Case Presentation: 19 month old female with a history of unspecified T- cell immunodeficiency presented with a 10 day history of cough, fatigue, and persistent fevers. The patient had just returned from Mexico and reportedly was diagnosed with influenza there. Previously the patient had been on Bactrim prophylaxis, but ran out of it while in [...]

Case Presentation: A 44 year-old man who resides in Alexandria, LA presented via air ambulance from Honduras with three weeks of fever, night sweats, and right upper quadrant abdominal pain. He had associated nausea, vomiting, diarrhea, and headache. Exam was notable for fever and hepatomegaly. Serum studies revealed a creatinine of 6 mg/dL, elevated AST, [...]

Case Presentation: A 48-year-old female with AIDS, HFrEF, asthma, and hypertension presented with weight loss, fatigue, chills, abdominal pain, vomiting, left neck swelling, and purulent mouth drainage over the last 2-3 weeks. She was febrile to 102.9 F, hypotensive (85/64), tachycardic, tachypneic, and had firm, mobile, 2-3 cm cervical lymph nodes and enlarged tonsils. Labs [...]

Case Presentation: A 72-year-old-female presented to the ED with an 8-month history of intermittent, progressive, substernal chest pain. EKG showed normal sinus rhythm without ischemic changes and troponin was negative. CT Angiogram showed a moderate pericardial effusion and mild wall thickening of the thoracic aorta concerning for vasculitis. Cardiac MRI showed aortitis with mild pericarditis [...]

Case Presentation: A 55-year-old woman with a history of rheumatoid arthritis presented for generalized weakness, dysuria, nausea, and dizziness of 1 week duration. She developed progressive weakness with associated decreased exercise tolerance, nausea, and diarrhea. Her oral intake decreased. There was no inciting event and did not note any recent close contacts with similar symptoms.Her [...]

Case Presentation: A 42-year-old female presented to the emergency department with a 2-week history of jaundice, intermittent abdominal pain, hip pain, and fevers. Her past medical history was significant for ankylosing spondylitis. She was on chronic immunosuppression with prednisone, Plaquenil and Infliximab. Initial evaluation was remarkable for abnormal liver function and thrombocytopenia (Table 1). The [...]

Case Presentation: A 61-year-old male with biopsy-proven untreated pulmonary sarcoidosis presented with altered mental status and fever. He had recent admissions for occipital CVA after presenting with dizziness and blurred vision, and pulmonary emboli after presenting with fevers and dyspnea. Urinalysis and blood cultures were negative. (1-3)-B-d-glucan was elevated to 246 pg/mL (65 years), immunocompromise [...]

Case Presentation: A 23-year-old male with a history of migraines and a renal transplant presented to the ED with diffuse headaches and photophobia. He was treated with Ganciclovir and Doxycycline for positive HHV6 and Lyme disease, respectively. His MRI was negative for intracranial abnormalities but, CSF showed elevated protein and glucose. A repeat LP a [...]

Case Presentation: A 63-year-old man was admitted to the hospital medicine service at a quaternary center for painful oral lesions that appeared 6 months prior. The lesions had started as multifocal soreness in the mouth floor 2 weeks after having undergone dental work. He was then evaluated by local oral surgery team who performed biopsies [...]

Case Presentation: A 40-year-old man with untreated HIV presented with two weeks of worsening nausea, headache and diplopia. In addition, the patient had some confusion limiting his ability to recall pertinent medical history other than several years ago he was treated for a fungal brain infection. He denied any fevers, weight changes, abdominal pain, or [...]