Case Presentation: A 56-year-old man with a past medical history of hypertension, hyperlipidemia, polysubstance abuse, and perforated appendicitis presented to the emergency department for one-week right lower quadrant abdominal pain. Of note, two-years prior, the patient had one-day of similar pain associated with nausea and emesis. A computed tomography (CT) scan of the abdomen and [...]

Case Presentation: An 88 year old man with a history of severe aortic stenosis with transcatheter aortic valve replacement and unprovoked pulmonary embolism (on lifetime warfarin) presented with four days of lethargy and weakness. He denied any fevers, chills, abdominal pain, diarrhea, or urinary symptoms. He was compliant with scheduled dental cleanings and took prophylactic [...]

Case Presentation: A 55-year-old man with gastroesophageal reflux disease and prostate cancer status post radical prostatectomy presented with a 3-year history of non-healing skin ulcerations. He was initially diagnosed with vasculitis and started on immunosuppressive therapy. Skin lesions worsened despite high dose steroids and different immunosuppressive medications (methorexate, mycophenolate, azathioprine, cyclophosphamide). On presentation, skin examination [...]

Case Presentation: A 2-year-old female presented to our Gastroenterology service with persistent failure to thrive (FTT). She was born at term and remained in the 10th percentile in weight for the first nine months. She continued to grow in length but did not gain weight. Initial inpatient workup at 13 months revealed a CBC, TSH, [...]

Case Presentation: A 17-year-old male presented to clinic with a pruritic and brown macular rash that was first noticed after ingesting food at a buffet a few months prior to his office visit. The rash began on his upper extremities and spread to his trunk, lower extremities, and head. He has a history of cutaneous [...]

Case Presentation: A 54-year-old Hispanic woman presented with 5 days of subjective fevers, jaundice, nausea, vomiting, and right-sided abdominal pain. On presentation, she was febrile with borderline hypotension and tachycardia, abdominal tenderness, and laboratory values notable for leukopenia and transaminitis with direct hyperbilirubinemia. The patient received vancomycin, cefepime, metronizadole, and intravenous fluids per sepsis protocol. She was intubated [...]

Case Presentation: A previously healthy 68-year-old woman presented with three weeks of progressive abdominal and leg swelling. While visiting family in Mexico two weeks prior, she developed an itchy rash on her thighs that spread distally. She denied fever, cough, dysphagia, vomiting, or abdominal pain, but did report a six pound weight loss. Physical exam [...]

Case Presentation: A 15-year-old female was referred to the hospital by her urologist for persisting urinary retention and bladder distention concern. The patient endorsed 5 months of increased urgency and decreased frequency of urination, as well as a decreased amount during each void. She denied dysuria, gross hematuria, incontinence, or history of UTI. She had [...]

Case Presentation: An 83-year-old man visiting from rural Mexico, presented with one-month-old diffuse, painful, multinodular subcutaneous lesions with a pruritic rash on the left leg. A week prior to admission, the patient reported new inguinal and upper extremity lesions and a violaceous, pruritic, non-painful, maculopapular rash at the waistband with progression to the upper arms. [...]

Case Presentation: A 51-year-old male with a history of chronic fentanyl use, smoking (20 pack-years), and occasional alcohol consumption presented with persistent back and flank pain lasting one week. The pain was constant, non-radiating, and accompanied by non-bloody diarrhea. Imaging revealed multiple concerning findings: a large lytic lesion in the right frontal skull (1.9 x [...]