Case Presentation: A 15-year-old female was transferred to our facility with a complaint of worsening chest pain for the previous two weeks. The pain initially started in her shoulders and then spread to her substernal area. She had initially presented to the same facility three days previously and was discharged with a diagnosis of musculoskeletal [...]

Case Presentation: A 64-year-old female with decompensated alcoholic liver cirrhosis was admitted to the hospital for lower abdominal pain. The initial paracentesis polymorphonuclear (PMN) leukocyte count was 149 cells/mm3, but the patient was found to have E. coli urinary tract infection. During the course of her treatment, the patient developed pancreatitis and her hepatic encephalopathy [...]

Case Presentation: A 41-year-old Caucasian female with a significant past medical history of Factor V Leiden deficiency presented to our institution for evaluation of new-onset seizures that began while driving. No head trauma or other bodily harm was sustained. The patient was non-ill appearing and hemodynamically stable. The physical exam was otherwise unremarkable. Laboratory evaluations [...]

Case Presentation: Heyde syndrome is a rare multisystem disorder characterized by the triad of aortic stenosis (AS), gastrointestinal bleeding, and acquired von Willebrand syndrome (AVWS). The pathophysiology of AVWS in Heyde syndrome is thought to be due to the increased circulatory shear forces resulting from AS, leading to cleavage of large VWF multimers and loss [...]

Case Presentation: A 78-year-old Japanese man with chronic heart failure and type 2 diabetes presented with a 2-day history of recurrent fever six days after the termination of a 12-day antimicrobial treatment for pyelonephritis caused by Escherichia coli. The physical examination revealed a body temperature of 38.9 °C, respiratory rate of 24 breaths per minute, [...]

Case Presentation: This is a 35-year old Indian female, living in the United States for the past several years, presented with chronic mid-epigastric and left upper quadrant pain radiating to the back, nausea, and bilious vomiting. She complained of oily loose stools for the past 2 months. Her medical history is notable for insulin-dependent diabetes [...]

Case Presentation: A 42-year-old African woman with past medical history of anxiety, depression, hyperlipidemia and recent diagnosis of hypertension presented with two days of acute onset, severe, persistent, cramping mid-epigastric abdominal pain worse with eating and drinking. The pain was associated with nausea and non-bloody non-bilious emesis. The patient was initiated on lisinopril-hydrochlorothiazide two days [...]

Case Presentation: 26-year-old woman presents with abdominal pain for one day. She developed sudden, sharp and constant abdominal pain in the right upper quadrant and epigastric area. The pain is associated with subjective fevers, nausea and non-bilious, non-bloody vomiting. Pain is worse with deep breathing and movement. She denies weight loss, no diarrhea or constipation, [...]

Case Presentation: A 61-year-old male with past medical history of HIV on HAART with undetectable viral load and bicuspid aortic valve (BAV) presented to the hospital with fevers, abdominal pain and diarrhea for three days found to have sepsis with leukocytosis of 13.7×10^3/uL and fever of 39°C, elevated trop of 168ng/L without acute ischemic changes [...]

Case Presentation: A 40-year-old man with a history of severe tophaceous gout, not currently on treatment, was directly admitted to the hospital after routine labs showed hypercalcemia (14.1mg/dL) and an elevated creatinine (4.2mg/dL). Vital signs were stable. Exam was significant for large nodules and tophi across most joints, with innumerable subcutaneous nodules embedded in the [...]