Case Presentation: A 15-week G2P3 pregnant 33-year-old woman with past medical history of chronic hepatitis C, current intravenous drug use (IVDU) presented from a correctional facility complaining of abdominal pain and hematuria. Exam revealed a gravid uterus and bilateral pedal edema. Patient responding only to pain and not following commands. Temp 102.8 F, HR 120’s [...]

Case Presentation: A 71-year-old woman who initially presented with sepsis from MSSA bacteremia was found to have an acute splenic infarct as well as a splenic artery pseudoaneurysm that was managed by coil embolization. She was discharged on a 4-week course of cefazolin for the treatment of her MSSA bacteremia. Two weeks later, she was [...]

Case Presentation: 71-year-old man with a history of atrial fibrillation, presented with four-months of fatigue, 50lb weight loss, night sweats and petechiae spreading from legs to abdomen and arms. On admission, vital signs were unremarkable. On physical exam, he had non-blanching, non-palpable petechiae extending from his lower extremities (LEs) to torso and upper extremities and [...]

Case Presentation: A 62-year-old female presented with one month of progressive bilateral lower extremity pain, weakness, and functional decline. Her medical history was significant for cirrhosis secondary to hepatitis C (treated), chronic pancytopenia, and hypothyroidism. Her medications included atorvastatin, levothyroxine, omeprazole, spironolactone, tiotropium, venlafaxine, and quetiapine. She was a current smoker with a 20-pack year [...]

Case Presentation: 49-year-old male patient with history of hypertension was sent by his nephrologist to the ER for unexplained worsening renal function and likely renal biopsy. Vital signs were stable, exam was unremarkable, however BUN was 85 mg/dL with creatinine of 10.1 mg/dL (baseline of 1.5 mg/dL). 24-hour urine protein excretion was 5.2 grams. The [...]

Case Presentation: A 67-year-old woman with a history of cocaine use presented with six weeks of progressive bilateral upper and lower extremity weakness, burning pain, and difficulty ambulating. Exam was significant for low grade fever and decreased sensation to pinprick in a stocking-glove distribution in all extremities. Muscle strength was reduced in the distal upper [...]

Case Presentation: 76-year-old Hispanic male, presented with two weeks of progressing rash, worsening AMS and new symptoms of fever and severe extremities pain. Previously treated for allergy, UTI, and Pneumonia without improvement. His past medical history included Hypertension, DM-2, and ischemic stroke. On examination he was disoriented and unable to answer questions. A disseminated non [...]

Case Presentation: A 71-year-old Caucasian female with history of atrial fibrillation, gastroesophageal reflux disease, chronic kidney disease stage 3a was admitted for 2-week history of nausea, vomiting, and decreased urinary output. The patient had a recent admission for atrial fibrillation with rapid ventricular rate without causative etiology identified and was discharged on amiodarone and apixaban. [...]

Case Presentation: A 58-year-old female presented to the emergency department with severe acute abdominal and bilateral flank pain. Medical comorbidities included hypertension and obesity.On arrival, she was hemodynamically stable and labs were notable for an elevated D-dimer. Due to concern for pulmonary embolism (PE), a heparin infusion was started. Soon afterwards, she developed acute hypotension. [...]

Case Presentation: A 72-year-old male presented to the emergency room for macrocytic anemia and a creatinine of 9.72 mg/dL on outpatient lab work. Past medical history was notable for paroxysmal supraventricular tachycardia, gastroesophageal reflux disease and heart failure with reduced ejection fraction. On admission, he complained of six months of fatigue with constipation, 60 lbs [...]