Case Presentation: A 21-year-old man with no previous medical history presented to the emergency department with nausea, vomiting and diarrhea for one week. Labs were significant for white blood cell (WBC) count 3.4 k/ul with decreased lymphocytes along with mild elevation of transaminases and lipase. He was thought to have viral gastroenteritis and was discharged. […]

Case Presentation: A 70-year-old male with a medical history significant for transurethral resection of bladder tumor and lung adenocarcinoma presented with diaphoresis and subjective fever 4 days after undergoing an uncomplicated aortic extension cuff placement for an abdominal aortic aneurysm. The patient was hemodynamically stable. Labs notable for leukocytosis of 18.4X10E9 cells/liter. CT abdomen demonstrated […]

Case Presentation: A 63-year-old woman with multiple sclerosis, hypertension, and venous insufficiency was admitted with shock and diffuse rash. Two months earlier, she had a confluent, erythematous, pruritic, painful, bilateral foot rash that spread from the dorsi to the ankles with associated swelling. Clotrimazole resulted in mild improvement. Two weeks prior to admission, she developed […]

Case Presentation: A 19 year old female with a history of systemic lupus was found at home unresponsive by family and brought to a local ED. At the ED she was hyperthermic to 106F and hypotensive then transferred to Vidant Medical Center fevers and septic shock. Of note she had recently been discharged from Duke […]

Case Presentation: A 40-year-old Caucasian woman with history of surgically-repaired lumbar spinal stenosis presented with a progressive swollen and painful right foot over past few hours. The patient was concerned of a spider bite though did not see a spider. The dorsal aspect of the foot was erythematous, edematous, with a pinpoint area of necrosis […]

Case Presentation: Patient is a 29 year old female with no significant past medical history who presented to our hospital with an unintentional 60 pound weight loss over 3 months and 4 days of palpitations, shortness of breath, leg swelling, and orthopnea. Physical exam revealed 4+ pitting edema, tachycardia (130 beats/minutes) and jugular venous distention […]

Case Presentation: A 45-years-old African American male with a past medical history of seizure disorder, chronic alcohol abuse, and cervical spine injury, presented to hospital after a witnessed tonic-clonic seizure episode that resolved spontaneously. Initial evaluation revealed hypotension (90/57mmHg), tachycardia (145), tachypnea (36), temperature of 39.1 degrees celsius, leukocytosis (24.2×10^3/microliter) with bandemia, and lactate of […]