Case Presentation: A 66-year-old Hispanic male with a history of primary hypertension and type 2 diabetes mellitus presents to hospital with 3 months of progressive fatigue, poor appetite, watery diarrhea, dizziness, and vomiting. Vital signs were notable for postural hypotension (BP 146/84 sitting, BP 118/72 standing). Physical examination was normal with no skin or mucous [...]

Case Presentation: A 73-year-old woman with past medical history of metastatic endometrial adenocarcinoma previously treated with Pembrolizumab (stopped 4 months prior) presented with six weeks of persistent fatigue, myalgias, nausea, and vomiting. On presentation, she was noted to be hypotensive with labs notable for hyponatremia and hypomagnesemia. She appeared lethargic with dry mucous membranes and [...]

Case Presentation: A 66-year-old female with a history of stage IV non-small cell lung cancer (NSCLC) (90% PD-L1 +) on pembrolizumab (status post cycle 9) with metastasis to the left adrenal gland presented with a two-week history of malaise, nausea, and vomiting. Vital signs were stable and physical exam was euvolemic, with mild epigastric tenderness. [...]

Case Presentation: A 70 year old female with metastatic melanoma presented to the emergency department with fatigue and lethargy for one month. She had recently completed 6 cycles of Nivolumab and Ipilimumab and was currently receiving Nivolumab monotherapy. Over the past month, she had worsening fatigue associated with nausea and decreased appetite. Lab work one [...]

Case Presentation: A 42 year old female with history of pain, anxiety, depression, substance use disorder, and atrial septal defect who was admitted for workup of 6-7 months of fevers at home. She had been admitted about 1 month prior for workup of fever of unknown origin. Workup at that time revealed candida esophagitis, but [...]

Case Presentation: A 46 year-old man with decompensated cirrhosis (MELD 45) presented with dizziness and confusion for two days. He denied any other new symptoms. Home medications included lactulose, propranolol, pantoprazole, folic acid and thiamine. On arrival, the patient was normothermic (99.2 F), with bradycardia to 30-40 BPM and blood pressures of 80s/40s mmHg. He [...]

Case Presentation: A 50-year-old man visited our hospital with complaints of malaise, appetite loss, diarrhea, and arthralgia, all of which he had experienced for 5 days before the visit. Although he had been previously healthy and fit, he had visited a different hospital one month earlier because of the sudden onset of a headache and [...]

Case Presentation: A 22 year-old G1P1000 pregnant woman at 24 weeks presented with hypertensive urgency and newly diagnosed intrauterine growth restriction in the setting of pre-eclampsia. On admission her physical exam and laboratory data were unremarkable. The patient was admitted to maternal fetal medicine for closer fetal monitoring. On hospital day (HD) 9 she began [...]

Case Presentation: 59 year-old female with past history of uncontrolled asthma with multiple exacerbations requiring systemic corticosteroids, and recurrent episodes of non-traumatic rhabdomyolysis, presented with muscle aches. On exam, patient was hemodynamically stable and afebrile, with bilateral upper and lower extremity tenderness. Laboratory analysis was concerning for elevated creatinine kinase levels of 1127 U/L. Complete [...]

Case Presentation: A 54 year-old female presented to the ED with five days of fatigue, nausea, vomiting, and abdominal pain, increasing confusion, and somnolence after a recent viral illness. On physical exam, she was noted to have large, fixed masses in her breasts with bulky axillary lymphadenopathy. Upon further questioning, the patient revealed that she [...]