Background: Hepcidin-25 is a liver-derived key peptide hormone that regulates iron homeostasis in humans. Recent studies have suggested that hepcidin also play a key role in host-defense mechanism. Iron is essential for the survival and growth of bacteria. When the bacteria infect macrophages, macrophages release a number of cytokines including interleukin-6, which increase production of [...]

Background: The clinical evaluation of febrile neonates ≤ 60 days has been extensively debated in the age of doing less invasive testing to yield the same clinical outcomes with fewer complications. Rates of serious bacterial infections (SBI) in this population have been reported to be between 8.5% and 12%, and up to 20% in neonates [...]

Background: Blood cultures are frequently ordered in hospitalized patients, often to work up undifferentiated fever or leukocytosis. This leads to low rates of positive cultures and high burden of false positive results resulting in avoidable interventions and waste. A recent study in hospital medicine patients identified several predictors of blood stream infection (BSI), but the [...]

Background: Blood stream infection is associated with high mortality and morbidity. Blood cultures are considered the gold standard for diagnosing bacteremia in sepsis patients. However, blood culture results may take at least 12 to 24 hours for a positive result and may even be complicated by contamination. Procalcitonin (PCT) a biomarker for bacterial infection is [...]

Case Presentation: 63-year-old male with past medical history of diabetes mellitus complicated by neuropathy, hypertension and recurrent UTIs presented with 1 week history of nausea, decreased oral intake and malaise. He endorsed dysuria and left flank pain. Upon admission, he was afebrile and normotensive but slightly tachycardic. Initial labs revealed WBC 21.1, Creatinine 1.56, increased [...]

Case Presentation: A 39-year-old man presented with several days of worsening lightheadedness, fevers, and joint pains. His temperature was 99.8 Fahrenheit, pulse 122 per minute, and blood pressure 80/51 mmHg. He looked ill and uncomfortable. His palms and soles had multiple tender, purple-to-black macules and patches 3-30 mm in dimension, consistent with embolic infarcts (image [...]

Case Presentation: The patient is a 67 years old female with Hepatitis C and alcoholic liver cirrhosis, HCC, atrial fibrillation who presented to the ED with fever, chills and altered mental status. Per husband, the patient did not have any focal symptoms including cough, abdominal pain, burning urination, headache or photophobia. On initial evaluation patient’s [...]

Case Presentation: An 87-year-old female with congestive heart failure (CHF), coronary artery disease, atrial fibrillation, COPD, and chronic kidney disease presented with 3-day-history of diarrhea, worsened dyspnea, leg swelling and weight gain. Vitals signs were temperature 38.3 C, pulse 104, respiration 20-25 and blood pressure 112/46. Examination was significant for bilateral crackles in lungs, irregular [...]

Case Presentation: This is the case of a 69 year old woman with a history of diabetes and peripheral arterial disease who presented with eye pain for two days prior to admission. Of note, she was recently admitted to the hospital for a left foot infection requiring amputation; her hospital course was complicated by MRSA [...]

Case Presentation: A 63-year-old woman with no significant medical history presented to the ED with three days of fever, confusion, and lethargy. She was responsive to physical but not verbal stimuli. Vital signs included temperature of 38.8C, heart rate of 110 BPM, blood pressure of 107/52 mmHg, with SpO2 of 94% on room air. Her [...]