Case Presentation: A 47 year old white male with alcoholism and cirrhosis was admitted to the ICU after being found altered in his bedroom in a pool of blood draining from his nose. A rhino rocket was inserted into the patient’s right nostril to stop the bleed and labs and imaging were obtained. Labs revealed [...]

Case Presentation: A 17 year old male recently diagnosed with high risk B-Precursor ALL and induction failure, was found in clinic to have an acute murmur. Three days prior, he had arm and leg aches, dry cough, a single fever and fatigue that improved with blood transfusion. Now he had a 3/6 holosystolic blowing murmur [...]

Case Presentation: An 80 y/o Hispanic man with past medical history significant for COPD, ascending aortic aneurysm s/p graft repair 10/06, and recent biventricular pacemaker implantation 4/16 due to third-degree heart block presented with dyspnea, productive cough, orthopnea and fever to 103 F in 5/16. Physical examination revealed III/VI diastolic murmur, bilateral pulmonary rales, peripheral [...]

Case Presentation: A 76- year old smoker woman with a medical history of emphysema and left MCA stroke six months back, presented with acute bilateral occipital headache and visual impairment.On Exam, she was well appearing, normal vital signs, and no murmurs on heart exam. Neurological exam was normal except for dysmetria due to visual impairment [...]

Case Presentation: A 55-year-old obese female presented with daily high fevers, chills, night sweats, malaise, decreased appetite, and nausea for two weeks. Her past medical history is significant for laparoscopic adjustable gastric band (LAGB) surgery eight (8) years prior. On presentation, she was febrile, tachycardic with pallor and hypotensive. Cardiopulmonary and abdominal examination was normal, [...]

Case Presentation: A 36-year-old male with a medical history significant for IV heroin abuse and bipolar disorder presented to the hospital with confusion, fever and chills. Initial vitals were concerning for septic shock, and the patient was promptly started on broad-spectrum antibiotics and aggressively fluid resuscitated following sepsis protocols. Physical examination was concerning for a [...]

Case Presentation: 27 year old Caucasian female admitted with fever, abdominal pain radiating to back. She was not an IV drug user. Has a recent history of facial abscess following spider bite but no signs of cellulitis over extremities. There was a small red spot on lower right eyelid, no Osler nodes, janeway lesions, no [...]

Case Presentation: A 55-year-old female presented with headaches and intermittent fevers. On initial examination, she had left hand weakness. Laboratory findings revealed leukocytosis; brain MRI demonstrated multiple bilateral cerebral infarcts. Initial workup was concerning for embolic stroke which initiated our search for a cardioembolic source. No significant abnormalities were seen on transthoracic echo (TTE) and [...]

Case Presentation: A 63-year-old man with a history intravenous heroin use disorder and chronic homelessness was readmitted for worsening right lower extremity pain secondary to recently diagnosed unprovoked bilateral deep vein thrombosis (DVT). He reported substernal chest pain without radiation and dyspnea but denied fevers, chills, weight loss or recent heroin use. His temperature was [...]

Case Presentation: 85 year old female was admitted on account of lethargy and decreased oral intake for the previous week, and evidence of anemia. She had undergone a transcatheter aortic valve replacement(TAVR) 5 months prior for her management of her severe aortic valve stenosis. Additionally, she suffered from recurrent gastrointestinal bleeding due to arteriovenous malformations, [...]