Background: Most cases of pneumonia in older people are aspiration pneumonia,[1] and the prognosis among patients hospitalized for aspiration pneumonia is very poor.[2] After being hospitalized for aspiration pneumonia, a certain number of patients become unable to take orally, and some chronic conditions are reported to be negatively associated with the retrievement of oral intake.[3] […]

Background: For most infections, shorter antibiotic durations are similarly effective to longer durations but have lower risk for side effects and antibiotic resistance.1-9 Since 2019, community-acquired pneumonia (CAP) guidelines have recommended hospitalized patients with CAP be treated until clinical “stability and for no less than a total of 5 days.”10 However, randomized clinical trials have […]

Background: Community acquired pneumonia (CAP) is one of the most common causes of hospitalization in the United States1 and a frequent source of antibiotic overuse.2 Two thirds of patients hospitalized for CAP receive excess antibiotic duration, primarily from excess therapy at discharge.3 Patients living in rural areas are known to have worse health outcomes than […]

Background: The CDC recognizes antimicrobial resistance as an urgent global public health threat and supports antibiotic stewardship initiatives to combat antibiotic resistance. Pneumonia is a frequent condition treated by both hospitalists and emergency room physicians and the most common reason for inpatient antibiotic use and over prescribing. Recent IDSA guidelines for the treatment of community […]

Case Presentation: A 61-year male presents with complaints of a cough and progressive dyspnea for over a week. Pertinent history included a Tuberculosis (TB) infection over thirty years ago with an unclear treatment course. Social history was positive for a 40 pack-year smoking history. On presentation, he was tachycardic, hypoxic and tachypneic. Physical exam was […]

Case Presentation: A 57-year-old male with a history of renal transplant currently on immunosuppressive medication presents to the hospital with fevers and general malaise. Laboratory findings were significant for hypercalcemia (15.6 mg/dL) with suppressed parathyroid hormone (PTH) levels. Infectious investigation including urinalysis, chest x-ray, commuted tomography (CT) of the chest, abdomen, and pelvis, blood cultures, […]

Case Presentation: A 36-year-old male with a history of B-cell acute lymphoblastic leukemia (ALL) treated with Hyper-CVAD with intrathecal chemotherapy and allogenic hematopoietic stem cell transplant (HSCT) from a haploidentical donor (CMV D-/R+). His ALL relapsed 8 months after transplant and he subsequently underwent pre-phase chemotherapy for future CAR T-cell therapy, developing pancytopenia. He was […]

Case Presentation: A 43-year-old man with ankylosing spondylitis (on adalimumab), presented with 2-days of fever, cough, diarrhea, and encephalopathy. He had no significant travel history. On exam, he was tachycardic (P = 120 bpm), febrile (temperature 103.0oF), tachypneic (RR = 30 bpm) and had left-sided crackles. Notable labs: WBC = 12.3 109/L, Na+ = 130 […]

Case Presentation: A 43-year-old male with a history of diffuse large B-cell lymphoma (DLBCL) in remission for 2 years after chimeric antigen receptor (CAR) T-cell therapy presented to his PCP with headaches and a mild cough. A PCR COVID-19 test was positive, a head CT showed cerebral edema, and MRI had diffuse dural thickening without […]

Case Presentation: We present the case of a 62-year-old female with a past medical history of breast cancer diagnosed one-year prior status post lumpectomy, adjuvant radiation, and letrozole, who presented to the hospital with a 1.5 month history of cough, night sweats, fevers, and weight loss. She reported the cough was initially productive of yellow […]