Case Presentation: A 23-year-old man with cystic fibrosis presented to the Emergency Department with a two-day history of gradual, persistent, right sided abdominal pain associated with dark, tarry stools. He was afebrile with unremarkable vital signs. Exam was notable for generalized abdominal tenderness most noticeable in the right lower quadrant and a normal rectal exam. [...]

Background: Sepsis is one of the leading causes of admission to intensive care units (ICU), and it is one of the most expensive conditions treated in United State Hospitals accounting for $20.3 billion or 5.2% of total hospitalization cost. Idiopathic pulmonary fibrosis (IPF) is one of the leading causes of interstitial lung disease, with currently [...]

Background: Myelofibrosis is a chronic myeloproliferative neoplasm characterized by progressive bone marrow fibrosis and extramedullary hematopoiesis leading to splenomegaly. Progressive splenomegaly is common in advanced myelofibrosis, and spleen volume is a predictor of survival. The oral selective small-molecule JAK 1/2 inhibitor ruxolitinib is used for symptomatic management of intermediate-2 and high-risk myelofibrosis, and leads to [...]

Case Presentation: A 31 year old male with cystic fibrosis presents to the ER complaining of episodic, sharp, and diffuse abdominal pain associated with nausea, vomiting, and obstipation for 3 days. On physical examination, the patient’s abdomen was distended and diffusely tender to palpation, with hypoactive bowel sounds, and no palpable masses.  CT abdomen revealed [...]

Case Presentation: A 78 y/o M with PMH of papillary thyroid CA, BPH, and primary myelofibrosis of the bone marrow (has JAK2 mutation, leukocytosis and thrombocytosis, has not received therapy to date) presented with 8 day history of early satiety, fatigue, and new increasing ascites. An inItial diagnostic paracentesis showed SAAG = 1.1, total protein [...]

Case Presentation: A 44 year-old Hispanic female with a past medical history of hypothyroidism presented from her endocrinologist with a diffuse, maculopapular rash, including the face, hands, wrists, torso, arms and legs. The rash had been intermittent for the past six years, painful, pruritic, and exacerbated by sunlight. She also complained of joint pain and [...]

Case Presentation: A 50 year-old African American male with type 2 diabetes requiring insulin, end stage renal disease on peritoneal dialysis, coronary artery disease, infertility, chronic pancreatitis, alcohol use disorder, and recent influenza presented with fever and cough. He was afebrile, hypotensive, tachycardic, and tachypneic with a leukocytosis and bibasilar consolidations on chest x-ray. He [...]

Case Presentation: A 54-year-old female with hypertension and tobacco use presented with two months of new onset constipation and progressively worsening, diffuse, generalized abdominal pain, early satiety, and a 30-pound weight loss. She was found to be anemic. A colonoscopy was performed that was unremarkable. Two months later, with no symptomatic improvement with laxatives, she [...]

Case Presentation: A 19-year-old male presented with three days of fevers, cough, and pleuritic chest pain. He had a history of cystic fibrosis (CF) with lung and pancreatic involvement and allergic bronchiopulmonary aspergillosis (ABPA). Home medications were albuterol, dornase alfa, 3% normal saline, inhaled tobramycin, voriconazole, and pancrelipase. He was febrile, tachycardic, and had diminished [...]

Case Presentation: Case 1: A 66 year old female presented in October 2017 with generalized weakness, fatigue, abdominal pain, and oliguria. The symptoms have been worsening since her abdominal endovascular aneurysm repair (EVAR). She had her EVAR done in August 2017. In the Emergency Room the patient was afebrile with a temperature of 36.4 C, [...]