Case Presentation: The diagnosis of a sexually active young male who presents with fevers, night sweats, weight loss with opportunistic infections and then found to have an acquired immunodeficiency is going to be HIV except when it isn’t. We present a patient with a presumptive diagnosis of HIV but a negative comprehensive HIV laboratory testing [...]

Case Presentation: A 36 year old male from Central America who immigrated to the United States ten years ago presented with cough and headache accompanied with fevers. He did not have any past medical conditions. On admission his vitals were T 39.1 C, HR 114, RR 20, BP 129/85 mmHg. He was noted to have oral [...]

Case Presentation: Pneumonia in an immunocompromised individual has a broad differential; the initial work-up and selection of antimicrobials can be challenging. We present a case of concomitant pulmonary nocardiosis and Pneumocystis jirovecii pneumonia (PJP). A 60-year-old male with hepatitis C infection status-post treatment with a negative viral load and chronic kidney disease (CKD) due to [...]

Case Presentation: A 40-year-old man with inconsistently treated HIV infection presented with a progressive cough, dyspnea, and pleuritic chest pain over a two-week period which were associated with fevers, chills, night sweats, and a 40-pound weight loss. He emigrated from Mexico 10 years prior and had traveled to the central valley of California. On physical [...]

Case Presentation: A 65-year-old male with a past medical history significant for hypertension initially presented with episodes of double vision, fatigue and dysphagia. Physical exam was remarkable for right-sided ptosis which improved with the ice pack test. Serology was positive for anti-acetylcholine receptor antibodies. Further workup revealed a decremental response to slow (2Hz) repetitive nerve [...]

Case Presentation: 5 59-year-old male with alcoholic cirrhosis, hypertension, COPD, and diabetes mellitus presented with a 3-month history of progressive confusion and altered mental status. His family reported memory decline, prompting multiple ER visits primarily focused on cirrhosis-related complications, overlooking the neurological symptoms’ etiology. Initial improvement following hepatic encephalopathy treatment was short-lived, leading to rapid [...]

Case Presentation: We present the case of a 77-year-old man admitted with failure to thrive and progressive dyspnea. He had a 6-year history of lung squamous cell carcinoma and a recent history of immune checkpoint inhibitor (ICI) toxicity (myocarditis, pneumonitis, and hepatitis), currently on week 27 of a prednisone taper (35 mg daily). He was [...]

Case Presentation: A 28-year-old male with a recently diagnosed HIV infection presented to the hospital with dyspnea, pleuritic chest pain and fatigue for 4 days. Six weeks prior, he was found to have HIV infection with a CD4+ cell count of 17 cells/ul and an HIV viral load of 41,399 copies/mL. He was prescribed antiretroviral [...]