Case Presentation: A previously healthy 37–year–old male patient presented with 4 days of fever, nausea, myalgias and headaches. Patient had returned from a 3–week vacation trip to Malawi 2 weeks before this episode. He did take doxycycline as prophylaxis for few days at the beginning of his trip. Two days before the admission patient noticed [...]

Case Presentation: 71 female with multidrug resistant HIV, stable on antiretroviral therapy for 4 years on a regimen containing tenofovir, with CD4 count of 140 cells/ml and non detectable HIV viral load, presented to the hospital with elevated creatinine levels. Decline in renal function was slow and progressive with baseline creatinine of 0.8 mg/dl which [...]

Case Presentation: A previously healthy 35–year–old male patient presented with 2 weeks history of fatigue and a maculopapular rash over his back, torso, extremities and face. He had flu–like symptoms and rinorrhea just before the rash. One week before the admission, patient developed a gradually worsening symmetric lower extremity swelling. He described his urine as [...]

Case Presentation: A 20–year–old African American Female was admitted with diffuse skin thickening and intractable pain in these skin lesions. Her past medical history was significant for recurrent kidney stones for which she had undergone bilateral nephrectomy a year previously and had been on renal replacement therapy. She was suffering from severe cachexia, tachycardia of [...]

Case Presentation: A 41–year–old African–American woman traveling in Ghana experienced progressive edema, diffuse joint pain and night sweats over a 9–day period. Three days before her presentation she noted dyspnea, dry cough and inability to walk due to knee pain. As a result of her declining health, she returned home prematurely. Prior to travel, she [...]

Case Presentation: A 58–year–old woman presented with a severe headache with onset 3 hours after taking prophylactic amoxicillin for a routine dental cleaning. She described a constant bifrontal headache with mild photophobia, multiple episodes of emesis, diarrhea, fevers, chills, and myalgias. She denied any phonophobia, visual changes, neck stiffness, or other neurologic symptoms. She described [...]

Case Presentation: A 49–year–old male with diabetes mellitus presented with jaw pain and an absolute neutrophil count (ANC) of 200 cells/mm3. He denied drug use. A periodontal abscess seen on computerized tomogram was treated by incision, drainage, and antibiotics. Incidental proteinuria and microscopic hematuria were noted. Neutropenia was attributed to glipizide toxicity. As an outpatient [...]

Case Presentation: A 50–year–old male presented to the emergency department with aphasia and weakness. He had been in his usual state of health until 7 hours prior, when he acutely developed right hand weakness and word–finding difficulties. His exam was notable for dysarthria and a right–sided facial droop. A head CT demonstrated multiple front and [...]

Case Presentation: A 77–year–old Caucasian female with a history of morbid obesity, breast cancer status post bilateral mastectomy with reconstruction, deep venous thrombosis, and hypertension presented with a 5–day history of abdominal pain, nausea and bilious emesis with decreased oral intake. She was still having multiple small bowel movements at the time of admission. She [...]

Case Presentation: A 52–year–old female with end–stage liver disease and no recent travel history sustained head trauma 3 weeks prior to presentation that required laceration repair. She was transferred to our medicine service from an outside hospital Emergency Department after being found down with evident maggot infestation. Exam was significant for presence of larvae in [...]