Case Presentation: A 27-year-old man with HIV/AIDS was directly admitted to the hospital by his infectious disease specialist for worsening and recurrent headaches accompanied by a multitude of episodic neurologic symptoms, including off-balance sensations, left arm numbness and tingling, left-sided decreased hearing, and slurred speech.  He had a history of shingles five months prior which [...]

Case Presentation: A 30 year old well male presented with one day history of multiple episodes of loss of consciousness. Each episode lasted several minutes with no preceding warning. There was no limb jerking, tongue biting or confusion. One week prior, he was treated for shingles with oral acyclovir. His temperature was 37.9° Celcius. He [...]

Case Presentation: A 31-year-old male with past medical history of narcolepsy, migraine, anxiety, depression, and motor tics disorder presented to the hospital complaining of headache, left sided weakness and intermittent left upper extremity paresthesia for 3 days. Physical examination was remarkable for decreased left upper extremity sensation; motor strength was 5/5 in all 4 extremities. [...]

Case Presentation: An 83-year-old male with type 2 diabetes (hemoglobin A1C of 10.9) and recurrent herpes zoster presented with 3 days of worsening unilateral facial pain, headache, rash, and nausea. Of note, the patient had been vaccinated with the live varicella zoster virus (VZV) vaccine (Zostavax) 3 years prior. Physical exam revealed a right sided [...]

Case Presentation: A 52 year old African American male presented to the ED complaining of dyspnea that started 1 day prior. He denied having a fever, cough, or sick contacts. On presentation the patient appeared to be in respiratory distress. Initial vital signs: Temp 98.1, HR 105, SpO2 71% on room air, RR 36, and [...]

Case Presentation: 62-year-old male admitted following new onset generalized tonic clonic seizure lasting 5-6 minutes witnessed by mother. Per EMS on scene, he was agitated and required ketamine and midazolam while on route to the hospital. Upon admission, he was hemodynamically stable with physical exam only remarkable for raised maculopapular rash extending from the left [...]

Case Presentation: A 55-year-old female with history of hypertension, fibromyalgia, systemic lupus erythematosus, radiculopathy, anxiety disorder, and childhood varicella presented to an outside hospital for new onset altered mental status. She was diagnosed with acute non-hemorrhagic stroke of the right occipital lobe and anterior right frontal lobe without known cause or findings suggestive of vasculitis [...]

Case Presentation: A 63-year-old woman presented with a 4-day history of progressive dysphagia, first to solid food, then to liquids and oral secretions. She endorsed hoarseness and mild lateral neck and chin pain, but denied trauma, headache, neck stiffness, and rash. Her past medical history included gastroesophageal reflux and remote esophageal erosions with normal follow-up [...]

Case Presentation: An 85-year-old female with a history of non-Hodgkin’s B-cell lymphoma on Ibrutinib is brought into the emergency department (ED) by ambulance for generalized, progressive weakness and recurrent falls. She was recently diagnosed with herpes zoster 2 weeks prior, on her right upper extremity and denies being started on any medication. She complained of [...]

Case Presentation: A 31-year-old man with rheumatoid arthritis (on adalimumab, methotrexate, and prednisone) presented with a 3-day history of fatigue, severe asymmetrical weakness of the lower extremities (left > right), and painful vesicular rash spanning multiple dermatomes in the left > right lower extremities (Image 1). There was no evidence of myelopathy or meningismus on [...]