Case Presentation: A 78-year-old female with dextrocardia presented to the hospital from her outpatient dermatologist for hypotension, hypoxia, and altered mental status. She became diaphoretic, dyspneic (SpO2 78%), and hypotensive with systolic blood pressure in the 80s after applying topical lidocaine for a microneedling procedure. Initial exam noted diaphoresis, diffuse facial erythema and flushing, orolabial [...]

Case Presentation: A 46-year old Caucasian male with history of anxiety/depression-on citalopram, tobacco, alcohol use, bilateral chronic knee pain, presented to an outside facility with concerns of nausea, vomiting and epigastric abdominal pain. While undergoing evaluation, he was suddenly unresponsive, underwent CPR x3, found to have ventricular fibrillation rhythm and subsequently cardioverted with successful ROSC. [...]

Case Presentation: Hypermagnesemia is a rare, but potentially fatal clinical condition. We report a case of symptomatic hypermagnesemia in an 84-year-old female with stage 4 CKD who was taking daily magnesium oxide with intermittent milk of magnesia for chronic constipation. She presented with confusion, delayed verbal and motor response, and dyspnea and her presentation was [...]

Case Presentation: A 53-year-old female with Stage IV diffuse large B cell lymphoma (DLBCL) with Myc and Bcl2 rearrangements. Chemotherapeutic regimens were initially successful at achieving remission, but her disease ultimately progressed. The patient elected to pursue CD19-directed Chimeric Antigen Receptor (CAR)-T therapy (axi-cel), and hospital admission was planned for the duration of therapy. The [...]

Case Presentation: A 70-year-old female with a medical history of fibromyalgia on Duloxetine, Systemic Lupus Erythematosus, and Paget’s disease admitted to the hospital for altered mentation was found to have elevated ALT 54 U/L, AST 63 U/L, normal bilirubin, and gamma glutamyl transferase. The mild elevation in Alkaline Phosphatase (ALP) 175 U/L was secondary to [...]

Case Presentation: The patient was an 85-year-old female who presented to the hospital with encephalopathy, rigors, new onset atrial fibrillation with rapid ventricular response and shock. Her past medical history was only noted as dementia and hypertension. Due to her change in mental status, CT head and CTA head and neck were obtained which did [...]

Case Presentation: A 69-year-old male with a history of severe peripheral neuropathy, C4-C5 spinal stenosis, and COPD presented with confusion, neuropathic pain, and acute respiratory failure. His respiratory failure resolved with diuresis. His neuropathy began eight years ago after moving into a trailer home; it involved all extremities and was debilitating. His wife noted progressive [...]

Case Presentation: A 27-year-old male presented to the hospital after developing jaundice with elevated transaminases on routine labs. Patient described preceding two-week febrile illness characterized by general malaise, chills, and myalgias. He received two courses of antibiotics without resolution of symptoms. To manage fever, he consumed 7 grams/day of acetaminophen consecutively for 5 days. His [...]

Case Presentation: 82-year-old female with atrial fibrillation, non-ischemic cardiomyopathy (EF 25%), rheumatoid arthritis, bed bound at home with hospice care presents for acute encephalopathy and tachycardia. Patient’s son (the primary caregiver) reported that patient is on four drops of oral 1% atropine solution daily for bronchorrhea. Accidentally a family member who is not a primary [...]

Case Presentation: An elderly man was diagnosed with clear cell renal cell carcinoma in 1987, and treated with left nephrectomy, though developed multi-organ metastatic disease in 2015. After he did not tolerate initial treatment with sunitinib, he received 15 cycles of NKTR-214 and nivolumab as part of a phase I/II study. Three months after his [...]