Case Presentation: A 60-year-old woman with type 2 DM, hypothyroidism, and Stage IVB cervical squamous cell carcinoma presented for progressive fatigue and anorexia. During her hospitalization, she had recurrent episodes of hypoglycemia with fingerstick glucose readings as low as 33 mg/dL in spite of discontinuing all diabetic medications several months prior due to excellent glycemic [...]

Case Presentation: A 50-year-old woman with hypertension presented repeatedly to the emergency department over one year with cough, wheezing, and exertional dyspnea. She was treated on multiple occasions for presumed asthma exacerbations with steroids, antibiotics, and bronchodilators without improvement. Chest radiographs and EKGs were unremarkable.On her sixth visit, she reported progressive throat tightness and hoarseness [...]

Case Presentation: A 52-year-old man with hypertension, type 2 diabetes (HbA1c 8%), BMI 17 presented with progressive dyspnea and orthopnea. Examination showed jugular venous distension, bibasilar crackles, and pitting edema. Laboratory studies revealed BNP >5000 pg/mL, and troponin 133 ng/L. Transthoracic echocardiography showed reduced left-ventricular systolic function (EF 40–45%) consistent with new HFrEF. Evaluation for [...]

Case Presentation: A 30-year-old man presented with five days of progressive holocephalic headache, posterior neck pain, and photophobia. He denied fever, focal weakness, sensory disturbances, or recent trauma. He emigrated from rural Guatemala ten years prior. Meningeal signs were present, including nuchal rigidity and pain with neck flexion, but his exam was otherwise normal. Non-contrast [...]

Case Presentation: A 60-year-old female with type 2 diabetes, depression, and hyperlipidemia presented with a week of nausea, vomiting, abdominal discomfort, and fatigue. She denied fever, diarrhea, chest pain, or dyspnea. Since starting Tirzepatide 7.5 mg weekly three weeks prior, she had reduced oral intake and unintentional weight loss. Her diabetes was previously managed with [...]

Case Presentation: A 59 year old male with history of End Stage Renal Disease (ESRD) on Hemodialysis, Cerebrovascular disease and Hypertension presents to emergency department (ED) with single episode of bloody emesis and hemoptysis without associated abdominal pain or melena. On exam he was afebrile, hypertensive without tachycardia. His mucous membranes were dry, sclera non-icteric, [...]

Case Presentation: A 43-year-old male with anxiety and chronic back pain presented to the emergency department with altered mental status. He was found by family exhibiting incoherent vocalizations and agitated behavior, despite acting normally the previous day. Vitals revealed a fever of 100.5 F and heart rate of 127 BPM. On exam, he was diaphoretic, [...]

Case Presentation: A 33-year-old previously healthy man presented with fever, diffuse joint pain, muscle pain, and weakness after a recent gastrointestinal illness. Musculoskeletal exam revealed generalized muscle weakness and asymmetric synovitis involving large and small joints. Initial differential diagnosis included reactive arthritis given his recent diarrhea, though his presentation prompted concern for sepsis due to [...]

Case Presentation: A 59-year-old male with a past medical history of hypertension and cocaine use disorder presented to the emergency department for altered mental status (AMS) and weight loss. For two months he had been having progressively more frequent episodes of left facial grimacing with sudden flexion of the left arm. Additional symptoms included progressive [...]

Case Presentation: A 62-year-old male with no significant past medical history presented with a two-month history of diffuse rash, generalized weakness, fever, weight loss, progressive dyspnea and recurrent bronchitis and pneumonia unresponsive to outpatient antibiotics. On admission, he was febrile (102.9 F), hypoxic, tachycardic and hypotensive. On physical exam, he appeared ill with bibasilar crackles, [...]