Case Presentation: A 81 year-old Caucasian male presented to the emergency department with fever and altered mental status for two days. Further chart review revealed history of nausea, vomiting, myalgias, abdominal pain, and unintentional 35 pound weight loss over the six months prior. At the time of admission the patient was lethargic, febrile and tachycardic. [...]

Case Presentation: A 71-year-old male with no known past medical history presented with chief complaint of fatigue associated with generalized weakness, malaise, slurring of speech and body aches specifically upper and lower back pain for 3 weeks. He reported working in the woods. Vital signs were unremarkable. Physical exam was remarkable for a faint erythematous [...]

Case Presentation: A 41-year-old gentleman with history of spinal trauma status post several spinal surgeries and chronic arachnoiditis presented to the emergency department reporting vertigo, generalized weakness, headache, and fever developing over the past two days. On exam he was alert and oriented, with irregularly irregular tachycardia, tachypnea, and a temperature of 39.2°C. Additionally and [...]

Case Presentation: A 71 year-old man with no medical history presented in October with fevers, headache, neck stiffness, photophobia, and confusion for 3 days. Per family, patient was fully functional with no memory deficits at baseline. He never traveled outside of New York tri-state area and has had no sick contacts or insect bites. Initial [...]

Case Presentation: An 86-year-old woman with history of EBV encephalitis four years prior presented for altered mental status and emesis in September. Previously, the patient was able to perform all activities of daily living. A week prior to presentation, patient developed a cough and was noted to have slow mentation. Exam was notable for fever [...]

Case Presentation: A 40-year-old-male with history of diabetes type 1 and renal transplant on immunosuppression presents with 2 weeks of weakness, anorexia, and cough. Initial exam revealed temperature 102.8 but was otherwise normal. He was started on empiric broad-spectrum antibiotics. Two days after admission, he was found obtunded and dysarthric. He suffered an aspiration event [...]

Case Presentation: A 64-year-old Caucasian male with hypertension and diabetes mellitus presented to the emergency room with confusion, ataxia, and urinary retention after a 10-day cruise to Aruba. During the cruise, he developed fever, diarrhea, and a rash. After returning home, he visited a local ED and was treated with ciprofloxacin and metronidazole for febrile [...]

Case Presentation: A 35-year-old woman with no significant medical history presented with severe headache, neck pain, photophobia, fevers, nausea, vomiting, and petechial rash for 5 days. She had recently attended a large outdoor wedding in rural Iowa. On exam her vital signs were within normal limits and neurologic exam was without focal deficits or meningeal [...]

Case Presentation: Case 1- 83 year old male with past medical history of knee surgeries and lumbar laminectomy presented with acute onset of fever, confusion and left lower extremity weakness for the past three days. Physical examination confirmed the same. He was started on empiric antibiotics for epidural abscess. MRI brain and spine, ECHO and EEG [...]

Case Presentation: A 65-year old man with a history of coronary artery disease, heart failure, and Crohn’s disease, who is a resident of northern Wisconsin presented with fevers, headache, and neck stiffness. Due to concern for meningitis, he was started empirically on Ceftriaxone, Vancomycin, Ampicillin, and Acyclovir. One day after initiation of therapy, he developed [...]