Case Presentation: A 61 year old female presented to the emergency department with 1 day of nausea, vomiting, and fever. The day prior to her symptom onset, she had undergone a colonoscopy for colon cancer screening that was normal. Her medical history was notable for splenectomy in 2000 for a hamartoma.On presentation, her temperature was [...]

Case Presentation: A 65 year-old woman with a history of renal cell cancer status post nephrectomy and breast cancer treated with lumpectomy and radiation presented with three weeks of progressive lower extremity weakness and confusion. She had poor short-term memory, word-finding difficulties, and difficulty walking. She had no fever, night sweats, or weight loss. Exam [...]

Case Presentation: A 60-year-old, Guatemalan female without prior medical history presented with a transient, erythematous, burning, rash involving her extremities and torso (Figure 1). Additional symptoms included fatigue, chills, joint pain, early satiety and weight loss. Blood counts, metabolic panel and serum protein electrophoresis were normal. C-reactive protein (13 mg/L, normal (N)

Case Presentation: A 88-year-old female presented to an outpatient office with 3 weeks history of severe progressive bruising and ecchymosis which initially developed on left wrist and then spread to bilateral upper extremities, upper trunk and bilateral breast. Patient was recently diagnosed with intraductal adenocarcinoma of right breast (T2,N2,M0, Stage IIB). She declined surgery and tamoxifen (20 [...]

Case Presentation: A 19 year-old Caucasian woman presented with progressive fatigue, dyspnea on exertion and dizziness for 3 weeks. Her symptoms were preceded by an unknown bug bite approximately 3 weeks ago. She was seen in urgent care two weeks prior to admission and given a course of unknown antibiotics and started on steroids. She [...]

Case Presentation: A 74-year-old female with a history of restless leg syndrome, hypertension, GERD, presented with worsening fatigue, shortness of breath, and anasarca over the last 6 months. Labs revealed anemia (hemoglobin, 8.0 g/dL), thrombocytopenia (platelet count, 46K/μL), reticulocyte count 11.4%, undetectable serum haptoglobin, serum LDH >2700 U/L, ferritin 1223 ng/mL, negative direct Coomb’s test, [...]

Case Presentation: A 94-year-old woman with a history of atrial fibrillation (not on anticoagulation), coronary artery disease, and metastatic lung adenocarcinoma (on Osimertinib) presented following a syncopal episode, which was complicated by a left thigh hematoma. On admission, she was hemodynamically stable, although her bloodwork was concerning for disseminated intravascular coagulation (DIC) including a hemoglobin [...]

Case Presentation: A 64-year-old male with a medical history of psoriatic arthritis on etanercept, coronary artery disease, adrenal insufficiency and alcohol use disorder who presented to the hospital with complaints of weakness, fatigue, night sweat, and transient slurring of speech. Physical examination was normal. Laboratory investigation showed Hemoglobin of 10, Platelets 150, WBC 6, CRP [...]

Case Presentation: A 43-year-old woman was admitted to the hospital for increasing lower extremity swelling and dyspnea on exertion. Past medical history is pertinent for hypertension, obesity, and stroke. A few months prior, she had a hysterectomy for leiomyomata. Physical examination was within normal limits except for jugular venous distension and irregular heart rate and [...]

Case Presentation: A 71-year-old man with type 2 diabetes mellitus, hypertension, coronary artery disease, and peripheral arterial disease presented with worsening bilateral lower extremity pain which started two days prior to admission. Physical exam revealed cold and pale lower extremities, tenderness, and absence of pulses on both lower limbs but no edema or ulceration. Range [...]