Case Presentation: A 44-year-old woman with a past medical history of systemic lupus erythematosus (SLE) not on maintenance therapy presented with joint pain, nausea, abdominal pain, and fever for one week. At the time of admission, the patient was found to have elevated ESR 72, CRP 30, and ferritin 4075. Admission labs were also notable [...]

Case Presentation: The patient is a 32-year-old male with a history of alcohol abuse who presented with two days of right upper quadrant pain and non-bloody emesis. He denied any prior diagnosis of liver disease (although alluded to a family history of cirrhosis), renal disease, confusion, or jaundice. He reported drinking a fifth of liquor [...]

Case Presentation: 41-year-old African American female with a history of Systemic lupus erythematosus (SLE) with antiphospholipid syndrome and cocaine abuse presents with acute onset of atypical chest pain, upper respiratory tract infection symptoms, myalgia, and arthralgia with an unremarkable physical examination. The labs were significant for urine drug screen positive for cocaine, elevated troponin, and [...]

Case Presentation: A 30-year-old female with limited past medical history presented to the emergency department (ED) with 5 days of recurring fevers, nausea, and new rash. The rash was noticeable along her face and arms with pronounced swelling, tenderness, and erythema in her fingers. Initial work-up was significant for hyperferritinemia over 15,000, aspartate aminotransferase of [...]

Case Presentation: 24-year-old female presented with greater than one month history of sporadic rash with migratory arthralgias, fevers, and pharyngitis with lymphadenopathy. Patient first developed a sporadic, erythematous, non-pruritic maculopapular rash that would wax and wane during a trip to Mexico two months prior to presentation. Patient also began to experience diffuse migratory arthralgias, starting [...]

Case Presentation: A 27-year-old incarcerated female with no past medical history presented with abdominal pain and fevers. Initial workup demonstrated neutropenia, anemia, and thrombocytopenia as well as an elevated ferritin level of 2000mg/dL. Abdominal imaging revealed hepatomegaly and diffuse adenopathy concerning for a lymphoproliferative disorder. A comprehensive workup revealed a positive EBV PCR, positive HSV [...]

Case Presentation: 54-year-old male patient diabetes mellitus type II presented with pain and swelling involving small joints of bilateral hands with wrists. Synovitis involving bilateral interphalangeal, metacarpo-phalangeal were noted.Labs revealed leukocytosis to 15.7K/microL. Hemoglobin was 7.7 g/dL. Anemia work up revealed low serum iron level of 23 µg/dL, low TIBC at 167ug/dL with saturation of [...]

Case Presentation: A 36 year old male with no past medical history presented to the ER with a 3 day history of fevers, nausea, vomiting, and diarrhea. Labs demonstrated hyponatremia to 126 and acute renal injury (1.7 up from 0.6). He was admitted for presumed viral gastroenteritis and treated supportively. Two days later his symptoms [...]

Case Presentation: A 64-year-old male presented to the Emergency Room with one week of worsening productive cough, fevers (Tmax 103F), vomiting, diarrhea, and malaise. His past medical history was significant for Rheumatoid Arthritis (RA), treated with etanercept, hydroxychloroquine, leflunomide and sulfasalazine. On physical examination, he was febrile, normotensive with tachycardia, and tachypneic with diminished breath [...]

Case Presentation: A 48 year old woman with a history of stroke, idiopathic intracranial HTN, type 2 DM, HTN, and obesity, presented a few hours after developing increasing confusion and lethargy. For 2 weeks, she also reports headache, neck pain, poor appetite, nausea, rare vomiting, and occasional diarrhea. Exposure history notable for owning a dog, [...]