Case Presentation: A previously healthy 48 year-old Guatemalan male presented with malaise, anorexia, 20-pound weight loss. Three weeks prior, he had fever, chills, emesis and diarrhea. A thorough history revealed that the patient was having intermittent confusion with labile, tearful mood swings. Lab-work confirmed pancytopenia, hyponatremia and mild transaminitis. Abdominal ultrasound showed hepatosplenomegaly. MRI brain [...]

Case Presentation: A 56-year-old healthy man who presents with three days of fatigue and bilateral thigh pain. He was born in Puerto Rico but lives in Boston and had no recent travel. He denies alcohol or drug use. He works as a cook at an urban restaurant. Admission vitals and physical exam are unremarkable. Initial [...]

Case Presentation: A 46-year-old man presented with 1 week of fevers, chills, fatigue, myalgias, cough, hemoptysis, nausea, vomiting, diarrhea, and confusion. One month prior to presentation the patient started a new job performing sanitation and sewage work in basements. On presentation, he was afebrile, with pulse 98 and blood pressure 98/71. Exam was notable for [...]

Case Presentation: A 57-year-old man with past medical history of hypertension and left partial nephrectomy for renal cell carcinoma presented to the emergency department with several days of fevers, diarrhea, and fatigue. On examination, the patient was lethargic and febrile to 103°F with a blood pressure of 80/50mmHg. His labs were notable for an elevated [...]