Background: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. Therefore, we aimed to evaluate the effect of fluoroquinolone stewardship on discharge fluoroquinolone use in patients with pneumonia or a [...]

Background: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. Therefore, we aimed to evaluate the effect of fluoroquinolone stewardship on discharge fluoroquinolone use in patients with pneumonia or a [...]

Background: With standard diagnostic methods, the etiologic pathogen of community acquired pneumonia (CAP) is detected in ≤ 50% hospitalized CAP patients. In our previous studies using a diagnostic “bundle”, we were able to detect etiologic pathogens in ≥ 70 % of the patients. Our bundle consisted of a nasopharyngeal swab for Biofire film array, that [...]

Background: Hyperlipidemia is a recognized risk factor for incident acute myocardial infarction (AMI) and acute decompensated heart failure (ADHF), and no such documented association with pneumonia. However, the influence of hyperlipidemia on long-term mortality after AMI, HF, or pneumonia has not yet been fully understood. The objectives are to estimate the effect of hyperlipidemia and [...]

Case Presentation: An 81-year old male with a significant medical history of essential hypertension, type 2 diabetes mellitus and coronary artery disease, was admitted to the hospital complaining productive cough, shortness of breath and pleuritic chest pain from one week. Chest X-ray revealed left lower lobe consolidation with left parapneumonic effusion. The nasopharyngeal swab was [...]

Case Presentation: A healthy 22-year-old woman presented to the ED with five days of fevers, dry cough, dyspnea and right-sided pleuritic chest pain. Lab work and a CXR were unremarkable. A nasal swab diagnosed Influenza B and she was discharged with Oseltamivir, which she did not take. Two days later, the patient returned with progressive [...]

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: A 44-year-old Nigerian woman with no medical history and recent travel to Mexico presents with cough for 4 weeks, fever, and malaise. She initially presented to urgent care with respiratory complaints, was diagnosed with pneumonia and given azithromycin. Her symptoms did not improve and she went to the ED. Vitals were notable for [...]

Case Presentation: A 59 year old man presented to the ER with shortness of breath, non-productive cough and fever of 103○F. He was also being followed for an enlarging left tricep mass that has grown significantly in size for the past 2 months, currently at 11cm in diameter. CBC now revealed a WBC count of [...]

Case Presentation: A 32 year old male with past medical history of tobacco and alcohol abuse presented with fever, dyspnea, night sweats, cough with green sputum, occasional hemoptysis and left sided chest pain for eight days. He also endorsed a ten pound weight loss during this time. Of note patient also had a history of [...]