Case Presentation: A 28-year-old, 447 lb man with hypothyroidism and depression was hospitalized for neurosurgical intervention for severe lumbar spinal stenosis. He had one risk factor from the Revised Cardiac Risk Index due to the spinal procedure, and his EKG, echocardiogram, and renal function were normal. He had no history of diabetes, TIA/CVA, or cardiac [...]

Case Presentation: A 56-year-old man was found unresponsive at home during a wellness check. Paraphernalia and the condition of other patients at the scene suggested a drug overdose. In the emergency department, his vital signs were HR 136 bpm, BP 164/90 mmHg, RR 22, and SpO2 94% on room air. Due to severe agitation, physical [...]

Case Presentation: A 79-year-old male with a past medical history of coronary artery disease presented to the emergency department with a 1-week history of generalized weakness, fever, and chills. He reported associated generalized myalgia involving his chest, abdomen, and neck, as well as headache, productive cough, and diarrhea. There was no associated skin rash.On presentation, [...]

Case Presentation: A 61-year-old woman presented to the emergency department with a one day history of left leg pain. Of note past medical history is significant for coronary artery disease status post stent times two, coronary artery bypass graft (CABG), hypertension, hyperlipidemia, gastroesophageal reflux disease, heart failure with preserved ejection fraction, deep vein thrombosis (DVT) [...]

Case Presentation: A 59-year-old male with chronic renal insufficiency due to IgG4-related disease (on chronic steroid therapy) and autoimmune pancreatitis presented to the ER with lightheadedness and numbness of bilateral upper extremities after masturbation. He experienced urinary incontinence, but no loss of consciousness. EMS found him hypotensive and bradycardic (BP 84/50, HR 30s) and administered [...]

Case Presentation: Hypermagnesemia is a rare, but potentially fatal clinical condition. We report a case of symptomatic hypermagnesemia in an 84-year-old female with stage 4 CKD who was taking daily magnesium oxide with intermittent milk of magnesia for chronic constipation. She presented with confusion, delayed verbal and motor response, and dyspnea and her presentation was [...]

Case Presentation: A 77-year-old male with past medical history of hypertension, hyperlipidemia, stroke, subarachnoid hemorrhage, and obstructive hydrocephalus status post ventriculoperitoneal shunt (VPS) placement presented with altered mental status and fever. A CT head showed worsening hydrocephalus. VPS was aspirated, fluid was non-infectious. Patient was empirically treated with vancomycin and zosyn for presumed sepsis. His [...]

Case Presentation: A 22-year-old woman with no known medical history presented with visual hallucinations, confusion, and jaundice. Her friend reported chronic nitrous oxide (N₂O) inhalation, escalating to three cans per day over the prior month. This increase coincided with a recent job loss and worsening mood. Days before admission, over 100 empty N₂O cans were [...]

Case Presentation: A 31-year-old man with chronic kidney disease following failed renal transplant on hemodialysis (HD) for 3 years via arteriovenous fistula and tertiary hyperparathyroidism presented for admission following a 3.5-gland parathyroidectomy. Intraoperative PTH levels dropped from 2280 to 503 pg/mL. Postoperatively, he presented with hypocalcemia (total calcium 5.9 mg/dL; corrected calcium 6.3 mg/dL) and [...]

Case Presentation: A 52-year-old female with discoid lupus on immunosuppressive medications and a history of gout presented with acute right wrist pain and swelling and subjective fevers. There was no history of trauma or other joint involvement. Notable examination findings include significant swelling of the right wrist without overlying erythema or induration. She was noted [...]