Case Presentation: A 49 year old female with a history of Depression and Multiple sclerosis (MS) presented with acute psychosis in the setting of recent polysubstance abuse.  The patient endorsed both visual and auditory hallucinations; stating she saw bugs and could hear her dead father calling her. In addition, the patient was convinced that her [...]

Case Presentation: A 32 year old Caucasian female with a fourteen year history of relapsing-remitting MS was admitted to the hospital for evaluation of severe headache, fatigue and dizziness. On physical exam she was tachycardic and very pale. Pertinent labs were as follows: hemoglobin (Hb) 4.1 mg/dL (baseline Hb 10.5 mg/dL), red cell distribution width [...]

Case Presentation: 41 years old Hispanic gentleman with no significant past medical history who presented to the hospital for difficulty walking and diarrhea.Over the last four years, he has had watery non-bloody diarrhea multiple times daily. He reported one bloody bowel movement a week before his presentation. He had lost a significant amount of weight [...]

Case Presentation: A 37-year-old female veterinarian with past medical history of migraines was diagnosed with multiple sclerosis (MS) in December 2015. In April 2016, she was admitted with 3weeks of progressive dysphagia and 20lb weight loss. Although MRI of the brain and cervical spine obtained during admission showed no new lesions, her symptoms were initially [...]

Case Presentation: Teriflunomide is a pyrimidine synthesis inhibitor used in management of Relapsing Remitting Multiple Sclerosis (RRMS). Leflunomide is the active agent which has been used in rheumatoid arthritis. Chronic diarrhea has been associated with both of these. However, there is no evidence in literature to suggest clostridium difficile (C.Diff) diarrhea associated with these agents. [...]

Case Presentation: We present a 59-year-old female with a past medical history of uterine fibroids and osteoarthritis who initially presented to the emergency department with a stroke alert for 10 days of slurred speech and facial droop. The patient was traveling with her husband in San Diego 2 weeks prior. Upon her return, she noticed [...]

Case Presentation: A 33-year-old woman presented with self-inflicted stab wounds to her neck and abdomen. Though she was initially alert and following commands, she was unwilling to provide a medical history and only shared that she had been experiencing headaches for three weeks prior to presentation.Labs were unremarkable, but CT scan on admission showed right [...]

Case Presentation: A 26-year-old male without prior medical history was referred by a spine surgeon to the emergency department (ED) with weakness, numbness, and discoordination of the right leg, worsening over a four month period and resulting in multiple falls. He reported three weeks of urinary and bowel urgency and incontinence. He had a family [...]

Case Presentation: A 59-year-old African-American female presented to our hospital with fatigue, exertional dyspnea and dark cola colored urine for two weeks. She was diagnosed with RRMS in 2009 and had been taking IFN-β since then with good response and no complications. Family history was significant for colon cancer in her mother, but no hematologic [...]

Case Presentation: Patient A is a 59-year-old man with medical history of hypertension, asthma, benign prostate hyperplasia, daily marijuana use and occasional alcohol use who presented with acute onset of progressive weakness of his right upper extremity and right lower extremity. He had been assaulted to the face but denied any neck or back injury [...]