Background: Urinary tract infection (UTI) and community acquired pneumonia (CAP) are the two most common infections treated in hospitalized patients and are often inappropriately diagnosed. Due to myriad factors—including diagnostic uncertainty—patients are commonly inappropriately diagnosed with UTI or CAP in the emergency department (ED). Antibiotics may be continued throughout the hospitalization even if new information [...]

Background: Studies addressing the utility of cardiac telemetry monitoring for patients hospitalized with COVID-19 pneumonia (PNA) is sparse. Patients hospitalized with COVID-19 PNA are at higher risk for cardiac complications (1-3), thus many hospitals instituted mandatory cardiac telemetry monitoring for patients hospitalized with COVID-19 PNA. However, there is scant data assessing the utility of cardiac [...]

Background: Elderly patients have a higher risk of developing aspiration pneumonia and have a higher risk of death if hospitalized for aspiration pneumonia. This study was conducted to confirm the effectiveness of an aspiration prevention program using the Gugging Swallowing Screen (GUSS) for elderly patients hospitalized with acute medical illness. Methods: Starting in April 2021, [...]

Background: Sepsis is one of the most common life-threatening conditions and is associated with significant mortality, length of stay, and cost for hospitals and health systems worldwide. Based on a recent report, there has been an increase in rates of hospital-acquired sepsis (HAS), or sepsis “not-present-on-admission”, in California from 2020 to 2021. Aspiration pneumonia was [...]

Case Presentation: A 67-year-old male with a past medical history of peripheral arterial disease, a chronic left lower extremity wound, and type 2 diabetes mellitus was admitted from vascular surgery clinic for osteomyelitis of the left lower extremity. He underwent multiple procedures by the podiatry service including a trans-metatarsal amputation. Intraoperative bone cultures returned positive [...]

Case Presentation: A 53-year-old immunocompetent female with a history of well-controlled type 2 diabetes mellitus had incidentally found asymptomatic right lower lobe lung masses, the largest of which measured 6.5 cm x 2.4 cm. She underwent a CT-guided lung biopsy of these for further evaluation. The pathology report did not reveal a malignancy, but instead [...]

Case Presentation: A 70-year-old woman with hypereosinophilic syndrome (HES) complicated by recurrent organizing pneumonia (OP) was admitted to a hospital medicine service with four weeks of involuntary spasms of her abdominal wall muscles and hypoxemia. She reported having similar episodes during past OP flares which resolved quickly with prednisone. Notable admission vitals included a heart [...]

Case Presentation: We present a 53-year-old Caucasian male with a history of Ankylosing spondylitis and Sjogren’s syndrome who presented to the ED with cough, fever, fatigue and mild rash that appeared during his admission for a recent knee replacement. Discharged on cefadroxil, his symptoms persisted after completing treatment. No concerns for surgical site infection were [...]

Case Presentation: A 32-year-old male with no significant past medical history presented to the emergency department with a 3-day history of anorexia, fever, and a rash after returning from a trip to Colorado. Additionally, he endorsed an 8-pound weight gain and dyspnea on exertion.Upon presentation, he was febrile, tachycardic and had a diffuse targetoid rash [...]

Case Presentation: An 85-year-old female with a history of insulin-dependent diabetes, chronic kidney disease, and pemphigus vulgaris presented with four days of dyspnea and non-productive cough. History was significant for recent rituximab infusions and chronic prednisone therapy for pemphigus. On presentation to the ED, the patient was noted to be hypoxic to SpO2 84% on [...]