Case Presentation: A 40-year-old woman with a history of anxiety presented with one week of diffuse abdominal pain, associated with constipation, decreased oral intake, nausea, and bilious emesis three times a day. She was admitted to an outside hospital one month prior with similar symptoms and treated for pneumonia. The patient lives alone and denied [...]

Case Presentation: Type A Lactic acidosis is commonly caused by decreased oxygen delivery and poor peripheral perfusion. Type B lactic acidosis ensues in absence of hypoxia or tissue hypoperfusion, mostly occurring in alcoholism, mitochondrial dysfunction, medications like metformin. We present an unusual case of Type B lactic acidosis induced by nebulized albuterol in the treatment [...]

Case Presentation: A 65-year-old man with a history of nasal polyps was admitted to the hospital with a lactate of 10 mmol/L (0.5-2.2 mmol/L). He reported drenching night sweats and a 10-pound weight loss over the last 2-3 months. He noted orthostatic and ambulatory dizziness, as well as left-sided tinnitus, sinus pain, and nosebleeds over [...]

Case Presentation: A 91-year-old male with a known history of benign prostatic hyperplasia (BPH), diastolic heart failure, pulmonary embolism, hypertension, and previous extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) urinary tract infection (UTI) presented with encephalopathy. He was not tachypneic nor tachycardic, but his bicarbonate was low at less than 8, and his lactic acid [...]

Case Presentation: A 69-year-old woman, previously diagnosed with type 2 diabetes and managed with Metformin, along with a history of heart failure with preserved ejection fraction, was admitted to the hospital due to abdominal pain, nausea, vomiting, and diarrhea that had been ongoing for the three days leading up to her presentation. On arrival at [...]

Case Presentation: A 38 year-old female with history of asthma presented to the emergency department (ED) with symptoms of progressive dyspnea, wheezing, and dry cough, consistent with asthma exacerbation. In the ED, she was treated with continuous albuterol nebulizer for nearly 8 hours along with intravenous methylprednisolone.  Her clinical status worsened with increased work of [...]

Case Presentation: 60-year-old woman with a twelve-year history of presumed gastroparesis of unclear etiology, was admitted for worsening chronic abdominal pain, nausea and vomiting with unintentional weight loss of over 80 pounds over a year. Evaluation included normal laboratory findings and abdominal imaging. Upper endoscopy showed mild mucosal erythema with normal biopsies of the stomach. [...]

Case Presentation: A 30 year-old woman with a history of severe asthma presented with two weeks of progressively worsening dyspnea. She has a history of multiple hospitalizations and intubations in the setting of asthma exacerbations. She noted a non-productive cough, but denied any fevers, edema or recent sick contacts.  Symptoms persisted despite increasing albuterol use [...]

Case Presentation: A 71-year-old male presented to the ER with complaints of constipation for one week. He has a past medical history of coronary artery disease status post CABG, congestive heart failure with reduced ejection fraction, Type II diabetes, chronic obstructive pulmonary disease, obstructive sleep apnea, peripheral vascular disease and hyperlipidemia. The patient was recently [...]

Case Presentation: A 71 year old male presents to the ED with diffuse abdominal pain and nausea for the day. He has an extensive medical history including Type II DM, CAD, HFpEF, and COPD. He was recently prescribed Bactrim for a UTI, but notes persistent dysuria and suprapubic discomfort which prompted him to take an [...]