Case Presentation: A 74 year old male, a nursing home resident was admitted to the hospital for fever and chills for 3 days. His history was significant for end stage renal disease. Patient had an episode of clostridium difficile (C diff) within 3 months prior to this admission. 3 weeks ago he was started on […]

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: This is a case of a 53 year old man with past medical history of Hodgkin’s disease s/p chemoradiation, intraabdominal desmoid tumor s/p resection, GERD, Chronic Kidney Disease and penicillin allergy who was admitted to the hospital with complaints of shortness of breath worsening over a period of 2 weeks. On admission he […]

Case Presentation: A 58‐year‐old Hispanic male with stage III diffuse large B‐cell lymphoma (DLBCL), status post 8 cycles of R‐CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone), presented with 2 days of double vision and difficulty looking to the right. One day prior to the onset of symptoms, he hit himself above the right eye with […]

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 78 year old man presented with neck pain, fever, and malaise for 3 days. He noted progressively worsening pain and stiffness of the anterior neck bilaterally. He reported right- sided headache and subjective fevers but denied any photo or phonophobia. He had no sick contacts or recent travel. Past medical history included […]

Case Presentation: A 53-year-old man presented with nine months of abdominal pain, nausea, constipation, dizziness and syncope with standing, weight loss, and edema.  He had anasarca, persistent orthostatic hypotension, anemia, hypoalbuminemia, and nephrotic-range proteinuria.  BNP was elevated.  Adrenocorticotropic hormone stimulation test was normal.  Echocardiogram showed left ventricular hypertrophy with normal ejection fraction.  Computed tomography showed […]

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 […]