Case Presentation: The patient is an immunosuppressed 57 year old male with small bowel and liver transplant due to trauma from a motor vehicle accident 20 years prior and end ileostomy due to anal carcinoma. His chief complaint was “dizziness,” consisting of lightheadedness and diplopia. His wife described three months of progressive forgetfulness and fabricating [...]

Case Presentation: A 51-year-old African American Female with PMHx of sickle cell trait, vitiligo (developed 5 years ago), T2DM, HTN, unspecified seizure disorder who presented with altered mental status and found to have severe pancytopenia. She presented hemodynamically stable with a physical exam notable for: pale conjunctiva and diffuse skin hypopigmentation consistent with vitiligo. Medications: [...]

Case Presentation: A 38-year-old male with self-reported history of asthma presented with generalized weakness and syncope. He endorsed 2-week of bilateral leg pain with numbness, loss of taste, and nausea. Vital signs were remarkable for tachycardia in 110s and hypotension at 101/52. Labs showed hemoglobin 3.3, WBC 3.6, platelet 83, MCV 93.9, reticulocyte 1.1%, total [...]

Case Presentation: A 77-year-old female with a history of hypertension and osteoporosis presented to the emergency department with dizziness, fatigue, decreased oral intake, and weakness for a few weeks. She also reported blurry vision and paresthesias in her lower extremities. Physical examination including a neurological examination was normal. Laboratory tests revealed a severe macrocytic anemia [...]

Case Presentation: A 45-year old male was escorted to our tertiary medical center from a prison for evaluation of 40 lb weight loss, paraplegia and recently developed urinary and fecal incontinence. The patient had been on a 7-month long hunger-strike, during which he only consumed one meal per day. In addition to incontinence, he reported [...]

Case Presentation: A 53 year-old female with poorly differentiated gastric adenocarcinoma metastatic to the lungs was hospitalized with repeated vomiting for almost two months. She reported vomiting with every meal but without abdominal pain. IV ondansetron, metoclopramide, and prochlorperazine provided only minimal improvement in the hospital. Esophagogastroduodenoscopy showed gastric body obstruction due to a large [...]