Altered Mental Status in a Psychiatric Patient: A Case of Anti-NMDA Encephalitis Case Presentation: 29-year-old female with a history of Bipolar I Disorder, in remission off medication, presented to the Psychiatric Emergency Department with hyperactivity, insomnia, impulsive purchasing and audiovisual hallucinations for two weeks. The patient was admitted to psychiatry for treatment of mania with [...]

Case Presentation: 17 year-old-male with a history of anti-NMDAr encephalitis three years prior presented with two days of confusion, agitation and insomnia. Associated symptoms included anorexia, blunted affect, slow movements and, though awake, refusal to respond or engage with others. Family also reported apparent hallucinations and associated aggression including biting. Neurologic examination with non-verbal patient, [...]

Case Presentation: Mr. L, a 37-year-old Native American man with alcohol abuse disorder presented to the emergency room with sub-acute development over two days of ataxia, bilateral lower extremity paralysis and loss of sensation below the nipple line. Five days prior, the patient began to feel lethargic and confused. His symptoms progressed to include significant [...]

Case Presentation: A 26 year old female with no past medicalor psychiatric history presented to our hospital by her friends after they reported complaining that she had been behaving impulsive and manic during the preceding week. As described by friends and family, patient had recently traveled from Arkansas to Chicago to visit her family. However [...]

Case Presentation: A 4-year-old presented with persistent fever, headache and vomiting. History was significant for a 5 day febrile illness 1 month earlier and a family history positive for late-onset rheumatoid arthritis in a maternal grandparent. Parents reported that 4 days following resolution of the illness, his fever (up to 104F) recurred and persisted daily [...]

Case Presentation: A 81 year-old Caucasian male presented to the emergency department with fever and altered mental status for two days. Further chart review revealed history of nausea, vomiting, myalgias, abdominal pain, and unintentional 35 pound weight loss over the six months prior. At the time of admission the patient was lethargic, febrile and tachycardic. [...]

Case Presentation: A 74-year-old man with a medical history of hepatitis C cirrhosis post-treatment was evaluated after he was found to have hepatocellular carcinoma on abdominal MRI. The carcinoma occupied almost the entire right hepatic lobe with macrovascular invasion without evidence of metastatic disease. The initial alpha-fetoprotein level exceeded 2000 nanograms per milliliter. Subsequently, the [...]

Case Presentation: A 39 year-old woman presented to our hospital in late August with non-neutropenic fever and a diffuse maculopapular rash involving her palms and soles. Past medical history was significant for HER2 positive, locally advanced inflammatory carcinoma of the breast. The patient had received neoadjuvant chemotherapy with adriamycin, cyclophosphamide, paclitaxel, pertuzumab, and trastuzumab two [...]

Case Presentation: A 62 year old woman with a history of hypertension suddenly developed a headache starting 3 days after receiving the influenza vaccine. The headache worsened and was associated with nausea, photosensitivity and vomiting. The next day she was lethargic, and that night, her husband states she sat up in bed and started “speaking [...]

Case Presentation: An 18-year-old woman admitted to the hospital due to a new-onset tonic seizure lasting five minutes. She had recent history of flu-like illness a few weeks earlier. A review of systems revealed auditory and visual hallucinations. On physical examination, she was drowsy and disorientated to time only, but was following commands. Neurological examination [...]