Background: Prior studies have shown that miscommunication between providers and families with a non-English language preference (NELP) has been associated with medication errors, inadequate follow-up, increased ED usage, and hospital readmissions. They have also noted barriers to providing translated instructions, such as difficulty with translation, limited resources, and inconsistent use of services. Specifically, our institution [...]

Background: Inequitable healthcare is delivered to those who are incarcerated and have a history of incarceration. Incarceration has a significant multiplicative impact on the health of those who experience it – worsening outcomes related to chronic illness and shortening life expectancy. Hospital based providers tend to interact sporadically with individuals who are incarcerated, limiting the [...]

Case Presentation: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that can involve multiple organs, including the central nervous system (CNS). Neuropsychiatric systemic lupus erythematosus (NPSLE) refers to a spectrum of neurological and psychiatric symptoms such as cognitive dysfunction, psychosis, mood disorders, and seizures. Status epilepticus is a rare and severe presentation often associated [...]

Case Presentation: A 32-year-old woman presented with progressively worsening abdominal distention for weeks associated with abdominal pain, postprandial nausea and emesis. The physical exam was notable for generalized tenderness and fluid wave. Lab work revealed proteinuria, acute kidney injury, normocytic anemia, and leukocytosis. She had undergone a diagnostic paracentesis at an outside hospital that had [...]

Case Presentation: A 38-year-old male with presumed seronegative rheumatoid arthritis (RA), irritable bowel syndrome with diarrhea (IBS-D), and reported Lyme disease (negative serology) presented with acute dyspnea, pleuritic chest pain, and chronic relapsing fevers. Initial treatment with broad-spectrum antibiotics failed, and he developed acute hypoxic respiratory failure, requiring transfer to the Medical Intensive Care Unit [...]

Case Presentation: A 37-year-old female with systemic lupus erythematosus (SLE), noncompliant with mycophenolate mofetil (MMF) and hydroxychloroquine, complicated by Class V membranous lupus nephritis and cirrhosis due to autoimmune hepatitis, presented with generalized weakness and altered mentation. This followed a recent admission for methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia and acute kidney failure requiring hemodialysis (HD), [...]

Case Presentation: A 48-year-old woman with a history of fibromyalgia presented with a three-month history of progressive dyspnea, muscle weakness, weight loss (20 kg), and worsening respiratory symptoms. She initially sought care for productive cough, fever, and dyspnea, receiving treatment for pneumonia with ceftriaxone on two occasions with transient symptom relief. However, her symptoms recurred [...]

Case Presentation: A 72-year-old male presented to the emergency room for macrocytic anemia and a creatinine of 9.72 mg/dL on outpatient lab work. Past medical history was notable for paroxysmal supraventricular tachycardia, gastroesophageal reflux disease and heart failure with reduced ejection fraction. On admission, he complained of six months of fatigue with constipation, 60 lbs [...]

Case Presentation: A 67-year-old female with a medical history of coronary artery disease, hypertension, and hyperlipidemia presented to the hospital with several days of worsening epigastric pain and chest pain. The pain had a band-like distribution with radiation to her back and no clear aggravating or alleviating factors. She reported chills and one day of [...]

Case Presentation: A 52-year-old female with discoid lupus on immunosuppressive medications and a history of gout presented with acute right wrist pain and swelling and subjective fevers. There was no history of trauma or other joint involvement. Notable examination findings include significant swelling of the right wrist without overlying erythema or induration. She was noted [...]