Case Presentation: We present a case of a 20-year old male with past medical history of polysubstance abuse and major depressive disorder who was found unresponsive by his roommate in the morning after black tar heroin use. Roommate injected Narcan without effect and called EMS. Roommate reported both the patient and himself were chronic heroin [...]

Case Presentation: A 33 year old male with systemic lupus erythematosus (SLE) complicated by recurrent diffuse alveolar hemorrhage (DAH) presented with ataxia, lethargy, cough, and dyspnea. He had been recently exposed to high intensity immunosuppression for his DAH as it was thought to be secondary to SLE. However, it was later diagnosed as herpes simplex [...]

Case Presentation: A 33-year-old male without significant medical history experienced visual changes, left-sided tingling and weakness, vertigo, nausea, and mild expressive aphasia for 2 months. At that time, he had mild upper extremity tremor and was able to walk, drive, and perform activities of daily living. On physical exam, the patient demonstrated left upper extremity [...]

Case Presentation: A 60-year-old female with history of hypertension, rheumatoid arthritis on Adalimumab, and end stage renal disease (ESRD) due to lupus nephritis for which she was recently started on mycophenolate and high dose steroids, presented with 2-3 hour history of sudden onset severe occipital headache, followed by vomiting episodes and complete loss of vision. [...]

Case Presentation: 46-year-old female patient with a past medical history of ESRD on hemodialysis, DVT on chronic anticoagulation with apixaban, chronic HFrEF and history of injectable drug use (fentanyl) who presented with a chief complaints of progressive headache followed by rapidly progressive confusion requiring intubation for airway protection. Diagnostic lumbar puncture was considered however deferred [...]