Coinfection with Babesiosis and Lyme Disease in a 61‐Year‐Old Woman

Case Presentation: Ms. Y. is a 61‐year‐old salad bar chef with a medical history of dyslipidemia and osteoporosis who was admitted with fever, chills, hot flushes, and extreme fatigue for 2 days. On the day [...]

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Cryptococcal Meningitis in an Immunocompetent Patient

Case Presentation: A 38‐year old Ethiopian man with a history of HIV, tuberculosis, and malaria was admitted to our institution for evaluation of progressively altered mental status. The patient immigrated from Ethiopia 2 weeks prior [...]

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Understanding the Gist of a Retroperitoneal Mass

Case Presentation: A 63‐year‐old African American woman presented with 2 weeks of progressively worsening right lower quadrant abdominal pain. She noted early satiety, constipation, and an unintentional 10‐pound weight loss. On exam, her abdomen was [...]

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Salmonella Osteomyelitis in a Patient on the Anti‐Tnf Agent Adalimumab

Case Presentation: A 62‐year‐old woman with a medical history of rheumatoid arthritis (RA), diabetes mellitus, and hypertension presented with fever of 102°F and 10/10 diffuse abdominal, lower back, and flank pain for the past week. [...]

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Acute Bilateral Facial Nerve Paralysis and Negative Workup

Case Presentation: A 46‐year‐old man presented with a 1‐week history of bilateral lower facial nerve paralysis and 3 weeks of fever, headache, mild transaminitis, and hepatosplenomegaly. Illness began with acute onset of fever (103°F), headache, [...]

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A Case of Gastrointestinal Bleed with a Congenital Twist

Case Presentation: A 48‐year‐old woman presented with 2 episodes of bright red blood per rectum. Medical history included diverticular disease responsible for a previous episode of gastrointestinal bleed and congenital adrenal hyperplasia from 21‐hydroxylase deficiency. [...]

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Nicolau Syndrome: Recognition and Management of an Uncommon Reaction to Intramuscular Injections

Case Presentation: A 40‐year‐old white woman received an intramuscular injection of medroxyprogesterone in her right deltoid. Within minutes she experienced excruciating pain in her entire right arm, mild finger paresthesias, and a mottled, reticular, livedoid [...]

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Spontaneous Acquired Benign Tracheoesophageal Fistula in a Patient with Mediastinal Tracheostomy

Case Presentation: A 76‐year‐old white man presented with a1‐year history of abdominal fullness, bloating, episodic choking spells, and wheezing. These episodes worsened with food, usually to liquids, but had become more frequent over the last [...]

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Erysipelas‐Like Cellulitis with Pasteurella Multocida Bacteremia—a Rare Presentation

Case Presentation: A 79‐year‐old man with a medical history of gout presented with fever of 103°F, chills, palpitations, left lower‐extremity pain, swelling, and redness. Patient denied any trauma to his limb. Physical exam was unremarkable [...]

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Awareness of Patients’ Health Insurance Status: Underutilized Tool in Optimizing in Quality of Care

Case Presentation: Case I—a 45‐year‐old man was admitted to the hospitalist service with fever and leg swelling. Physical examination was significant for tachycardia, hypotension, and gangrene of left leg. From blood cultures, complete blood count, [...]

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Elevated Lactic Acid in Severe Asthma

Case Presentation: This is a 27‐year‐old woman transferred from the university emergency department to our Maryland General Hospital for management of severe asthma exacerbation. A few days prior to this visit, she was having coldlike [...]

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It Only Hurts When I Breathe

Case Presentation: A 55‐year‐old woman presented with 2 months of progressively worsening dyspnea on exertion, cough productive of yellow sputum, and occasional hemoptysis. She had noted edema of the lower extremities. Her lungs were clear [...]

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Hypertension … and a Bruit?

Case Presentation: A 34‐year‐old woman with no medical history presented with complaints of severe, intermittent headaches and dizziness of 3 months’ duration. Her primary care physician had diagnosed her with “malignant hypertension” and initiated treatment [...]

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Esophageal Perforation: Can We Hold the Tray and Spare the Knife?

Case Presentation: A 38‐year‐old African American man with a medical history of hiradenitis suppurativa (HS) presented with 1‐year history of left leg ulcer with a 2‐week increase in size and malodorous discharge. He denied any [...]

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Massive Splenomegaly: To Cut or Not to Cut

Case Presentation: A 20‐year‐old woman with no medical history presented with splenomegaly by outside imaging. She described 7 months of left upper quadrant pain that intensified prior to admission, was 8/10, nonradiating, and worse with [...]

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