Case Presentation: A 71 years old white male, with a past medical history of severe eosinophilic asthma, was transferred to our hospital with hypoxemic respiratory failure and worsening infiltrates. Respiratory PCR was negative. The patient was febrile with T-max of 101 F, required 6 L of oxygen. Labs showed WBC 21,000, Hemoglobin was7.4, and Creatinine [...]

Case Presentation: A 72-year-old female never-smoker was admitted for progressive dyspnea, pleuritic chest pain, and non-productive cough after failing outpatient treatment for presumed community-acquired pneumonia based on chest x-ray findings. On arrival, she was afebrile, hemodynamically stable, and breathing comfortably on room air. Physical exam revealed pulmonary crackles and a clean-based ulcer on the lateral [...]

Case Presentation: A 14 y.o. male with acne presented to dermatology for follow up. Having failed multiple acne treatments he was started on isotretinoin. Approximately 6 weeks later he developed fatigue, non-purulent conjunctivitis, retrosternal chest pain associated with dyspnea, joint pains, and bilateral lower extremity muscle aches. He was evaluated by cardiology with normal cardiac [...]

Case Presentation: The diagnosis of a sexually active young male who presents with fevers, night sweats, weight loss with opportunistic infections and then found to have an acquired immunodeficiency is going to be HIV except when it isn’t. We present a patient with a presumptive diagnosis of HIV but a negative comprehensive HIV laboratory testing [...]

Case Presentation: A 79-year-old woman with a past medical history of uncontrolled hypertension, migraine, and chronic kidney disease stage 3 presented with one week of poor oral intake, nausea, vomiting, vague abdominal pain, and chronic nonproductive cough. Physical exam revealed poor skin turgor, and lungs with crackles bilaterally. Laboratory studies showed Creatinine of 5.31 mg/dl [...]

Case Presentation: A 65-year-old male with a past medical history of hypersensitivity pneumonitis/bronchiolitis, coronary artery disease, hypertension and hyperlipidemia was admitted for uncontrolled pain. Myalgias and fatigue were present for a month following a tick bite and shingles. He was treated with doxycycline 100mg twice a day for 14 days and valacyclovir 1g three times [...]

Case Presentation: Introduction: Hydralazine is an adjunctive antihypertensive medication that is associated with antineutrophil cytoplasmic antibody (ANCA) – associated vasculitis. Kidney involvement usually comprises a pauci-immune, necrotizing glomerulonephritis with crescents. We describe a rare case of hydralazine induced ANCA positive vasculitis with acute tubulointerstitial nephritis and without glomerular involvement. Case Report: A 74 year old [...]

Case Presentation: A 65 year-old female with past medical history of type 1 diabetes mellitus, renal transplant, breast cancer, sarcoidosis, and hypothyroidism presented with acute onset of severe pain, numbness, and weakness of bilateral upper and lower extremities. The patient developed rapidly progressive fatigue and weakness over three days following acute bronchitis six weeks prior. [...]

Case Presentation: A 43 year-old-woman with no known medical history presented with two months intermittent fever, cough, pleurisy, hematuria, and weight loss. On exam she had diffuse crackles and lower extremity edema. The patient was intubated for respiratory distress. Laboratory workup revealed acute anemia and urinalysis consistent with nephritic syndrome. Chest x-ray showed bilateral diffuse [...]

Case Presentation: A 54-year old man with active cocaine use and untreated hepatitis C presented with fever and rash. He last smoked cocaine 4 days prior to admission. In the next several days, tender enlarging rashes appeared on the left arm and legs. On admission he was febrile (100.5 F) with HR of 101 and [...]