A 38-year-old woman had shortness of breath, fever, and cough with yellow sputum soon after childbirth. Her symptoms initially resolved with antibiotics, but she soon had nonproductive cough, wheeze, and shortness of breath. Test your diagnostic and therapeutic skills at NEJM.org.

An 89-year-old man was brought to the ER for evaluation of changes in his cognition and personality. He exhibited poor memory for recent events and difficulty expressing himself. Test your diagnostic and therapeutic skills at NEJM.org.

A 50-year-old woman presented with fatigue and shortness of breath. One week before presentation, she experienced the gradual onset of dyspnea after moderate exertion, profound malaise, and a non-productive cough. In the 48 hours before admission, her ...

A 78-year-old man presented with four months of worsening fatigue, generalized weakness, and anorexia with an unintentional weight loss of 25 pounds (11.4 kg). He reported subjective fevers, chills, drenching night sweats, dry mouth, nonproductive cough, ...

A 39-year-old woman (gravida 2, para 0) presented to her obstetrician at 32 weeks of gestation with pain in her lower back that began 2 days earlier. The pain was abrupt in onset and constant; she reported no fever, chills, nausea, vomiting, dysuria, ...

A 71-year-old woman presented with abdominal pain and reported that intermittent drenching night sweats, a global nonpulsatile headache, sinus pressure, and left maxillary pain radiating into her teeth had developed 4 weeks earlier. Amoxicillin was ...

A 25-year old woman presented to her primary care physician for evaluation of abdominal pain. Her abdominal discomfort began six months earlier, and was localized to the right upper quadrant. She described a constant pressure unrelated to food intake and ...

This interactive Journal feature presents the case of an 88-year-old woman who presented to the ER with complaints of intermittent confusion. Direct the investigation of the case, test your diagnostic and therapeutic skills, and compare your performance with that of others at NEJM.org.

An 18-year-old black woman presented with fever, ear pain, and dull discomfort on the right side of the chest that was unchanged with movement or inspiration. She had no other symptoms and had previously been well, aside from mild exercise-induced asthma. ...

A 60-year-old man presented with fatigue, increasing frequency of urination, and increasing thirst. He reported no dysuria, urgency, incomplete bladder emptying, straining to initiate urination, fevers, chills, arthralgias, or rash. What diagnostic and management steps do you choose?

A 31-year-old woman originally from Nepal presented to her physician after unsuccessful attempts at pregnancy for the past 18 months. She had no history of sexually transmitted diseases, pelvic inflammatory diseases, use of an intrauterine device, exposure to diethylstilbestrol, abnormal Papanicolaou smears, or previous pregnancies. What diagnostic and management steps do you choose? Direct the investigation of the case, test your diagnostic and therapeutic skills, and compare your performance with that of others at NEJM.org.

A 40-year-old woman presented with diarrhea. It had begun 2 years ago with four to five loose bowel movements a day and progressed in recent months to 15 large-volume, watery stools daily. The patient's diarrhea persisted with fasting and also occurred at ...

A 45-year-old white man was brought to the emergency room by emergency-medical-services personnel after a syncopal event. He did not report any chest pain. He was found to have a monomorphic, wide-complex tachycardia at a rate of 240 beats per minute, ...

A 58-year-old woman presented to her primary care physician after several days of dizziness, weakness, urinary frequency, fever, and dry mouth. A urinary dipstick test was positive for leukocyte esterase and nitrites, and a urine culture grew more than 10^...

This interactive Journal feature presents the case of a 57-year-old man with painful purple discoloration of three toes on his left foot, intermittent blurry vision, intermittent chest pain, fatigue, anorexia, drenching night sweats, and weight loss. Direct the investigation of the case, test your diagnostic and therapeutic skills, and compare your performance with that of others at NEJM.org.

A 31-year-old woman in the 37th week of pregnancy presented to the emergency department with severe bitemporal headache and shortness of breath. Direct the investigation of the case, test your diagnostic and therapeutic skills, and compare your performance with that of others at NEJM.org.

A 62-year-old woman presented to the urgent care clinic with gingival bleeding after periodontal scaling of her lower right second molar. She had undergone the procedure 5 hours before presentation, and the bleeding had persisted despite the application ...

A 52-year-old man with diabetes mellitus was admitted to the hospital after presenting to the emergency department with abdominal discomfort. His symptoms began 5 weeks earlier, when epigastric discomfort developed that did not radiate elsewhere. The pain ...