Case Presentation: A 65 year old female with a history of type one diabetes presented to an outside hospital with malaise, fatigue, and fever for two weeks. Her social history was notable for frequently participating in the interactive game of Geocaching in the outdoors of southeastern PA. On arrival she had severe sepsis with a [...]

Case Presentation: A man in his late 70s presented to the emergency department after multiple falls and new onset altered mental status. Past medical history included hypertension, hyperlipidemia, chronic kidney disease (CKD) stage III, and previous infection with anaplasmosis over a decade prior.On clinical exam, the patient was afebrile, hypoxic, and meeting SIRS criteria with [...]

Case Presentation: An 81-year old healthy male from Upstate New York without significant past medical history presented as a transfer from an outside hospital with a 5-6 day history of fevers, malaise, vague abdominal pain, and worsening confusion. There was no travel outside of the local area in the previous six months. The patient was [...]

Case Presentation: A 23-year-old male with HgB SS sickle cell disease and iron overload due to chronic transfusions presented from an outside hospital with sickle cell pain crisis complicated by a total bilirubin level of 30 U/L. At the time of admission, his pain crisis had resolved. Physical exam revealed scleral icterus and gallbladder ultrasound [...]