Background: Post-operative tachycardia in patients undergoing hip and knee arthroplasty is a common, but incompletely explored phenomenon. Post-operative tachycardia, noted in up to 33% of our orthopedic surgical population, presents a diagnostic dilemma to the consulting hospitalist. Post-operative tachycardia is often attributed to catecholamine release in response to operative stress or anemia. However, the heart […]

Case Presentation: A 42-year-old female with no past medical history presented with increased dyspnea on exertion.  She was initially diagnosed with pericarditis and pulmonary nodules at an outside hospital. After continued symptoms, studies revealed a heterogenous, echodense mass was visualized in the right atrium near the entrance of the superior vena cava and the interatrial […]

Case Presentation: A 50 year old African-American male presented with 2 weeks of headaches, neck pain, and photophobia. Exam revealed positive meningeal signs and a fever of 101oF. CT head and MRI showed small cerebellar infarcts.  Lumbar puncture was done and empiric acyclovir, vancomycin, and ceftriaxone begun.  After the LP, the headache improved. Cerebrospinal fluid […]

Case Presentation: A 50-year-old Caucasian male presented with complaints of worsening shortness of breath, cough productive of thick, yellow colored phlegm and fever for three days. His past history was significant for adenocarcinoma esophagus requiring subtotal esophagectomy with upper gastrectomy and anastomosis along with chemotherapy and radiation four years ago. Prior to admission he was […]

Case Presentation: A 45 yo male with PMH of morbid obesity, hypertension, congestive heart failure, diabetes mellitus type II,  and obstructive sleep apnea presented for evaluation of shortness of breath and hemoptysis x24hrs. The patient had completed a 22hr non-stop car trip the day prior to presentation. CTA Chest revealed multiple acute pulmonary emboli involving the right middle and […]

Case Presentation: A 74 year old male with a history of cerebral vascular disease as well essential thrombocythemia that had progressed to myelofibrosis maintained on ruloxitinib for 13 months presented with four months of intermittent somnolence, confusion and failure to thrive.  His symptoms were first noted during a hospitalization for health care associated pneumonia and […]

Case Presentation: A 38 year-old male with diet controlled diabetes presented with 3 months of unprovoked episodes of sweats. He noted that these episodes would come on at any time of day, last several minutes and leave him “drenched.” Blood sugar readings during these episodes were normal. He reported generalized myalgias, worsening fatigue and eyelid […]

Case Presentation: A 63 year old gentleman with a history of throat cancer and hypertension was transferred from a community hospital with a diagnosis of meningitis. Ten days prior, the patient awakened with a severe headache, facial rash, periorbital edema and conjunctival injections followed by the development of neck pain and stiffness hours later. He […]

Case Presentation: A 78-year-old male was admitted to the hospital with a one week history of shortness of breath and lower extremity edema. His past medical history was significant for atrial fibrillation, chronic obstructive pulmonary disease, lung cancer status post right upper lobectomy and dyslipidemia. His symptoms began after receiving his fifth monthly intraocular injection […]

Case Presentation: A thirty-five year old African-American female with a history Multiple Sclerosis and uterine fibroids presented with anemia, acute kidney injury (AKI), and lower extremity edema for two weeks. Initially AKI was attributed to obstructive uropathy secondary to massive fibroids affecting both kidneys, with atrophic R kidney seen on imaging. However, when AKI began […]