Case Presentation: A healthy five-year-old girl was admitted from Ophthalmology Clinic for evaluation of bilateral anterior uveitis, fatigue and weight loss. History was notable for a cat scratch to the right eye one month prior which had prompted the referral to Ophthalmology Clinic. Patient also reported fatigue, night sweats, intermittent headache, poor oral intake, and [...]

Case Presentation: A 37-year-old-male with no significant past medical history who presents to the hospital with 2 months of progressive exertional dyspnea, palpitations and scrotal pain. He has also noticed some leg swelling and has a nonproductive cough. For the past 6 months, he has had ongoing diarrhea and unintentional weight loss of about 20 [...]

Case Presentation: A 56-year-old Caucasian female with history of mechanical aortic and mitral valves on chronic warfarin therapy, atrial fibrillation, and questionable history of SLE was admitted to the intensive care unit for emergent splenectomy following a motor vehicle accident. After initially being sent home from a regional hospital, she was diagnosed five days later [...]

Case Presentation: A 38-year-old man with untreated hyperthyroidism presented with two-week history of progressively worsening weakness and dyspnea along with a six-month history of unintentional 38 pound weight loss, diarrhea, and palpitations.  Exam was notable for confusion, cachexia, diffuse thyromegaly, jugular venous distension, exophthalmos, thyroid bruit, bilateral rales, and tachycardia (HR to 150s).  A transthoracic [...]

Introduction: Thyrotoxic crisis is rare and presents as a life-threatening exacerbation of hyperthyroidism. It can have a myriad of manifestations affecting multiple organ systems. The mortality rate is as high as 30% even with treatment. Thyrotoxic crisis is usually precipitated by acute illness, surgery especially on the thyroid, or radioiodine treatment of a patient with partially treated [...]

Case Presentation: A 28-year-old female with unremarkable past medical history presented with a 3-day history of fever, diffuse abdominal pain, nausea, and vomiting. Vital signs were significant for temperature of 38.3 C and heart rate of 180 BPM. Physical exam revealed left-sided costovertebral angle tenderness. Laboratory studies were notable for total bilirubin 2.7 mg/dL, direct [...]

Case Presentation: A 70-year-old man with PMH of chronic lymphocytic leukemia (with good hematologic response to Ibrutinib, stopped three months ago due to persistent fevers of unknown etiology), nephrolithiasis (with recent ureteral stent placement), presented with fever to 40.5 degrees Celsius. Patient was found to have E. coli bacteremia due to urinary tract infection and [...]

Case Presentation: A 67-year-old male with a history of Graves’ disease, paroxysmal atrial fibrillation status post cardiac ablation not on anticoagulation, and chronic ibuprofen use presented to the emergency department with progressive dizziness, fatigue. He noted 10 days of black stools. Additionally, patient’s wife reported he had confusion that started yesterday. Patient presented stable on [...]

Case Presentation: A 38 year old lady with past medical history of recurrent kidney stones presented to the emergency department with a 1 day history of lethargy, confusion, and severe right sided abdominal pain. She was febrile with temperature of 38.9oC and tachycardic with heart rate of 168 bpm. She had leukocytosis of 13,000/ml and [...]

Case Presentation: Patient is a 29 year old female with no significant past medical history who presented to our hospital with an unintentional 60 pound weight loss over 3 months and 4 days of palpitations, shortness of breath, leg swelling, and orthopnea. Physical exam revealed 4+ pitting edema, tachycardia (130 beats/minutes) and jugular venous distention [...]