Introduction: Right bundle branch block with ST-segment elevation in leads V1 through V3 is the electrocardiographic (ECG) marker of the Brugada pattern. The Brugada pattern was first described as a genetically, autosomal dominant, determined disease caused by mutation in the sodium channel. However over time, the Brugada pattern has also been reported to be transient, [...]

Case Presentation: A 51-year-old male with a history of recent pneumonia and cocaine use (most recently 4 weeks prior) presented to the emergency department for shortness of breath. Exam demonstrated decreased left sided breath sounds with x-ray confirming left lower lobe consolidation and effusion.  Labs revealed neutropenia and a negative urine drug screen.  Neutropenia was [...]

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 [...]

Case Presentation: A 19-year-old female with mild persistent asthma, borderline personality disorder, and substance abuse presented with three days of a non-productive cough and dyspnea. She endorsed generalized malaise and body aches, without fever or chills. In the emergency department she was tachypneic and hypoxic to 87% on room air. A chest X-ray showed a [...]

Case Presentation: A 47-year-old African American woman with poly-substance abuse presented with a facial rash, bilateral hand joint pain and painful ulcers to the lower extremities for one week. Physical examination revealed violaceous tender skin lesions on the bilateral helices and right naris. There was mild erythema to the malar area involving the naso-labial folds. [...]

Case Presentation: 29 y.o. female with a history of autoimmune hepatitis presented with worsening lower extremities ulceration. The onset of rash was four months ago during which she visited dermatology clinic. Vitals signs were within normal limits, physical examination was consistent with large deep necrotic painful ulceration with violaceous erythema, retiform purpura on bilateral lower [...]

Case Presentation: A 40-year-old Caucasian male with a past medical history of polysubstance abuse, with a preference for cocaine, presented to the emergency department complaining of right groin pain. He was diagnosed with purulent cellulitis and broad spectrum intravenous antibiotics were initiated. Initial blood work found low WBC (3.7 x 103/mcL), with a low neutrophilic [...]

Case Presentation: A 54 year old woman with history of substance abuse(cocaine and recent synthetic marijuana use) presented to the emergency room with complaints of sudden onset, severe left upper and lower quadrant abdominal pain. Pain started at night waking her up from her sleep. Complete blood count showed microcytic anemia with hemoglobin of 8.4. [...]

Case Presentation: The prevalence of cocaine use is growing worldwide. Damaging effects of cocaine on the cardiovascular, neurologic, and pulmonary systems are well-established. In recent years, evidence has emerged for cocaine-induced damage to other organs, such as the liver and kidney. This is a case of end-organ damage from regular cocaine use. A 65-year-old man [...]

Case Presentation: A 67 year- old man presented with three weeks of progressively worsening painful ulcers in bilateral lower extremities and fingers. The lesions started as numerous erythematous lesions on his legs and fingers five months ago that subsequently turned into inflamed blisters and ultimately evolved into painful crusted ulcers. He was treated with antibiotics and [...]