Case Presentation: A 40-year-old female presented in June of 2023 with emesis and a fever of 38.9 °C. She complained of epigastric pain radiating to the back. The patient reported no recent travel. She worked in a daycare and had a pet dog. She had not hiked or camped recently. She walked her dog at [...]

Case Presentation: A 65-year-old female with uterine carcinosarcoma was hospitalized for ascites, dyspnea, and fatigue. Initial findings revealed peritoneal carcinomatosis with massive ascites, potential liver metastases, and acute kidney injury (AKI) with creatinine 6.6 mg/dL (baseline 0.9) with oliguria. She declined dialysis. High urate (14.5 mg/dL) prompted administration of rasburicase due to an initial concern [...]

Case Presentation: A 43-year-old man with no significant past medical history presented with 3–4 days of rapidly progressive right upper extremity pain, swelling, and bullae. Symptoms began with a bulla at the antecubital fossa and extended distally and proximally. He also developed bilateral thigh and hip cramping with difficulty walking. He denied trauma or IV [...]

Case Presentation: We report a case of a 52-year-old woman with chronic pain, depression, and poorly controlled diabetes who presented with acute hypoxic respiratory failure secondary to multifocal Streptococcus pneumoniae pneumonia and empyema. During a protracted ICU course requiring mechanical venitation and tracheostomy, she exhibited persistent neurological abnormalities including dystonia and tremor, which, along with [...]

Case Presentation: A 75-year-old man with advanced urothelial carcinoma on enfortumab vedotin and pembrolizumab presented with new muscle weakness. His weakness began two weeks prior as cramping in his lower extremities and progressed upwards, leading to difficulty raising his head. He also noted progressive dyspnea on exertion and lower extremity edema. On exam, he had [...]

Case Presentation: A 28-year-old male who was immunosuppressed with Infliximab for Crohn’s disease was seen in the hospital in early summer for non-resolving fever of four-week duration. Blood and urine cultures and computed tomographic (CT) imaging of chest, abdomen and pelvis was negative along with molecular testing for common tick-borne diseases like Anaplasmosis, Babesiosis, respiratory [...]

Case Presentation: We introduce a 17-year-old male with history of cholecystectomy two years prior, who presented to his pediatrician with transaminitis and hyperbilirubinemia. Workup revealed significant peripheral eosinophilia, along with elevated level of Immunoglobulin G (IgG). Autoimmune workup was significant for anti-smooth muscle antibodies and anti-neutrophil cytoplasmic antibodies (p-ANCA), but magnetic resonance cholangiopancreatography (MRCP) revealed [...]

Case Presentation: A 17-year-old female presented to the ED with progressive encephalopathy. Three weeks prior, patient began experiencing pre-syncope, anorexia, increased sleep, and frequent urination. Her family described pressured, child-like speech. Patient endorsed smoking marijuana prior to symptom onset. History ascertainment was limited by her family’s inconsistent presence at bedside and her poor engagement during [...]

Background: Proficiency in multiple languages as healthcare professionals can reduce miscommunication, enhance patient safety, and improve patient care in the clinical setting. In Washington counties, up to 51% of households speak a language other than English, and up to 12.6% speak an Asian or Pacific Island language. Purpose: The Elson S. Floyd College of Medicine’s [...]

Background: Venous thromboembolism (VTE) prophylaxis is a critical component of inpatient care, butinappropriate or unnecessary pharmacologic administration can expose patients to avoidablerisks, such as bleeding, and increase healthcare costs. At our institution, there has been shownto be an unnecessary amount of prophylaxis used on patients that don’t meet criteria forneeding VTE prophylaxis. For low-risk non-ICU [...]