Case Presentation: A 57-year-old woman with history of bipolar I disorder treated with risperidone and lithium for over 10 years was sent to the ED for stroke evaluation by her primary care physician due to significant confusion and slurred speech. The patient’s family reported a 3-day history of tremulousness, a week of ataxia with a [...]

Case Presentation: A 64-year-old woman with end-stage renal disease (ESRD) on peritoneal dialysis (PD) presented with altered mental status. She reported “seeing monsters when I close my eyes,” “bouncing off the walls like I was drunk,” and slurring her speech at home. Her family added that she was highly functional at baseline, lived independently and [...]

Case Presentation: A 94-year-old female with a past medical history of cerebrovascular accident (no residual effects) presented with an intertrochanteric fracture of the right proximal femur after a mechanical fall. On arrival, the patient was afebrile, vital signs hemodynamically stable. On exam, the patient was alert and oriented x3 with no focal deficits, extremities warm [...]

Case Presentation: A 68 year old man with PMH of cerebral palsy, cognitive impairment, and chronic pain with intrathecal baclofen pump initially presented with sepsis due to baclofen pump pocket infection, and underwent explantation of baclofen pump. Intraoperative cultures grew pseudomonas, so on POD 3 cefepime was initiated. On POD 4, he developed encephalopathy, becoming [...]

Case Presentation: Four years after kidney transplantation a 65 year-old woman with type 2 diabetes, hypertension, and no psychiatric history is referred to the hospital by her primary care physician to evaluate altered mental status. She was successfully maintained on tacrolimus with stable trough levels. During the preceding three months she had developed progressive symptoms [...]

Case Presentation: A 75-year-old white male presented to the Emergency Department with a 2-day history of gait disturbance, flailing bilateral upper extremity movements, and confusion. His wife stated that his symptoms had been occurring for the past 1 month and acutely worsened over the past several days. For the past year, he had been evaluated [...]

Case Presentation: A 64-year-old male with a history of spinal cord injury complicated by quadriplegia, neurogenic bladder and bowel presented with an obstructed suprapubic foley catheter, severe localized pain over the suprapubic area, and a blood pressure of 84/56 on arrival. The patient was administered intravenous fluids and started on 4.5g of piperacillin/tazobactam every 8 [...]

Case Presentation: A 59-year-old male with a past medical history of end-stage renal disease on hemodialysis, hypertension, diabetes mellitus, and a recent diagnosis of multi-microorganism osteomyelitis due to diabetic foot ulcer on intravenous vancomycin and ertapenem for the past 2 weeks presented to the hospital for visual and auditory hallucinations. The symptoms started shortly after [...]

Case Presentation: A 54-year-old woman with stage IV endometrial stromal sarcoma s/p TAH, BSO, and ileocolic resection for bowel involvement, presented with acute onset of altered mental status on the evening of receiving her day 3 of cycle 3 ifosfamide infusion. On presentation, patient was tachycardic to HR 110s, afebrile, and otherwise with stable vital [...]

Case Presentation: A 63-year-old female with history of end-stage renal disease, atrial fibrillation (AFib), cirrhosis, and Parkinson’s disease was admitted to the hospital after an unwitnessed fall with persistent encephalopathy and altered mental status. Upon admission the patient was found to have wide QRS complexes with an Atrial fibrillation, clinical findings of heart failure, and [...]