Case Presentation: A 62-year-old male with a history of paroxysmal atrial fibrillation presented with hypotension and 2 week history of chest pain after an ablation with pulmonary vein isolation. Transthoracic echocardiography demonstrated a pericardial effusion. Pericardial fluid sampling revealed an elevated leukocyte count of 130,000 cells per cubic millimeter and culture grew rare strep mitis/oralis [...]

Case Presentation: An 85-year-old female with a medical history of hypertension, hyperlipidemia and tobacco abuse presented to the ED with a several day history of intermittent, non-radiating substernal chest pain that occurred at rest. Physical exam revealed normal vital signs, regular cardiac rhythm, no murmurs or gallops, clear lungs, and no jugular venous distention or [...]

Case Presentation: A 58-year-old man with a medical history of recurrent acute on chronic pancreatitis due to alcohol use disorder presented with a 3-day history of right-sided pleuritic chest pain and dyspnea. Chest X-ray revealed a new large right-sided pleural effusion.   Analysis of the aspirated serosanguinous exudative pleural fluid yielded a total amylase of 24,600 [...]

Case Presentation: A 36-year-old Haitian female presented with a four-month history of “pus like drainage from a left abdominal wall opening”. It began with left flank pain followed by a “bump” in that area which progressed to a chronic draining fistula. There was associated lumbar back pain,aggravated by walking and relieved by lying on her [...]

Case Presentation: A 41-year-old male with a past medical history of chronic alcoholic pancreatitis and right-sided pancreatic pseudocyst presented with shortness of breath and right-sided chest pain that began three days prior. Chest X-ray showed near-complete opacification of the right hemithorax. A diagnostic thoracentesis revealed an exudative pleural effusion with a pleural amylase level of [...]

Case Presentation: A 63-year-old female with no PMH or FH of heart disease presented to the ER with dyspnea and pressure-like central chest pain. She reported a 3-week history of cough, sore throat and rhinorrhea. On evaluation, vital signs were T 97.8°F, BP 143/85 mmHg, HR 150/min, RR 20/min and SpO297%. Physical exam was significant [...]

Case Presentation: A 62-year-old male with a history of paroxysmal atrial fibrillation presented with hypotension and 2 week history of chest pain after an ablation with pulmonary vein isolation. Transthoracic echocardiography demonstrated a pericardial effusion. Pericardial fluid sampling revealed an elevated leukocyte count of 130,000 cells per cubic millimeter and culture grew rare strep mitis/oralis [...]

Case Presentation: A 58 year-old Caucasian female presented with a history of painful lesions of the gluteal, perineal, and vulvar areas. These lesions had been progressive with worsening drainage and scar formation over the last decade. She was treated with multiple antibiotics and antifungals in the past without improvement. No lesions were seen in her axilla. [...]

Case Presentation: An 80 year-old female presented to the emergency room with shortness of breath and melena. She was afebrile, with blood pressure of 121/70 and heart rate 93. Labs showed hemoglobin of 5.2 g/dL with normal INR and platelet count. She underwent an upper endoscopy revealing a 2 mm clean-based duodenal ulcer. As this [...]

Case Presentation: We present a 68 year-old man, with a history of benign prostatic hypertrophy, who presented with several months of progressive personality changes and mild gait changes. His wife noticed he had become more introverted, and his gait had become more ataxic with prolonged ambulation. He also started having subtle memory problems. On physical, [...]