Case Presentation: A 60-year-old African American male with a recent diagnosis of thromboangiitis obliterans (Buerger’s disease) presented with new painful penile and scrotal ulcerations in the setting of digital ischemia, palmar skin lesions, bloody diarrhea, a 50-pound weight loss, and progressive dyspnea over the past six months. No vascular etiology for ischemia was found. Labs [...]

Case Presentation: A 64-year-old woman with a history of right kidney transplant and Crohn’s disease in remission presented to the emergency department with five days of severe abdominal pain. Her pain was accompanied by nausea, vomiting, and chills. Physical examination was notable for an abdomen that was distended and diffusely tender to palpation, but not [...]

Case Presentation: A 52 year old man with a PMHx of IVDU and HLD presents with a CC of “Cold Leg”. This was preceded by sudden onset numbness and weakness of his right foot and leg, inability to ambulate and severe pain in his thigh. He reported prodromal fevers, sweats and arthralgias. His last IVDU [...]

Case Presentation: A 57-year-old female with end-stage renal disease (ESRD) on hemodialysis and a history of calciphylaxis presented with a non-healing wound on her right hand. Two months prior, she developed a wound on the dorsal surface of her right fourth finger without antecedent trauma. The lesion became painful and discolored, resistant to multiple courses [...]

Case Presentation: A 48-year-old female with Hashimoto’s thyroiditis (on Synthroid), prediabetes, and active tobacco use (30 pack-years) who exercises daily presented to the ER with chest pain after a high-intensity workout. The pain radiated to her left arm and neck and intensified to 10/10, associated with palpitations.On exam, she had cool extremities and diaphoresis. Vital [...]

Case Presentation: A 55 year-old man with a history of MSSA Bacteremia, Type II Diabetes, and Hypertension was admitted with pseudomonas bacteremia. Physical exam was notable for a cushingoid appearance. Laboratory studies were remarkable for hypernatremia, hyperkalemia and metabolic alkalosis. Serum morning cortisol was 162 mcg/dL and serum morning ACTH was 297 pg/mL (normal 7-63 [...]