Case Presentation: A 57 year-old African-American male with past medical history of osteoarthritis, opioid dependence secondary to arthralgia, and chronic bilateral lower extremity venous thrombi secondary to both protein C and protein S deficiency, presented with acute altered mental status resulting from synthetic cannabinoid intoxication. The pain was so severe; he was only able to tolerate [...]

Case Presentation: A 49-year-old actively competing male powerlifter presented to our institution for a second opinion of swelling, painful purpura, and necrotic skin ulcerations of the arms and legs. One month prior to presentation, he noticed swelling and discoloration of his right leg, and 10 days prior, he developed a painful ulceration with a central [...]

Case Presentation: An 81-year-old man with a history of heart failure (HF) and recent diagnosis of an ileocecal mass with associated bulky lymphadenopathy and peritoneal carcinomatosis (Figure 1) presented to the emergency room with decreased appetite, abdominal pain, and worsening abdominal distention. Upon arrival, the patient was afebrile and hemodynamically stable. Physical examination was remarkable [...]

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: Our patient is a 77-year-old female with no past medical history who presented with two weeks of dyspnea on exertion, scant hemoptysis, and rhinorrhea with occasional blood. Vitals showed tachycardia, tachypnea, and hypoxia with saturations 95% on 15 L/min via heated high flow nasal cannula. Exam revealed accessory muscle use, faint bibasilar rales, [...]

Case Presentation: A 45-year-old male with a history of smoking and hypertension presented to his primary care provider for progressive left-sided pleuritic chest pain without night sweats or fever and reported 2 months of intentional weight loss with diet and exercise. He was sent for an outpatient CT which revealed splenomegaly of 16x19cm with possible [...]

Case Presentation: A 49 year old Hispanic male presented with epigastric abdominal pain for 2 months, nausea and vomiting without a significant past medical history. He rarely consumed alcohol and denied any recent trauma. He presented one month earlier with similar symptoms and due to noted cholelithiasis on abdominal ultrasound, he was diagnosed with gallstone [...]

Case Presentation: A 70 year-old female with hypertension and diabetes presented to the hospital with a one-day history of non-positional, left-sided chest pain associated with shortness of breath and subjective fevers. Physical exam and vitals were unremarkable. Work up included three negative troponins, EKG in normal sinus rhythm (Figure 1), and D-Dimer of 1100 ng/mL. [...]

Case Presentation: A 20 year old man with history of Systemic Lupus erythematous (SLE) with Lupus nephritis presented to the hospital with cough and hemoptysis for the past few days. He was found to have severe anemia (5.4 mg/dl), thrombocytopenia (52,000/mm3), elevated LDH (829), low haptoglobin (<8), hypocomplentemia (low C3 and C4), schistocytes on peripheral [...]

Case Presentation: A 75 year old male was transferred into the ICU, already intubated, requiring antibiotics and pressors. He was hypotensive, tachypnic with respiratory distress, had severe oliguric AKI with serum creatinine of 6.0, and anemia with hemoglobin below 7.0. His initial CXR and CT showed scattered bilateral pulmonary opacities. After he did not improve [...]