Background: Antibiotics are frequently prescribed—and overprescribed—at hospital discharge, leading to adverse-events and patient harm. Antibiotic overuse at discharge varies widely across hospitals, with rates of overuse differing up to 5-fold.(1) Our understanding of what approaches optimize prescribing at discharge is limited. Recently, we published the ROAD (Reducing Overuse of Antibiotics at Discharge) Home Framework which […]

Case Presentation: A ten month old male born at term with a past medical history of pneumonia diagnosed at six months of age presented with fever, cough and respiratory distress. His exam was notable for decreased breath sounds and crackles over the entire left lung. A chest x-ray was obtained and demonstrated near complete opacification […]

Background: Community-acquired pneumonia (CAP) is the most common infectious diagnosis necessitating adult hospitalization in the United States (US). Timely diagnosis of CAP is important to improve patient outcomes. However, overdiagnosis of CAP, or treatment of CAP despite inadequate signs or symptoms of CAP, may also pose a significant threat to patient safety. Potential harm of […]

Case Presentation: A 54-year-old female with essential hypertension, hyperlipidemia, hypothyroidism and MGUS presented to Wheeling Hospital complaining of weakness, dyspnea on exertion and right lower extremity pain for two weeks. Patient was treated for a right gastrocnemius DVT, acute SARS-CoV-2 pneumonia and pulmonary emboli in right middle and lower lobe pulmonary artery branches with smaller […]

Case Presentation: A 40-year-old Hispanic male with a history of diabetes mellitus presented with recurrent febrile episodes. His temperature on admission was 41.6oC associated with seizure-like activity requiring intubation. Labs were significant for WBC 1,800, platelets 85,000, creatinine 1.53, AST 178, ALT 199, ALP 254, and HA1c 10.3%. RUQ ultrasound showed a hepatic lesion concerning […]

Case Presentation: A 53-year-old male with a past medical history of hypertension who recently emigrated from El Salvador presented to an ambulatory clinic for evaluation of substernal chest pain that started eight days earlier. He described the chest pain as intermittent, non-radiating, and associated with palpitations, chills, shortness of breath, and diaphoresis. He denied fever, […]

Background: Hospital-at-Home (HaH) is a safe and effective alternative to high-cost, traditional hospitalization in patients with a range of medical conditions, such as non-severe community-acquired pneumonia (CAP). The COVID-19 pandemic created a unique situation with favorable policy changes, hospital resource constraints, and a clearly defined patient population that helped to increase HaH program deployment and […]

Case Presentation: 71-year-old female with history of DM2, HTN, breast carcinoma in situ status post mastectomy, B-cell lymphoma (R-CHOP in 2016 & RT, currently in remission), autoimmune hepatitis related cirrhosis on Azathioprine presented to the hospital with a 4-day history of progressively worsening productive cough, mild hemoptysis, fever and shortness of breath. In the Emergency […]

Case Presentation: A 56-year-old male with a past medical history of large B cell lymphoma on ibrutinib with recently diagnosed COVID pneumonia, and recurrent ascites due to portal hypertension, presented to the hospital due to shortness of breath, and fever for one week. Physical examination was unremarkable on admission except for fever. His initial labs […]

Background: Pneumonia is one of the most common conditions seen in hospitalized patients. While utilization of inhaled bronchodilators would be a consideration in the treatment of patients with exacerbations of underlying lung disease (ULD; i.e. asthma, COPD), their role in the absence of such underlying pathologies is not well defined. There is very little information […]