Background: Pneumonia is often treated for longer than necessary, yet factors associated with excess duration of treatment are unknown. We sought to: (a) develop an algorithm to determine appropriate antibiotic duration in non-intensive care unit (ICU) patients hospitalized with pneumonia and (b) apply this algorithm to an ongoing prospective study to determine patient-, provider-, and [...]

Background: Pneumonia is often treated for longer than necessary, yet factors associated with excess duration of treatment are unknown. We sought to: (a) develop an algorithm to determine appropriate antibiotic duration in non-intensive care unit (ICU) patients hospitalized with pneumonia and (b) apply this algorithm to an ongoing prospective study to determine patient-, provider-, and [...]

Background: Surgical site infections (SSI) can complicate any operative procedure although this risk is mitigated through the use of preoperative antibiotic prophylaxis.  While antibiotic prophylaxis can provide great benefit, inappropriate use can lead to the development of multi-drug resistant organisms causing increased morbidity, mortality, and cost. Although national clinical guidelines for preoperative antibiotics prophylaxis were [...]

Background: Inappropriate antibiotic use is associated with bacterial resistance, adverse events, and an increased risk of Clostridium difficileinfection. However, providers often prescribe antibiotics for viral respiratory infections and treat infections such as bacterial pneumonia for unnecessarily prolonged durations.  Serum procalcitonin (PCT)-guided treatment is known to safely reduce antibiotic use and duration of treatment in pneumonia. [...]

Case Presentation: A 62-year-old woman with a medical history significant for seizure disorder presented with a right tibia fracture following a mechanical fall. She underwent open reduction and internal fixation of the right tibia and was extubated without difficulty following surgery. The following day, she became febrile and hypoxemic, requiring an escalating amount of oxygen [...]

Case Presentation: This is a previously healthy 41-year-old man who presented with fevers, headache, and neck stiffness for 5 days. He also reported photophobia, anorexia, insomnia, nausea but no vomiting. He denied any recent travel and was not aware of any insect bites. The patient had a faint macular rash on his upper chest and [...]

Case Presentation:       A 33 year-old Hispanic male without significant history presented with an unremitting fever for 5 days, associated with myalgais, fatigue, night sweats, and a rash. Upon admission, he was tachycardic, hypotensive and febrile at 103F. Physical exam revealed a diffuse non-blanching, maculo-papular rash, sparing the face, palms and soles. Labs [...]

Case Presentation: A 55 year old male with past medical history significant for congestive heart failure, severe persistent asthma and eosinophilic pneumonia on chronic prednisone and status post bronchial thermoplasty presented with fever, cough, shortness of breath and chest pain of 2 weeks and hemoptysis of 3 days duration. He also had two recent hospitalizations [...]

Case Presentation: We present the case of a 46-year-old male from Guyana with a history of type-2 diabetes mellitus who presented with cellulitis of his left foot.  He is a rice farmer working in brakish water environments and had sustained a laceration on the left medial surface of his foot. Five days prior to admission, [...]