Background: Acute decompensated heart failure exacerbation is the leading cause of hospitalization in the United States. It was associated with total medical costs of more than $30 billion in 2012 with projections estimating around $70 billion in costs by 2030. Currently, six million people in the U.S. have heart failure, with a little over half [...]

Case Presentation: A 46-year-old female with a past medical history of hypertension, diabetes mellitus, and asthma who initially presented 2 weeks prior to the emergency department for right-sided facial paralysis and was diagnosed with idiopathic facial paralysis (Bell’s palsy). Despite being started on prednisone and valaciclovir, 2 weeks later she had suddenly developed left-sided facial [...]

Case Presentation: A 49 year-old man with a recent diagnosis of myasthenia gravis presented with 3 days of fever up to 103, rhinorrhea, frontal headache, mild lower extremity weakness, a mildly productive cough, and a leukocytosis to 16. As he had been started on prednisone and azathioprine 10 days prior to his presentation, he underwent [...]

Case Presentation: A 73 year old man with a past medical history notable for type 2 diabetes and hypothyroidism presented with ten days of dark urine and jaundice. He had developed worsening jaundice, pruritus, and a five pound weight loss prior to presentation. Labs showed alkaline phosphatase 731, ALT 369, AST 174, total bilirubin 5.64 [...]

Case Presentation: A 55-year-old female with a past medical history of stage IV intranasal mucosal melanoma (status post resection of the nasopharynx, medial maxilla, floor of the sphenoid sinus, and clivus – two years prior) and current use of nivolumab presented to the hospital with two weeks of a worsening, pressure-like right temporal headache and [...]

Case Presentation: A 23 year-old man with schizophrenia presented to the emergency department complaining of nausea, vomiting, headache, and subjective fever, followed by acute onset of right lower quadrant abdominal pain. His medications included chlorpromazine and benztropine. Vital signs: temperature 39 degrees C, pulse 155, respirations 18, and blood pressure 116/58. Admission exam was remarkable [...]

Case Presentation: A 61-year-old Indian man with past medical history of type 2 diabetes mellitus and dyslipidemia presented with a 3-month history of intermittent dry cough associated with fevers, chills, night sweats, and generalized weakness. He worked in California as an engineer doing home remodeling, never smoked, and had no sick contact, or animal exposure. [...]

Case Presentation: A 9-year-old female presented with two months of hyperpigmented skin and stiffness mainly in her lower extremities. She had difficulty brushing her hair and walking accompanied by weight loss and dyspnea. On examination, diffuse hyperpigmentation and peau d’orange skin changes were observed with the “groove sign” on her right medial thigh. She also [...]

Case Presentation: A 40-year-old Caucasian male presented with a recent diagnosis of stage IV metastatic duodenal adenocarcinoma. Given the metastatic disease, after duodenal stent placement, the patient started on adjuvant mFOLFOX6 chemotherapy. During the second day of the first cycle of chemotherapy, the patient suddenly experienced complete right-sided weakness, headache, confusion, and slurred speech. He [...]

Case Presentation: We present a multicenter 3 case series of a rare, but important sepsis mimic.Case 1 72-year-old female presented with generalized abdominal pain. Labs showed acute renal failure, lactic acidosis, thrombocytopenia and markedly elevated LFTs. She was treated for presumed sepsis with broad spectrum antibiotics. She developed a coagulopathy, DIC, and Pancytopenia requiring blood [...]