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Medicine and Health Sciences

Thomas Jefferson University

The Medicine Forum

2011

Internal medicine residents

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65-Year-Old Man With Weight Loss, Anorexia, And Distal Extremity Numbness, Leigh Van Vranken, Ms Iii, William Kim, Ms Iii, Darren N. Seril, Md, Toshimasa Okabe, Md Jul 2011

65-Year-Old Man With Weight Loss, Anorexia, And Distal Extremity Numbness, Leigh Van Vranken, Ms Iii, William Kim, Ms Iii, Darren N. Seril, Md, Toshimasa Okabe, Md

The Medicine Forum

Case Report

A 65-year-old Caucasian male with no significant pastmedical history presented to the emergency department with an unintentional 44-pound weight loss over a four-month period. The weight loss was preceded by fatigue and anorexia,which had been increasing for approximately eight months.In addition, he noted numbness and tingling of his hands and feet that began over the same time period. The patient was initially treated for depression with sertraline by his primarycare physician. However, his symptoms persisted without significant improvement. An initial workup at outside hospital one month prior to presentation included an abdominal CTscan, which revealed a mass in …


A 30 Year-Old Man Infectious Endocarditis And Cerebrovascular Accident, Neerav G. Sheth, Md, Joseph Desimone, Md Jul 2011

A 30 Year-Old Man Infectious Endocarditis And Cerebrovascular Accident, Neerav G. Sheth, Md, Joseph Desimone, Md

The Medicine Forum

Case Report

A 30 year old male with a remote history of intravenous drugabuse (IVDA) and Hepatitis C was admitted in July 2008 with changes in mental status and a new right sided paresis. According to the family, the patient was in his usual state of health until approximately 2-3 weeks prior to admission when he developed headaches, generalized malaise, and fever to 101 degrees Fahrenheit after swimming in a lake. He was seen in an outside hospital emergency department, diagnosed with otitis media and subsequently discharged on prednisoneand ciprofloxacin. The morning of admission, the patient was found naked, nonverbal, …