Case Presentation: A 44-year-old female with severe opioid use disorder (OUD) was admitted after a benzodiazepine withdrawal seizure. Her history was significant for methadone 165 mg daily dosing, anxiety managed with daily unprescribed benzodiazepines, and alcohol use disorder in remission. She had a prolonged QT interval, with a notable episode 18 months prior, when she [...]

Case Presentation: A 76-year-old man with history of diabetes mellitus, atrial fibrillation, colonic adenoma, and recent self-reported bed bug infestation presents with one month of pruritic rash. On interview, he also endorses progressive edema, dyspnea on exertion, orthopnea, as well as 5 days of melena. Admission exam is notable for anasarca and diffuse, tense fluid-filled [...]

Case Presentation: 42-year-old female with lung adenocarcinoma (with metastases to T-spine s/p corpectomy and XRT to T-spine and lung) presented with four weeks of constant pressure-like headaches and oral intolerance due to nausea and vomiting. She denied fevers, chills, night sweats or hemoptysis. Home medication included osimertinib for her lung cancer. She had no significant [...]

Case Presentation: A 53-year-old Vietnamese monk living in a rural Texas monastery presented with fatigue, muscle aches, and fever that progressed to respiratory distress after a two-week delay in seeking care. He was intubated and sedated at a tertiary care center. He was afebrile, tachycardic (HR 122 bpm), and normotensive. Labs showed a leukocytosis (WBC [...]

Case Presentation: A 51-year-old female presenting with increasing epigastric pain radiating to her back, nausea, and vomiting for five days. Her past medical history is relevant for coronary artery disease and CABG, type 2 diabetes, hypertension, prior tobacco use, and mood disorder. She had visited her primary care doctor the day prior to presentation with [...]

Case Presentation: A 66 year-old woman presents with three weeks of acute onset bilateral lower extremity pain and foot weakness; two weeks of dyspnea, non-productive cough, epistaxis; and one week of oliguria and lower extremity edema. Her past medical history includes COPD, prior heavy tobacco use, and pre-diabetes. Medications and allergies are non-contributable. Her father [...]

Case Presentation: An 84-year-old male with a past medical history significant for improving chronic kidney disease stage 3 (baseline creatinine of 0.72 mg/dL) and prediabetes presented to the emergency department with altered mental status and poor oral intake from a low resource facility. Patient was recently hospitalized for perforated diverticulitis after sigmoidectomy and ostomy complicated [...]

Case Presentation: A 68-year-old male with a three-year history of kidney transplantation on chronic immunosuppression presented with persistent hypotension and acute right leg pain secondary to a right lower extremity abscess. Initial comprehensive computed tomography (CT) revealed multiple additional abscesses, including neck, forearm, retroperitoneal, paravertebral and numerous pulmonary nodules. Given concerns for possible disseminated Nocardia, [...]

Case Presentation: A 27-year-old man with metastatic gastroesophageal junction adenocarcinoma presents with five weeks of worsening thigh pain. Labs are notable for CSF with malignant cells. Brain and spine MRI reveal diffuse leptomeningeal carcinomatosis. His course is complicated by severe pain that requires increasing doses of opioids. During his hospitalization, the patient develops worsening headaches, [...]

Case Presentation: A 27 y/o M presented after an episode of confusion and abnormal behavior. Patient reported 1 week of intermittent headaches, nausea, emesis, and dizziness. He had no sick contacts or recent travel. Family history was significant for SLE. On exam he had diffuse weakness but was otherwise neurologically intact without meningeal signs. Initial [...]