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 [...]

Case Presentation: A 66-year-old Hispanic male with a history of primary hypertension and type 2 diabetes mellitus presents to hospital with 3 months of progressive fatigue, poor appetite, watery diarrhea, dizziness, and vomiting. Vital signs were notable for postural hypotension (BP 146/84 sitting, BP 118/72 standing). Physical examination was normal with no skin or mucous [...]

Case Presentation: A 17 y.o. female with systemic lupus erythematosus (SLE) presented with several weeks of worsening migratory polyarthralgia, as well as sporadic fevers, night sweats, and chills. Prednisone was begun 3 weeks prior for a presumed SLE flare, given elevated anti double-stranded DNA (anti-dsDNA) and erythrocyte sedimentation rate (ESR) and hematuria, but provided no [...]

Background: Pneumocystis pneumonia (PCP) is a life-threatening opportunistic infection that leads to severe pneumonia in immunocompromised hosts. This results in respiratory failure and hypoxemia. Its reported survival rate ranges from 20% to 50%. Despite its seriousness, there is limited research on the occurrence of PCP in children, likely due to its infrequency. Current national data [...]

Background: Hepatic artery pseudoaneurysm (HAP) is a rare entity, potentially life threatening and associated with high mortality. The aim of this study was to evaluate Mayo Clinic enterprise’s clinical experience with HAP occurrence, clinical features and outcome in the last 20 years, and to compare our results with what the literature. Methods: This retrospective analysis [...]

Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization of hospitalized patients is associated with higher readmission rates and increased morbidity. Depending on the mechanisms of transmission, numerous potential control interventions exist to reduce the burden of disease. These interventions include decolonization, improving hand-washing adherence, and enhanced environment cleaning. To evaluate the impact of various types of control, [...]

Background: Inappropriate diagnosis of urinary tract infections (UTI) contributes to antibiotic overuse. We previously validated and refined a patient safety measure that defines inappropriate diagnosis of UTI (i.e., treatment of asymptomatic bacteriuria [ASB]) and was endorsed by the National Quality Forum. Use of this measure as a pay-for-performance metric in the Michigan Hospital Medicine Safety [...]

Background: Urinary tract infections (UTIs) are a common bacterial infection in infants, with potentially serious consequences. Even though urinalysis (UA) is a commonly used screening test for UTI, there is a lack of consensus on its accuracy in well-appearing febrile infants below 28 days old. This study aims to evaluate the accuracy of UA, both [...]

Background: Syphilis cases in the United States increased by 28.6% between 2020 and 2021. San Francisco was the highest-risk county for early syphilis in 2017, and between 2017 and 2021, syphilis diagnoses further increased by 12%, with a 200% increase in syphilis cases among women and a 333% increase in congenital syphilis cases compared to [...]

Background: Helicobacter pylori (HP) infection is one of the most prevalent chronic bacterial infections, infecting more than half of the global population. The sensitivity of HP diagnostic tests decreases with the use of antibiotics and/or antisecretory drugs. Given the increasing rates of macrolide resistance worldwide, comprehensive testing for HP eradication is imperative. In this quality [...]