Case Presentation: A 58-year-old woman with self-reported history of mast cell activation syndrome and chronic back pain presented to the hospital three times over a two-month period for recurrent skin/soft tissue infections. Her first hospitalization (10/19 – 10/24) was for bilateral hand/wrist abscesses requiring extensive tenosynovectomy and radiocarpal arthrotomy; cultures grew MSSA and she was [...]

Case Presentation: A five-year-old boy with autism presented to the hospital with two-months of fatigue, lower extremity pain, and a petechial rash. Review of systems was notable for a two-kilogram weight loss, intermittent gingival bleeding and refusal to walk for one week. On admission he was afebrile with a heart rate of 160 beats per [...]

Case Presentation: A 24-year-old man with no significant past medical history presented with a petechial perifollicular rash, polyarthralgia of his large joints (hips, spine, knees), 20-pound weight loss, myalgia, and fatigue, all of two months duration. For prior six months, the patient had been homeless, living in his car which he scrupulously cleaned with Lysol [...]

Case Presentation: A 49-year-old male with past medical history of anxiety, chronic diarrhea and alcohol dependency presented with blood-tinged emesis. The patient endorsed a three-week history of non-bilious, blood-streaked emesis after ingestion of both solids and liquids. He also endorsed a cough productive of blood-streaked sputum and easy bruising. He was a retired librarian. He [...]

Case Presentation: A Caucasian man in his 60s presented to the ED with a 6-week history of extensive bruising, worse in both legs and buttocks, along with shortness of breath on minimal exertion. He stated he had a chronic wound on his right leg (Figure 1). He was not taking any regular medications. Days later [...]

Case Presentation: A 71-year-old woman presented with one month of progressive dyspnea, fatigue, weight loss, bilateral lower extremity edema, and new “purple and red spots” on her extremities. Her medical history included breast cancer more than two decades ago for which she underwent surgery and radiation therapy. She had since been out of care. On [...]

Case Presentation: A 7-year-old boy with autism spectrum disorder, restricted diet, developmental delay, and iron deficiency anemia presented to the emergency department with decreased oral intake, gingivitis, and progressive refusal to walk over several weeks.Family noticed red and swollen gums one month prior to presentation. He then developed acute refusal to walk one week prior [...]

Case Presentation: A 35-year-old woman with a history of congenital renal dysplasia complicated by end stage renal disease (ESRD) on hemodialysis, chronic macrocytic anemia, and malnutrition with folate, vitamins B12 and A deficiencies, presented with fatigue, dyspnea, and new rash. One week prior to presentation, the patient started experiencing progressive dyspnea on exertion. At her [...]

Case Presentation: A 56-year-old woman with a history of Parkinson’s disease and seizures presented with a month of dyspnea and associated easy bruising. She had previously presented to the emergency room two weeks before her current presentation with swelling of her right lower extremity and bruising. Workup at this time included a lower extremity doppler [...]

Case Presentation: A 62-year-old female presented with one month of progressive bilateral lower extremity pain, weakness, and functional decline. Her medical history was significant for cirrhosis secondary to hepatitis C (treated), chronic pancytopenia, and hypothyroidism. Her medications included atorvastatin, levothyroxine, omeprazole, spironolactone, tiotropium, venlafaxine, and quetiapine. She was a current smoker with a 20-pack year [...]