Case Presentation: A 41–year–old female with a history of substance abuse presented to the Emergency Department with 1 month of bilateral lower extremity rash and severe pain. On arrival patient had altered mental status, met SIRS criteria of fever and tachycardia, and was leukopenic with an ANC of 1600. The rash was purpuric with bullous [...]

Case Presentation: A 32–year–old African American woman with history of Sickle Cell Disease (SCD) with various complications, depression, and frequent visits to the Emergency Department (ED) presents with a chief complaint of pain crisis. Multiple hospital staff have documented concern regarding the patient’s adherence with medical care, particularly in terms of missing clinic appointments and [...]

Case Presentation: A 17–year–old male presented with a three–day history of shortness of breath, non–productive dry cough, pleuritic chest pain, and fatigue. He had recently recovered from infectious mononucleosis. He was hypoxic with an oxygen saturation of 92% on room air and a chest x–ray was consistent with multilobar pneumonia. The patient was admitted and [...]

Case Presentation: An 85–year–old woman with hypertension, coronary artery disease (angioplasty and stent in 1998), peripheral vascular disease presented to the emergency room after a mechanical fall at home. The patient had a sudden fall and hit her head on the refrigerator door. There was no loss of consciousness, and no dizziness, vertigo, palpitations, abdominal [...]

Case Presentation: A 60–year–old man presents to the hospital with 4 days of rash accompanied by severe pain and pruritus. The rash began on the patient’s hands bilaterally, then, began to spread centrally. He denied any exposure to wooded areas or bug bites. He had no fevers, chills or constitutional symptoms. His past history was [...]

Case Presentation: A 71–year–old man with hypothyroidism presented with atypical left–sided pain to the emergency room. The patient developed acute left–sided pain about 2 months prior to presentation to ER. The pain started in the lower extremity and advanced to his thigh, abdomen, arm, and neck. He described the pain as dull in nature. The [...]

Case Presentation: A 42–year–old male with no medical history was brought to the emergency room unconscious after he had a generalized tonic clonic seizure. As per his wife, he had fatigue and headache for several days prior. He had taken “2 pills” of ibuprofen daily for over a month. He was intubated due to hypoxia [...]

Case Presentation: A 72–year–old male with a remote history of splenectomy secondary to Hodgkin’s lymphoma presented with high–grade fever and confusion for 3 days. Nine months prior to this admission, he was diagnosed with pneumococcal meningitis and pneumococcal mitral valve endocarditis. During that time, transesophageal echocardiogram (TEE) showed vegetation and abscess on posterior mitral leaflet [...]

Case Presentation: A 58–year–old female presented with severe respiratory distress, diaphoresis, hypertension and tachycardia. Vital signs: BP 215/106, HR 139, RR 38, SaO2 48% on room air. She was intubated due to hypoxia. Her medical history was unobtainable. A large neck mass and a BNP value of 950 were noted. Initial differential diagnoses included congestive [...]

Case Presentation: A 15–year–old primigravida with no prenatal care at 32 weeks of gestation presented with preterm contractions, abdominal pain, elevated BP and headache. An elevated sodium of 153 mEq/L was initially believed to be the result of dehydration. After IV hydration with normal saline serum sodium continued to rise and was 160 mEq/L in [...]