 10g/dl, platelets of 22/dL, and WBC 2.8/dL. Two [...]

Case Presentation: A 15 year-old female with obesity presents to the hospital with vomiting, headache, and decreased responsiveness. Prior to arrival she had about 10 episodes of non-bloody vomiting, after which she had altered consciousness. She denied any diarrhea, dysuria, blood in stool, and vaginal bleeding. She denied bleeding and bruising easily. No recent consumption [...]