Case Presentation: A 29-year-old woman presented with a 4-day history of nausea, vomiting, and watery, non-bloody diarrhea. She also had fever, headache, and dark urine. She had traveled to Puerto Rico one-week prior, where she ate raw fish and vegetables and drank tap water. She also went to visit a waterfall, where she swam in [...]

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 previously healthy 13-year-old female presented to a pediatric emergency department with 5 days of abdominal pain, emesis, headache, arthralgia, and fever. Vital signs included temperature of 100.2 F, heart rate of 122 beats/minute, normal blood pressure for age, and oxygen saturation of 99% on room air. She was ill appearing with bilateral [...]

Case Presentation: A 69 year old woman presented to our hospital with 5 days of fever, diarrhea, abdominal pain & debilitating leg pain. Her only known medical problem was hyperlipidemia, for which she had recently increased her statin dose. 6 weeks prior to admission, she visited her hometown in Jiangxi, China. There, she drank tap [...]

Case Presentation: A 25-year-old woman with no significant past medical history presented for a three-day history of fevers to 39.9 Celsius, frontotemporal headaches, and diffuse myalgias. She reported working outdoors for a summer camp without known insect or tick bites. Physical exam was notable for tenderness with neck flexion, nuchal rigidity, and abdominal tenderness to [...]

Case Presentation: A 58 year-old undomiciled man with no known medical history presented with three days of anorexia, malaise, abdominal pain, nausea and decreased urine output. His exam was notable for scleral icterus. Initial lab work was remarkable for sodium 133 mEq/L, BUN 132mg/dL, creatinine 8.82 mg/dL, platelet 64 K/uL, total bilirubin 6.4 mg/dL, and [...]

Case Presentation: Mr. D is a 60-year-old male building superintendent with a history of asthma and moderate alcohol use disorder who presented with six days of fatigue. Later, he developed headache, substernal pleuritic chest pain, epigastric and RUQ abdominal pain, nausea, vomiting, and weight loss of around 20 pounds in a week. The patient reported [...]

Case Presentation: A 68-year-old woman with an unknown past medical history presented to the emergency department after a bystander who had previously seen her sleeping in a park noticed her looking unwell. Her vital signs were normal. She endorsed moderate, bilateral leg pain. Exam was notable for scleral icterus. While alert and oriented, she was [...]

Case Presentation: A 62-year-old male from a major urban city in Northeast US with history of hypertension and type II diabetes mellitus presented with fevers and thigh pain for three days. He had no recent travel history, sick contacts, or bug bites. Physical examination was notable for injected conjunctiva. Lab work revealed leukocytosis, thrombocytopenia, acute [...]