Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

Background: As a group of medical students in a five-week leadership program, we were charged with making a medicine inpatient unit at an urban quaternary care academic medical center the best unit in the hospital. Research shows that the hospital spends an estimated $2721 for every inpatient day (Kaiser, AHA Annual Survey, 2015). Longer lengths [...]

Background: The 2001 Institute of Medicine Report Crossing the Quality Chasm cited a lack of care coordination as a contributing factor to the “chasm” between evidence-based and delivered care and suggests team-based models of care delivery. Hospitalists are tasked with increasing efficiency in inpatient care. LOS is designated as a measure of care coordination and [...]

Background: Clostridium difficile infections (CDI) is a notorious nosocomial threat to health and a leading cause of infectious diarrhea. It is associated with billions of dollars of US health care costs annually due to long hospital stays and readmissions. While CDI is mostly caused by toxin-producing strains, some strains do not express these proteins. These [...]

Case Presentation: 27-year-old African American woman with no medical history presented with one day of sudden onset bilateral hearing loss and tinnitus. Review of systems was positive for red eyes, blurred vision, photophobia and gait imbalance. This constellation of symptoms was preceded by a viral upper respiratory infection. She denied excessive noise exposure, head trauma [...]

Case Presentation: A morbidly obese, but otherwise healthy, 57 year old male, presented to his initial visit with his primary care provider with complaints of dysphagia, vomiting, and unintentional weight loss of 15 pounds over the previous month. He reported a sudden onset of vomiting after eating a large meal about a month prior. Following [...]

Case Presentation: Teriflunomide is a pyrimidine synthesis inhibitor used in management of Relapsing Remitting Multiple Sclerosis (RRMS). Leflunomide is the active agent which has been used in rheumatoid arthritis. Chronic diarrhea has been associated with both of these. However, there is no evidence in literature to suggest clostridium difficile (C.Diff) diarrhea associated with these agents. [...]

Case Presentation: A 51-year-old woman presented with recurrent confusion and altered mental status over the past 6 months. She reported associated hallucinations, altered sleep cycle and hyper-arousal symptoms. She was treated with lactulose and rifaximin for suspected hepatic encephalopathy with no improvement. She denied any other symptoms. Past medical history was significant for cirrhosis secondary [...]

Case Presentation: A 55 year old male with a history of hypertension, hyperlipidemia and significant history of alcohol abuse presented after presyncope with subsequent fall and head trauma. On presentation he was confused and dysarthric. He complained of generalized malaise for the past two weeks associated with nausea and poor nutritional intake. He denied fever, [...]