Case Presentation: After suffering a left-sided middle cerebral artery stroke and subsequent right sided weakness, an 85-year-old female fell and sustained a fracture of her right intertrochanteric femur. She initially had an ORIF at an outside hospital, but this subsequently failed and the patient had continued pain. She had repeat x-ray imaging of her femur [...]

Case Presentation: A 40-year-old man presents with painful, progressive bilateral vision loss which began two months prior, and was described as the patient feeling as if he were “looking through a straw”. He noted excruciating eye pain, redness, and tearing. Despite work as a tree trimmer, patient denied known trauma. He endorsed a twenty-pound unintentional [...]

Case Presentation: A 49 year-old woman with end stage renal disease on peritoneal dialysis (PD) for the past year, presented with progressively worsening abdominal pain, fevers, and nausea. This was her second presentation as she had been treated with antibiotics for presumed culture-negative PD-catheter-associated bacterial peritonitis three weeks earlier without improvement. Admission vital signs and [...]

Background: Hospital Onset Clostridium difficile infection (HOCDI) is one of the most common causes of hospital acquired diarrhea. As per a recent study, the mean healthcare costs attributable to primary Clostridium difficile infection (CDI) is about $24,205 per patient. This would be a lot more if the patients were to be discharged to skilled nursing [...]

Background: Stony Brook University Hospital (SBUH) identified an opportunity to develop and implement prevention strategies to reduce hospital onset C. difficile infections (CDI). Hospital Onset (HO) CDI are included in National Healthcare Safety Network (NHSN) reporting and included with other hospital-acquired infections as publically reported data. CDI contribute to prolonged hospital stays, inappropriate antimicrobial use, [...]

Background: Though the advent of highly active anti-retroviral medications has improved survival in HIV infection, mortality from non-infectious complications such as pulmonary arterial hypertension (PAH) has increased. Also, studies have shown that PAH is the leading cause of hospitalization and death in patients with HIV associated PAH (HIV-PAH). However, not much is known about the [...]

Background: Patients hospitalized with hematologic malignancy are particularly vulnerable to infection. Clostridium difficile infection (CDI) has become the most common cause of healthcare-associated infections in U. S. hospitals, and the excess healthcare costs related to CDI are estimated to be as much as 4. 8 billion dollars for acute care facilities alone. We sought to [...]

Background: Data is emerging on the efficacy of fecal microbial transplantation (FMT) for recurrent clostridium difficile infection (CDI) management with success rates of 80-90% in general population. Immunocompromised patients continue to be excluded from randomized trials involving FMT due to concerns related to its safety and efficacy. Current guidelines recommend caution with FMT in immunocompromised [...]

Background: Rifaximin 550 mg tablets is a nonsystemic antibiotic indicated for reducing the risk of overt hepatic encephalopathy (OHE) recurrence in adults and may be used alone or in combination with the cathartic lactulose. This analysis evaluated the safety profile of rifaximin alone vs rifaximin + lactulose (combination) in patients with cirrhosis. Methods: In a [...]

Background: Guidelines on the treatment of Clostridioides (Clostridium) difficile infection (CDI) have historically recommended avoiding antimotility agents (AAs) in patients with active CDI based on theoretical concerns that administration of AAs may precipitate serious adverse events such as toxic megacolon in these patients. These recommendations, however, are based on limited and conflicting data. We previously [...]