Case Presentation: A 65-year-old male presented to the emergency department with a 5-week history of epigastric pain, nausea, constipation and weight loss. Past medical history was significant for combined liver and kidney transplant 3 years prior due to hepatitis C cirrhosis and hepatorenal syndrome. Chronic immunosuppression consisted of mycophenolate mofetil, tacrolimus and prednisone. Laboratory studies [...]

Case Presentation: Mr. A is a 53-year-old male who presented with a painful thigh. The patient was released from prison one week prior and had been living under a bridge next to a creek ever since. On the day of admission, Mr. A decided to bathed himself in the creek. As he was wading through [...]

Case Presentation: A 49-year-old male with history of cirrhosis and hepatocellular carcinoma secondary to alcohol use and alpha-1 antitrypsin deficiency, who underwent liver transplant 1 month prior that was complicated by a bile leak at the biliary anastomosis requiring stenting, presented to the hospital for sudden onset of fever, chills and headaches. He was on [...]

Case Presentation: A 19-year-old male with a history of trauma, depression, anxiety, foster system placement, and poorly controlled type 1 diabetes mellitus (T1DM) (A1C>14) with frequent admissions for diabetic ketoacidosis (DKA) presented with presyncope and 2 weeks of severe epigastric and RUQ abdominal pain. He endorsed inconsistent insulin use and frequent dietary indiscretion in part [...]

Case Presentation: A 63 year-old woman with a history of liver transplant presented to a rural hospital for evaluation of rigors, nausea and vomiting. Her post-transplant course had been complicated by HCV recurrence treated successfully with interferon and ribavirin; cirrhosis, and refractory gastric variceal bleeding for which she received a transjugular intrahepatic portosystemic shunt (TIPS) [...]

Case Presentation: A 14-year-old healthy male presented with throbbing, right sided abdominal pain, intermittent headache, and bilateral neck and shoulder pain in the setting of six days of fever (temperature max 103° F). He had a history of a normal endoscopy after elevated stool calprotectin that normalized without intervention. Exposure history was notable for freshwater [...]

Case Presentation: A 34-year-old man with a recent history of perforated appendicitis was admitted with a 2-week complaint of nausea, vomiting, abdominal pain and fever. His past history only included an appendectomy 6 months prior, with no history of intravenous drug use, prior diverticulitis, or biliary disease. On exam, he was febrile to 101.1°F, tachycardic, [...]

Case Presentation: A 70-year-old female with coronary artery disease (s/p drug-eluting stent x 2 10 years ago), Type 2 Diabetes Mellitus, rheumatoid arthritis, Chronic Obstructive Pulmonary Disease, and remote history of bladder cancer presented to the emergency department with two weeks of nausea, jaundice, dark colored urine, loss of appetite, and clay-colored stool. The patient [...]

Case Presentation: A 40-year-old female with adult-onset Still’s disease (AoSD) refractory to methylprednisolone and who had been recently started on anakinra 2 months prior to hospitalization was admitted with 2 weeks of fatigue, nausea, diffuse pruritis, jaundice, and intermittent fevers and rash. Exam was notable for jaundice and salmon-colored rashes on her trunk and back. [...]

Case Presentation: A 51-year-old male with a history of alcoholic liver cirrhosis presented with severe bilateral leg pain associated with nausea, vomiting, and diarrhea, after consuming raw oysters 36 hours prior to admission. Physical exam revealed an encephalopathic obese man with a temperature of 38.2oC, heart rate of 102 bpm, and BP of 85/50 mmHg. [...]