Case Presentation: 84 year old previously healthy female with history of hypertension, Diabetes and chronic kidney disease stage 2 presented to the ER with dizziness. She reported light headedness with frequent room spinning while ambulating. She denied any other associated symptoms. In the ER she was noted to have a Blood pressure of 208/103 and [...]

Case Presentation: A 39-year-old male post-splenectomy due to hereditary spherocytosis presented with syncope, fatigue, fever and dark urine. He had associated tachycardia and fever. Physical exam was unremarkable. Labs showed an elevated lactate, creatinine, bilirubin, transaminases, and markedly elevated D-dimer. CBC was normal. He received IV fluid resuscitation and IV Rocephin. The patient subsequently desaturated [...]

Case Presentation: A 65-year-old female with a history of focal epilepsy and carotid stenosis with recent endarterectomy presented with four weeks of abrupt aphasia, right sided weakness and several days of altered mental status and unusual left-hand movements. Since the endarterectomy one month prior to presentation, her family reported cognitive decline, memory loss and increased [...]

Case Presentation: A 53-year-old male with a history of Goodpasture syndrome, systemic lupus, and Wegener’s granulomatosis underwent a deceased donor kidney transplant for end-stage renal disease. Two days post-surgery, the patient developed anemia and thrombocytopenia, elevated lactate dehydrogenase, and increased creatinine, prompting a preemptive diagnosis of TTP. Plasmapheresis was initiated every other day, alternating with [...]

Case Presentation: A 63-year-old male with past medical history of hyperlipidemia and diabetes mellitus presented to an outside hospital with diplopia and new onset weakness, paresthesia, and numbness in bilateral lower extremities three days following a mild viral infection. The patient was discharged after two days without acute intervention following extensive negative workup including imaging, [...]

Case Presentation: 62-year-old man with recent hospitalization for septic shock due to toe osteomyelitis,complicated by severe C. difficile infection requiring fecal transplant 3 weeks prior to admission,presenting with confusion,right-sided weakness,and ataxia.Symptoms were first noted 2 weeks after the fecal transplant and consisted of depressed mood and right shoulder weakness.Neurological exam was notable for neglect of [...]

Case Presentation: 49-year-old male patient with history of hypertension was sent by his nephrologist to the ER for unexplained worsening renal function and likely renal biopsy. Vital signs were stable, exam was unremarkable, however BUN was 85 mg/dL with creatinine of 10.1 mg/dL (baseline of 1.5 mg/dL). 24-hour urine protein excretion was 5.2 grams. The [...]

Case Presentation: We present the case of a physically active 41-year-old male with a history of anxiety and restless leg syndrome who presented to the emergency department with complaints of vertigo, left arm numbness, and voice changes that progressed over less than two days. Initial concerns for an acute ischemic stroke prompted a stroke code, [...]

Case Presentation: A 55-year-old female with alcohol use disorder and untreated hyperthyroidism was admitted to an outside hospital for abdominal pain, atrial fibrillation with heart rate in the 190’s, and hypotension requiring vasopressors and ICU care. Work up revealed low TSH (< 0.010 [range: 0.450 - 5.330]) and elevated free T4 (FT4) (4.74 [range: 0.60 [...]

Case Presentation: A 60-year old male gardener presented with generalized body aches, night sweats, chills, malaise, fevers and headache (frontal and occipital) intermittently for a month. He reported abdominal pain, dyspnea, joint stiffness and myalgia. Around 2 weeks prior, the pain intensified and he received a treatment for upper respiratory infection with azithromycin. He finally [...]