Case Presentation: A 27-year-old white male with adult-onset asthma and recurrent pneumonia presented to a rural hospital with a one month history of ascending lower extremity numbness. He also reported fever, fatigue, night sweats, and a twenty-pound weight loss over three weeks. Initial workup revealed leukocytosis and eosinophilia, prompting transfer to our facility for further [...]

Case Presentation: A 69 year old male with past medical history of hypertension and lumbar spinal stenosis presented with numbness of the first and second digits of the left hand that progressed to weak grasp over the previous 24 hours. On arrival, vital signs were normal. Exam was significant for a well appearing male in [...]

Case Presentation: A 57-year-old female with a history of herpes simplex virus was seen at Rheumatology clinic for 3 weeks of myalgias and arthralgias, positive rheumatoid factor and elevated inflammatory markers. By her first visit, her symptoms resolved. Review of systems revealed chronic sinusitis associated with nasal septal deviation and nasal polyps, which previously failed [...]

Case Presentation: A 51-year-old male with a past medical history of diabetes, hypertension, and chronic kidney disease (CKD) presented to the hospital following a fall at home. The patient described a disease course that started six months prior with bilateral knee weakness and shooting pains that progressed to severe gait imbalance and inability to ambulate. [...]

Case Presentation: A 69-year-old male with a past medical history of urothelial carcinoma status post left nephrectomy began immunotherapy and was started on Atezolizumab. He developed bilateral lower extremity weakness that began following his first dose. After 3 doses, in 02/2022, his lower extremity weakness worsened to the point where he could not walk. A [...]

Case Presentation: 26 year old male with no history of substance use, only history of hypothyroidism status post radioactive Iodine treatment three years ago for Graves’ disease presented with three days of lower limbs pain, numbness and edema which impaired ambulation. He reported he had been doing a lot of walking at a convention when [...]

Case Presentation: Thiamine deficiency is a known complication of bariatric surgery presenting commonly as Wernicke encephalopathy or dry beriberi. Pure sensory ascending neuropathy as a presenting complaint, however, is rare, which we describe here in the acute setting after intragastric balloon (IGB) placement. A 48 year old obese but otherwise healthy female underwent an uncomplicated [...]

Case Presentation: A 60 year-old woman with a history of chronic hepatitis C without cirrhosis and schizophrenia with paranoid delusions was admitted with severe progressive bilateral burning foot pain. She had a history of intermittent alcohol use and recent homelessness. She lacked a primary care doctor and sought care for her bilateral lower extremity pain [...]

Case Presentation: A 29 year-old man presented with 3 weeks of paresthesias, fatigue, and weight loss. The patient also reported nausea, constipation, urinary urgency, and erectile dysfunction. Physical examination demonstrated decreased temperature perception and sharp-dull discrimination in the bilateral distal lower extremities. Laboratory studies revealed elevated ESR (57 mm/hour), elevated CRP (2.0 mg/dL), and decreased [...]

Case Presentation: A 27-year-old Chinese-American woman presented to the ED for sore throat, flank pain, dysuria, and generalized weakness for 1 week. The symptoms began after returning on a domestic flight. She initially denied any medical history or substance use to multiple providers and insisted her symptoms were due to infrequent bathroom use during the [...]