Case Presentation: A 49 year old female with a history of Depression and Multiple sclerosis (MS) presented with acute psychosis in the setting of recent polysubstance abuse.  The patient endorsed both visual and auditory hallucinations; stating she saw bugs and could hear her dead father calling her. In addition, the patient was convinced that her [...]

Case Presentation: A 36-year-old male with a history of IV drug use presented with right upper extremity (RUE) pain that started after he used IV methamphetamine. Physical exam revealed tachycardia and erythema, edema, and blistering of the RUE. Labs showed WBC 26.7, sodium 129, and lactic acid 3.1. CT RUE revealed moderate soft tissue edema [...]

Case Presentation: A 51 year old female recently diagnosed with metastatic goblet cell carcinoid mixed adenocarcinoma of the appendix with metastasis to the peritoneum, mesentery, small and large bowel status post ileo-cecectomy and ileostomy presented with acute onset anxiety and mania. Patient presented with a two-day history of decreased sleep, flight of ideas and increased [...]

Case Presentation: A 78-year-old African American female with a history of hypertension, coronary artery disease, heart failure with reduced ejection fraction, chronic kidney disease (CKD) stage 4, and systemic sarcoidosis in remission, presented for an acute change in mental status with delusions, and memory loss for 1 week. She had a history of dysphagia with [...]

Case Presentation: 78-year-old female with a past medical history of diabetes, hypertension, and vascular dementia was brought to the hospital by her family for worsening dementia, behavioral disturbances including agitation, insomnia, hallucinations and delusions. Her lab workup showed hemoglobin of 11.5 g/dl, troponin of 0.09 ng/ml, CK of 88 u/l, CK-MB of 2.25 ng/ml. Electrocardiogram [...]

Case Presentation: A 27-year-old man with no known medical history was brought in by his family for progressive personality change and worsening insomnia. Three months prior to presentation, the patient had begun skipping coursework for his PhD program, and was noted to have new outbursts of unprovoked anger and impulsivity. On presentation, he was oddly [...]

Case Presentation: A 57-year-old woman presented to the emergency department with confusion, generalized weakness, poor appetite, abdominal pain, depressed mood, and constipation for the past week. She states that she has auditory hallucinations and paranoia and thinks a man is going to kill her which caused her to stay at home. She did not have [...]

Case Presentation: A 59-year-old previously healthy female presented to the emergency department with progressive cognitive decline, psychomotor retardation, and both auditory and visual hallucinations of subacute onset for which she was previously admitted to inpatient care at two separate hospitals. Extensive testing during these admissions were negative for: infection, metabolic derangement, hematologic malignancy, toxins, heavy [...]

Case Presentation: A 20 year old female with a history of childhood seizures, major depressive disorder, and post-traumatic stress disorder was evaluated for acute onset of bizarre behavior, confusion and disorganized thoughts for the past three days. Her initial psychiatric exam was notable for labile mood, psychomotor agitation and paranoia, but otherwise neurologic examination was [...]

Case Presentation: This is a 64 year old male with a past medical history of bipolar disorder without previous psychiatric admissions, type 2 diabetes mellitus, stroke and autoimmune encephalitis that presented to the emergency room from a subacute rehabilitation facility (month long stay since an L3-L4 discectomy) with altered mental status. While at the rehabilitation [...]