Case Presentation: A 28-year-old man, recently experiencing homelessness, presented to the ER of an urban medical center with complaints of severe chest pain, shortness of breath, and lower extremity edema. For the past 5 days he did not take his outpatient medications including isosorbide, doxazosin, hydralazine, nifedipine, carvedilol, and furosemide prescribed by his nephrologist, who [...]

Case Presentation: A 44-year-old male with a history of opioid use disorder and intravenous drug use (IVDU) presented to the emergency department with chest pain and malaise. On presentation, his temperature was 103.3 degrees Fahrenheit, blood pressure was 86/58 mmHg, and heart rate was 157 beats per minute. The initial electrocardiogram showed multi-lead ST-elevations and [...]

Case Presentation: A 54-year-old woman with a history of uterine fibroids developed six weeks of progressive abdominal swelling and unintentional weight loss. Initial supportive care at an outside clinic failed to relieve symptoms. A month later, abdominal CT scan demonstrated extensive peritoneal carcinomatosis with bulky retroperitoneal adenopathy, moderate intra- and extrahepatic ductal dilatation, featureless pancreas, [...]

Case Presentation: 69-year-old male with past medical history of sarcoidosis was found to have a positive quantiferon gold on outside labs and thus presented to the hospital for TB rule-out. On presentation, patient reported generalized fatigue, weakness and mild shortness of breath for the past year and denied fevers, chills, night sweats, or weight loss. [...]

Case Presentation: A 44-year-old female with severe opioid use disorder (OUD) was admitted after a benzodiazepine withdrawal seizure. Her history was significant for methadone 165 mg daily dosing, anxiety managed with daily unprescribed benzodiazepines, and alcohol use disorder in remission. She had a prolonged QT interval, with a notable episode 18 months prior, when she [...]

Case Presentation: 42-year-old female with lung adenocarcinoma (with metastases to T-spine s/p corpectomy and XRT to T-spine and lung) presented with four weeks of constant pressure-like headaches and oral intolerance due to nausea and vomiting. She denied fevers, chills, night sweats or hemoptysis. Home medication included osimertinib for her lung cancer. She had no significant [...]

Case Presentation: A 53-year-old Vietnamese monk living in a rural Texas monastery presented with fatigue, muscle aches, and fever that progressed to respiratory distress after a two-week delay in seeking care. He was intubated and sedated at a tertiary care center. He was afebrile, tachycardic (HR 122 bpm), and normotensive. Labs showed a leukocytosis (WBC [...]

Case Presentation: An 84-year-old male with a past medical history significant for improving chronic kidney disease stage 3 (baseline creatinine of 0.72 mg/dL) and prediabetes presented to the emergency department with altered mental status and poor oral intake from a low resource facility. Patient was recently hospitalized for perforated diverticulitis after sigmoidectomy and ostomy complicated [...]

Case Presentation: A 68-year-old male with a three-year history of kidney transplantation on chronic immunosuppression presented with persistent hypotension and acute right leg pain secondary to a right lower extremity abscess. Initial comprehensive computed tomography (CT) revealed multiple additional abscesses, including neck, forearm, retroperitoneal, paravertebral and numerous pulmonary nodules. Given concerns for possible disseminated Nocardia, [...]

Case Presentation: An 84-year-old male with a past medical history of hypertension, type two diabetes mellitus, and left herpes zoster ophthalmicus treated three months prior presented to the hospital with two days of worsening confusion and altered mentation. Initial Computed Tomography (CT) of the head revealed no evidence of acute infarction. Initial serologic workup revealed [...]