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: Neonatal herpes simplex virus (HSV) infections are one of the most clinically challenging infections of the newborn period because of the often subtle presentation and devastating consequences of a missed diagnosis. The availability of HSV polymerase chain reaction (PCR) testing has led to widespread use of both HSV testing and empiric therapy but guidelines [...]

Case Presentation: Disseminated Coccidioidomycosis is a rare fungal infection that can have various presentations in a hospitalized patient. Given the high mortality rate associated with delayed diagnosis, it is essential to keep this rare infection on the differential. A previously healthy 37-year-old Hispanic male presented with a one-month history of cough, high-grade fevers, night sweats, 15-pound [...]

Case Presentation: Mr. M is a 66 year old man with a history of a kidney transplant and extensive coronary disease with a recent myocardial infarction and code blue arrest 2 months prior to admission. He presented to an outside facility with altered mental status and seizures attributed to severe hyponatremia (Na 115). The patient [...]

Case Presentation: A 64 year old male suffered from gradual onset fatigue and change in mentation over the course of a month. His symptoms then progressively worsened as he became confused and developed intermittent headaches. Past medical history includes pulmonary sarcoidosis, treated with 20mg of prednisone daily. On presentation, the patient had no neck stiffness. [...]

Case Presentation: A 35 year-old undomiciled male with a history of epilepsy and recurrent aseptic meningitis was brought in to the emergency department after being found unresponsive. Initial vital signs were notable for temperature of 102˚F. He was intubated in the emergency department and a lumbar puncture was done consistent with a bacterial meningitis (WBC [...]

Case Presentation: 68 year-old female presented with three days of progressively worsening myalgias, headaches, fevers after a cruise through Antica, Saint Martin, and Puerto Rico (PR). She also was confused and unable to walk. She had no neck stiffness or photophobia. On exam, she was alert and oriented to name only, with temperature 103 Fahrenheit. [...]

Case Presentation: A 29-year-old Caucasian male lettuce farmer with no significant past medical history presented to our ED with acutely worsening holocranial throbbing headache, polyarthralgias, intermittent migrating burning rashes, and severe paresthesia to tips of all toes. He reported a three-week history of neck pain, excruciating hyperesthesias to light touch, diffuse abdominal pain, and constipation. [...]

Case Presentation: A previously healthy 20-year-old male presented with sudden onset urinary retention. He reported mild headaches, fevers, fatigue later followed by acute urinary retention associated with lower abdominal and back pain. Last void was over 24 hours ago. Vitals were stable except for a temperature of 39.9°C. No cervical neck stiffness, meningeal irritation or [...]

Case Presentation: A 64-year-old Caucasian male with hypertension and diabetes mellitus presented to the emergency room with confusion, ataxia, and urinary retention after a 10-day cruise to Aruba. During the cruise, he developed fever, diarrhea, and a rash. After returning home, he visited a local ED and was treated with ciprofloxacin and metronidazole for febrile [...]