Case Presentation: The patient is a 66-year-old female with a past medical history of asthma-COPD overlap (ACO) with recent exacerbation who presented with sudden-onset severe dyspnea. Patient was intubated for ACO exacerbation three weeks prior to admission and was started on heparin for deep vein thrombosis prophylaxis with platelet at 293, 000/microliter. At the rehabilitation [...]

Case Presentation: A 70-year-old female with a medical history of fibromyalgia on Duloxetine, Systemic Lupus Erythematosus, and Paget’s disease admitted to the hospital for altered mentation was found to have elevated ALT 54 U/L, AST 63 U/L, normal bilirubin, and gamma glutamyl transferase. The mild elevation in Alkaline Phosphatase (ALP) 175 U/L was secondary to [...]

Case Presentation: Tumor lysis syndrome (TLS) is a potentially fatal complication usually seen in rapidly proliferating and chemo-sensitive malignancies like acute leukemia and lymphomas. (1-3) It is termed “spontaneous” (STLS) when TLS occurs without prior chemotherapy. (1) The incidence of STLS in solid tumors is infrequent/rare and can be fatal without early recognition and aggressive [...]

Case Presentation: A 55-year-old man with a history of obesity, gout, and multiple cervical spine surgeries, including a remote C4 laminectomy, C6-C7 fusion, and anterior cervical discectomy and fusion (ACDF) at C5-C7, presented for a higher level of care due to septic arthritis in his right knee. His medical history also included prolonged courses of [...]

Case Presentation: A 79-year-old male with cerebral amyloid angiopathy was admitted to the hospital due to the sudden onset of left-sided hemiparesis, sensory loss, neglect, facial palsy, and cognitive impairment. Upon neurological examination, the patient’s NIHSS score was determined to be 9, attributable to left-sided neglect, motor weakness, and facial palsy. CT head revealed a [...]

Case Presentation: An 80 year old man presented to the hospital with progressively worsening dyspnea for three weeks. His past medical history was most significant for stage IV parotid gland adenocarcinoma. One week prior to presentation he was hospitalized for exertional dyspnea. Though the hypoxia workup at that time did not reveal a clear etiology, [...]

Case Presentation: A 51-year-old male with a history of chronic fentanyl use, smoking (20 pack-years), and occasional alcohol consumption presented with persistent back and flank pain lasting one week. The pain was constant, non-radiating, and accompanied by non-bloody diarrhea. Imaging revealed multiple concerning findings: a large lytic lesion in the right frontal skull (1.9 x [...]

Case Presentation: An 88-year-old male presented to the emergency department (ED) for dyspnea. Of note, patient is from nursing home (NH) and history was obtained from nurse (RN). RN notes that he was at baseline, talkative and pleasant. He had tested positive for COVID as NH had outbreak, and then weakened over a few days. [...]

Case Presentation: A 65-year-old male with hypertension, hyperlipidemia, type 2 diabetes, and hypothyroidism was admitted to the hospital with fevers and chills in the setting of leukopenia and thrombocytopenia. Symptoms began on his way home from India four days prior and progressed to a Tmax of 102F with chest congestion. His physician ordered labwork that [...]

Case Presentation: The patient was an 85-year-old female who presented to the hospital with encephalopathy, rigors, new onset atrial fibrillation with rapid ventricular response and shock. Her past medical history was only noted as dementia and hypertension. Due to her change in mental status, CT head and CTA head and neck were obtained which did [...]