Chronic bloody diarrhea in an HIV patient
The case we discussed today was that of a patient with HIV (on HAART) who presented with bloody diarrhea, abdominal pain and weight loss (25-40 lbs) over the past 4 months. Given that the differential diagnosis is broad in an immunodeficient patient, a CT abd/pelvis was obtained which showed segmental involvement of cecum through proximal sigmoid […]
An Unusual Cause of Abdominal Pain
A 69 yo M with pmhx of HTN, atrial fibrillation on warfarin, unspecified hx of thyroid and parathyroid cancers status post resection presents with acute left-sided abdominal pain. Subsequent labs showed a significant drop in hematocrit and imaging showed a large left-sided adrenal hemorrhage. The patient had his anti-coagulation reversed, then was taken to IR-suite […]
Carotidynia and Fever
After the holiday weekend, people are back in action and solved/managed this complex case today. 53 yo F presenting with fevers, productive cough, nausea/vomiting/diarrhea with left neck/shoulder pain x 3 days. Tenderness was localized to area right below the angle of the jaw and overlying the carotid bifurcation. She was eventually found to have a mycotic […]
Acetaminophen Toxicity
34 yo M with DM, HTN, DVT on coumadin presenting with a perirectal abscess and was subsequently found to have markedly elevated LFT’s (ALT – 3300, AST – 380). On further history, it was found that the patient was taking Vicodin (acetaminophen + hydrocodone) multiple times daily due to the rectal pain. Patient was diagnosed […]
That’s Rancid
This is a case of a 45 y/o incarcerated, actively smoking gentleman with severe GERD, seizure disorder due to EtOH withdrawal who presented with cough productive of gray, foul smelling (not only to patient but innocent bystanders as well) sputum for 2 weeks. CXR on admission revealed a right upper lobe cavitary lesion which was confirmed […]
Hyponatremia and Hyperkalemia in a Post-Op Patient
Peripheral eosinophilia with hypoxia
53 yo F smoker, presenting with acute onset hypoxia and found to have a 33% peripheral eosinophilia (abs eos 1.8). CXR had some increased interstitial markings and LLL ?atelectatic plates/vague infiltrate. CTPA was neg for PE but did show groud glass opacity alongwith tree in bud appearance in LUL. She was empirically started on PO […]
Bubble Trouble
This was a case of a 63 year-old man who presented with right upper extremity edema, erythema, and pain over 1 day duration, which included 2 large bullae on the forearm. Past medical history included hypertension, gout, and hyperlipidemia. Medications included furosemide, valsartan (previous angioedema reaction to lisinopril), allopurinol, and tamsulosin. Labs were normal. Initially […]
Just Simply an Upper Respiratory Infection?
We have a 30 year old woman with history of asthma, chronic pain syndrome s/p MVA with rib resection, and history of gonorrhea and HPV presenting with 2 days of persistent cough. With subjective fevers and chills, her concern has been coughing “fits”, as she describes it, with one to two episodes of post-tussive emesis. […]
Hepatocellular Carcinoma
This was a 54 year-old man from Vietnam (immigrated to USA 20 years ago) with no past medical history, presenting with a week of epigastric pain. He also endorsed a 10-lb. weight loss over the past year, and had a significant smoking and alcohol abuse history, though stopped 1 year ago. He had remotely used […]