Case Presentation: A 56-year-old African American male with hyperlipidemia on a statin presented with two days of generalized abdominal pain, malaise, and weakness. Physical exam was unremarkable. Initial labs were notable for WBCs of 22.7 X103/ml, creatinine phosphokinase (CPK) of 28,992 U/L, BUN/Cr of 82/2.02, and AST of 957 U/L. Urine dipstick was positive for [...]

Case Presentation: A 73-year-old woman with a past medical history of hypertension and osteoarthritis presented to the emergency department with progressive right lower back pain after a mechanical fall, subacute oropharyngeal dysphagia, and diffuse proximal and distal muscle weakness. On presentation, she was afebrile with unremarkable vital signs. Her labs were significant for a WBC [...]

Case Presentation: A 64-year-old woman with a history of ankylosing spondylitis, Crohn’s disease, asthma, and prior diagnosis of drug-induced lupus presents for a diffuse pruritic rash. Six days prior, she developed a single flat violaceous lesion limited to her left jaw and urticaria on her chest. She was started on prednisone 60 mg by her [...]

Case Presentation: A 44 year old gentleman with a past medical history significant for Crohn’s disease presented for evaluation of painless jaundice and a pancreatic mass in the setting of significant unintentional weight loss and recent flu-like symptoms including night sweats, low-grade fever, and dizziness.  Prior to admission, the patient underwent computerized tomography of the [...]

Case Presentation: A 36-year-old female with a history of morbid obesity and hypertension presented with three weeks of progressive dyspnea and productive cough. She was previously diagnosed with community-acquired pneumonia and completed two five-day courses of azithromycin, without improvement in her symptoms. She denied smoking but reported increased smoke inhalation due to local forest fires. [...]

Case Presentation: A 73  year old female with borderline diabetes mellitus and hypertension presented to the emergency department with the sudden onset of nontraumatic swelling, pain and ecchymosis of her right leg. She did report receiving an influenza vaccination at her left arm 3 weeks prior to this visit resulting in bruising from her shoulder [...]

Case Presentation: A 50-year-old African American female with a history of mixed connective tissue disorder with positive ANA titer, speckled pattern 1:1280, and spindle apparatus pattern 1:640, presented with worsening dyspnea, numbness, and weakness of both lower extremities. Two days prior she received the first dose of COVID-19 mRNA vaccine and later developed nausea, vomiting, diarrhea, and anorexia.   In the emergency department, patient was found to have an elevated blood pressure of [...]

Case Presentation: A 32 yo male presented after 1 week of high spiking fevers and a pruritic rash. Sulfamethoxazole-trimethoprim had been started 5 weeks prior. Treatment was started with antihistamines, topical steroids, and prednisone 60mg daily without improvement. Exam revealed facial edema, conjunctival injection, and diffuse erythematous papules. No vesicles or bulla and Nikolsky sign [...]

Case Presentation: A 57 year-old female with a history of COPD and CKD presented with recurrent syncope. The patient reported a two year history of recurrent syncopal events and progressive worsening of orthostatic intolerance with inability to ambulate independently. She denied any gastrointestinal or urinary symptoms as well as changes in her sweating patterns. Blood [...]

Case Presentation: A 70-year-old Caucasian woman with history of hypertension, hyperlipidemia, and newly diagnosed atrial fibrillation presented with persistent exertional dyspnea, fatigue, malaise, and anorexia for the past few days. She was recently discharged for community-acquired pneumonia twice at another institution without improvement of nonproductive cough, mild proximal muscle weakness, and exertional dyspnea. She was [...]