Case Presentation: A 29-year-old otherwise healthy man presented to the emergency room with five weeks of progressively worsening pruritus and fatigue. The patient denied recent ingestion of herbal supplements, and reported lifetime abstinence from alcohol use. Physical exam revealed jaundice and scleral icterus. No ascites or hepatomegaly were noted on initial exam. Admission labs revealed [...]

Case Presentation: A 73-year-old man with a past medical history of pancreatic adenosquamous carcinoma, biventricular heart failure with reduced ejection fraction (30-35%), and paroxysmal atrial fibrillation presented to the hospital with a 2-day history of bilateral lower extremity edema and 5-pound weight gain. Physical exam was notable for tachycardia, jugular venous distension, scleral icterus, and [...]

Case Presentation: 59 years old Hispanic male with history of alcoholic cirrhosis, esophageal varices that presented with 1 day history of abdominal pain and worsening renal function. Patient gets therapeutic paracentesis every 2 weeks, and the last one was one day prior his presentation. He was seen by his PCP who instructed him to present [...]

Case Presentation: This patient was a 44-year-old female with a past medical history of localized scleroderma (morphea) of the breast diagnosed by punch biopsy. She presented to the emergency department with right upper quadrant pain and nausea. At that time, a CT scan showed a heterogeneous liver without a definitive underlying mass. Her workup revealed [...]

Case Presentation: A 65 year old male with no significant medical history presented to an outside facility complaining of fatigue, weakness, nausea and vomiting. He had moderate alcohol history and significant weight loss over the past 6 months. Initial lab workup was notable for elevated liver transaminases with a hepatocellular pattern, Maddrey score of 53.6 [...]

Case Presentation: A 68-year-old Caucasian male with a history of stage IV follicular lymphoma treated with rituximab and bendamustine presented with generalized malaise, weakness, and acute encephalopathy of two weeks.He was hypotensive and his exam showed dry mucous membranes and poor skin turgor. Laboratory examination was remarkable for: creatinine 7.6 mg/dL, AST and ALT 691 [...]

Case Presentation: A 21-year-old male with end-stage renal disease for 3 years (cause unknown) presented to the hospital with a 19lb weight loss (10% of body weight) over 2 months. Exam was notable for jaundice, diffuse abdominal tenderness, and innumerable purple, papular lesions covering his body, which he had noticed for 8 months. Labs revealed [...]

Case Presentation: We present a 96-year-old male who presented to the emergency department with syncope and worsening fatigue. He noted yellowing of his eyes and skin, clay colored stools and dark urine. He had a remote cholecystectomy but no prior liver disease and denied alcohol use.Physical exam revealed prominent jaundice and scleral icterus with a [...]

Case Presentation: A 95 year old woman with a remote history of treated breast cancer and endometrial cancer presented to the hospital with severe abdominal pain and somnolence. One month prior, the patient was living independently in her usual state of health. She developed dysuria and malaise and visited an outside hospital. Routine laboratory testing [...]

Case Presentation: IntroductionMost cases of mushroom ingestion are benign with fatalities being rare. Symptoms range from acute gastro-enteritis to psychotropic manifestations that are usually self-limiting. Our case highlights a unique case of mushroom poisoning fatality The Case 72 y.o F Korean visitor to NE USA presented with acute onset of emesis, diarrhea, abdominal pain and [...]