Case Presentation: A 53-year-old male with a past medical history of hypertension who recently emigrated from El Salvador presented to an ambulatory clinic for evaluation of substernal chest pain that started eight days earlier. He described the chest pain as intermittent, non-radiating, and associated with palpitations, chills, shortness of breath, and diaphoresis. He denied fever, [...]

Case Presentation: A 22-year-old man with Asperger syndrome presented with five days of fever and acute confusion after an episode of pharyngitis. Vital signs were significant for T 39.3°C, HR 120/min, BP 93/57 mmHg, and RR 22/min with O2 sat 94% on 4L. Physical exam was remarkable for thick oral secretions, tenderness to palpation of [...]

Case Presentation: A 48-year-old man with a past medical history of congenital solitary right kidney, chronic idiopathic pancreatitis, pancreatectomy and islet cell transplant, splenectomy, and alcohol use disorder presented with fever, chills, and night sweats. He was bitten by a dog three days prior to presentation. Shortly after arrival, he developed septic shock with lactic [...]

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: 55-year-old male with past medical history of diabetes mellitus type 2, complete heart block status post pacemaker, nonischemic cardiomyopathy and Crohn’s disease was admitted for headache, loss of consciousness and seizures. Physical exam showed nuchal rigidity. Complete blood count showed mild leukocytosis. Urinalysis was benign and x-ray chest didn’t show any infiltrates. CT [...]

Case Presentation: 39-year-old female with a history of ulcerative colitis (UC), but not on therapy, presented with abdominal pain and hematochezia for two weeks, along with weight loss and night sweats. On admission, vital signs were notable for tachycardia and physical examination revealed a diffusely tender abdomen. Laboratory studies were remarkable for leukocytosis of 23,250/mm3. [...]

Case Presentation: A 53-year-old female with chronic small fiber polyneuropathy and erythromelalgia presented with severe headaches, nausea, vomiting, diarrhea, body aches, photophobia, and neck stiffness for two days. Symptoms started one week after receiving intravenous immunoglobulin (IVIG) for an erythromelalgia flare. On presentation to the ER, she was afebrile and physical examination was unremarkable. Respiratory [...]

Case Presentation: Lemierre’s disease is a rare and deadly infection caused by the Fusobacterium species which results in bacterial pharyngitis that spreads through pharynx soft tissues into the carotid arteries, resulting in widespread bacteremia and thrombosis. Outcomes are reliant on early diagnosis and initiation of treatment, with mortality rates as high as 20%. The rarity [...]

Case Presentation: The patient, a 29-year-old G1P1 female, presented to the emergency department with a 3-day history of double vision, frontal headache, and gait instability. Eye examination was significant for asymmetric bilateral internuclear ophthalmoplegia. Admission labs demonstrated mild leukocytosis without left shift and elevated inflammatory markers including complement levels and IL-6. An MRI of the [...]

Case Presentation: 29-year-old Hispanic male with history of intravenous drug use (IVDU) with fentanyl and methamphetamine, was brought to the hospital after being found confused on the streets. Patient was very cachectic, tachypneic and had track marks in the cubital fossa suggestive of IVDU. Patient was febrile with 100.6 F, had leukocytosis with WBC 18 [...]