Case Presentation: A 35 year-old undomiciled male with a history of epilepsy and recurrent aseptic meningitis was brought in to the emergency department after being found unresponsive. Initial vital signs were notable for temperature of 102˚F. He was intubated in the emergency department and a lumbar puncture was done consistent with a bacterial meningitis (WBC [...]

Case Presentation: A 54 year-old man with a history of opioid use disorder, housing insecurity and hypoplastic myelodysplastic syndrome presented with one month of shortness of breath, productive cough, fever, and chills. He also endorsed a twenty pound weight loss over the course of three months. He had presented to an outside hospital three weeks [...]

Case Presentation: A 52 year-old man was hospitalized for hypoxia one month after surgery for ruptured appendicitis. He also reported abdominal pain and steatorrhea along with a 50 pound weight loss in five months. On exam he was anicteric but cachectic. CT pulmonary angiogram on admission revealed peripheral-based pulmonary lesions concerning for septic emboli and [...]

Case Presentation: A 46-year-old male with alcohol use disorder and cirrhosis presented to the emergency department for 1 day of persistent ascitic fluid leakage from his umbilicus. Exam was significant for ascites and a reducible, ulcerated umbilical hernia. The ulcer was cleaned, sealed with skin glue, and the patient was discharged. He presented again 7 [...]

Case Presentation: A 43-year-old female patient with no medical history presented with multiple abdominal wall abscesses. She attended a cosmetic spa four months prior where she received weight loss injections known as “carboxy therapy” to her abdomen. Subsequently, she developed enlarging painful red lesions of varying sizes at the injection sites. She underwent incision and [...]

Case Presentation: A 64-year-old male with past medical history of hypertension (HTN), hyperlipidemia, coronary artery disease, and end stage renal disease, secondary to HTN, on hemodialysis presented with a 3-day history of nonproductive cough and malaise with no other associated symptoms. On admission vital signs were within normal limits; physical exam revealed decreased breath sounds [...]

Case Presentation: A previously healthy 50 year old female presented to the emergency department with abrupt onset of an intractable headache with altered mental status. On presentation, symptoms were pertinent for headache, neck pain, fever, nausea, and vomiting. Temperature was 103.1F, Heart rate 95 beats per minute (bpm), and blood pressure 102/71. Initial labs were [...]

Case Presentation: An 83 year-old female with history of hypertension presented to the emergency department with altered mental status for the past 2 days. Family reported patient to have a low impact fall, 2 weeks prior. In route, patient was noted to be febrile at 101.7˚F. Upon arrival, vitals were stable. Patient was found to [...]

Case Presentation: A 63-year-old male with a past medical history of end-stage renal disease status post living-related kidney transplant three years ago presented with dyspnea and joint pain. His immunosuppressive regimen included mycophenolate mofetil, prednisone, and belatacept, which was switched to everolimus due to concern for synovitis at outpatient rheumatology one month prior when he [...]

Case Presentation: A 68 year old caucasian female presented to the emergency department with 1 week of fever, chest pain, and dyspnea. On exam, she appeared cachectic and toxic . Her temperature was 101F, heart rate was 124/min, and she was in Atrial fibrillation. Her BP initially was 100/66, and respiratory rate was 25/min. Pulsus [...]