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 49-year-old male presented with altered mental status and diffuse body pain. He denied any alcohol or drug intoxication, chest pain, shortness of breath, or infectious symptoms. His past history included chronic hypothyroidism and alcoholism. He had a temperature of 36.8 degrees Celsius with a heart rate of 96 bpm and was alert [...]

Case Presentation: A 69-year-old female with a medical history of morbid obesity presented to a rural hospital with a one-week history of extreme fatigue, malaise, jaundice, and anorexia. Her initial vital signs were unremarkable. Physical exam revealed a distressed-appearing woman with diaphoresis, scleral icterus, jaundice, and lower extremity edema. Laboratory findings revealed significant elevation of [...]

Case Presentation: A 44-year-old African American female with a medical history of chronic heart failure with preserved ejection fraction (HFpEF) presented with a six month history of multiple hospitalizations for acute decompensated HFpEF and right upper quadrant pain. One month ago, she presented with an acute elevation of alkaline phosphatase (ALP) to greater than four [...]

Case Presentation: A 23-year-old male with HgB SS sickle cell disease and iron overload due to chronic transfusions presented from an outside hospital with sickle cell pain crisis complicated by a total bilirubin level of 30 U/L. At the time of admission, his pain crisis had resolved. Physical exam revealed scleral icterus and gallbladder ultrasound [...]

Case Presentation: We present a case of symptomatic meropenem induced cholestasis in a 57 year old male with insulin dependent diabetes complicated by polymicrobial foot ulcers that required multiple toe amputations. He presented with chief complaints of fatigue, decreased appetite, and weight loss. He was septic on arrival and was found to have wet gangrene [...]