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: A 52-year-old male with hypertension, sleep apnea, and polycythemia presented to an outside hospital for abdominal bloating and pain with emesis for 2 weeks. Labs showed WBC up to 26k/µl, AST of 166, ALT of 155, and total bilirubin of 2.8 mg/dl with normal range lipase and lactate. Initial CT abdomen pelvis (CTAP) [...]

Case Presentation: A 78-year-old woman with amyotrophic lateral sclerosis presented with abdominal fullness. She had undergone tracheal tube intubation, mechanical ventilation and percutaneous gastrostomy 4 years previously because of difficulty in respiration and ingestion. Upon physical examination, her abdomen was distended with board-like rigidity and her legs were cyanotic. Her blood pressure was 96/71 mm [...]