Case Presentation: A 74-year-old African-American woman presented to our Emergency Department with hemoptysis and severe respiratory distress. Two weeks prior to presentation, she was admitted with persistent cough and blood streaked sputum of 1-month duration and was treated with antibiotics for a presumptive diagnosis of pnemonia after a negative bronchoscopy and bronchoalveolar lavage (BAL). Her [...]

Case Presentation: A 21-year-old man presented with two weeks of progressive dyspnea. He denied chest pain, lower extremity edema, orthopnea, melena, hematochezia, hemoptysis, cough, or fever. He had a previous presentation with similar symptoms of unknown etiology a few weeks before treated with steroids, blood transfusions, and antibiotics with improvement in symptoms. He was on [...]

Case Presentation: 51yoM with no significant medical history presents to ED for evaluation of progressive bilaterally injected, painful conjunctiva of 1 months duration, nonproductive cough and pleuritic chest pain of 1 week’s duration. He was recently treated with moxifloxacin for conjunctivitis without improvement in symptoms. After treatment, he developed nonproductive cough associated with pleurisy and [...]

Case Presentation: 51yoM with no significant medical history presents to ED for evaluation of progressive bilaterally injected, painful conjunctiva of 1 months duration, nonproductive cough and pleuritic chest pain of 1 week’s duration. He was recently treated with moxifloxacin for conjunctivitis without improvement in symptoms. After treatment, he developed nonproductive cough associated with pleurisy and [...]

Case Presentation: An 86-year-old woman with a history of hypertension on oral medications and chronic systolic heart failure presented to the hospital with chest pain and dyspnea. She was noted to be acutely hypertensive, tachypneic and hypoxemic. Physical exam revealed diffuse crackles, jugular venous distention and lower extremity pitting edema. EKG was consistent with an [...]

Case Presentation: An 83-year-old male with past medical history of hypertension managed chronically with hydralazine presented to the hospital complaining of acute onset of dyspnea, fever, and cough. He was treated for community acquired pneumonia with incomplete resolution of his symptoms. One month later he returned with fatigue and hemoptysis. Work up was significant for [...]

Case Presentation: 17 year old female with no medical history presented with malaise. Labs were WBC 3.78 with normal differential, a microcytic anemia 7.1, platelets 7, and uric acid 10.6. On admission, she was found to have epistaxis, conjunctival hemorrhage, and hemoptysis. She required escalation to high flow nasal cannula. Chest x-ray was concerning for [...]

Case Presentation: 63-year-old female with medical history significant for idiopathic thrombocytopenia purpura (ITP), requiring splenectomy in 2013, pulmonary embolism requiring IVC filter placement due to ITP and asthma, presented with acute onset of shortness of breath. Patient had diffuse petechial rash on extremities. She was tachypneic, hypoxic and had rales on examination. Initial evaluation with [...]

Case Presentation: A 59-year-old Caucasian woman with asthma and PsA, treated with monthly guselkumab injections, presented with a one-week history of progressive shortness of breath and generalized weakness. Initial laboratory findings revealed leukocytosis and lactic acidosis, and arterial blood gas (ABG) indicated respiratory acidosis. Chest X-ray showed bilateral ground-glass opacities, and echocardiography revealed preserved ejection [...]

Case Presentation: A 76-year-old woman presented with right flank pain and intermittent painless hematuria. Exam was unremarkable. Labs revealed a Cr of 2.35 mg/dL (0.50 – 1.20 mg/dL), BUN 54mg/dL (6.0 – 23.0 mg/dL), and urinalysis with 229 RBCs and >300 protein, but no casts. CT showed bilateral renal nephrolithiasis without hydronephrosis and a distended [...]