Background: Accumulating evidence suggests that peripherally inserted central catheters (PICCs) are associated with central line–associated bloodstream infection (CLABSI). Whether this risk is less than with traditional central venous catheters (CVCs) is unknown. We performed a systematic review and meta‐analysis of the literature to compare the risk of PICC‐related CLABSI to that of other CVCs. Methods: […]

Case Presentation: 78 year old woman with persistent non valvular atrial fibrillation was admitted with palpitation and dyspnea. She was in atrial fibrillation with rapid ventricular rate. Given symptomatic atrial fibrillation after rate control, decision was made for transesophageal echocardiogram (TEE) and elective direct current cardioversion (DCCV). She was successfully converted to sinus rhythm with […]

Case Presentation: As physicians, we frequently engage patients and families in goals of care discussions in the context of advanced serious illnesses. These discussions can be challenging for numerous reasons. We present an atypical case of a woman, who experienced acute onset of confusion, numbness, pre-syncope, chest pain, and abdominal pain, after initiating a discussion […]

Case Presentation: A 54 year old man with Hepatitis C without cirrhosis, complicated by porphyria cutanea tarda (PCT), presented with painful bruising and swelling of his legs and arms. There was no inciting trauma, he took no antiplatelet agents or anticoagulants and had no family history of coagulopathy.  He recently completed a course of pegylated […]

Case Presentation: Patient is a 29 year old female with no significant past medical history who presented to our hospital with an unintentional 60 pound weight loss over 3 months and 4 days of palpitations, shortness of breath, leg swelling, and orthopnea. Physical exam revealed 4+ pitting edema, tachycardia (130 beats/minutes) and jugular venous distention […]

Case Presentation: A 64-year-old man with atrial fibrillation on warfarin presented with one week of progressive bilateral lower extremity weakness. Neurologic examination was significant for paraplegia with hypertonia, decreased sensation to the T12 level, and bilateral dorsiflexion of the hallux on plantar reflex testing. Laboratory results were significant for supratherapeutic INR of 22. Initial diagnostic […]

Case Presentation: A 57-year-old male with HIV/AIDS and Kaposi sarcoma (KS) was admitted to the hospital with intermittent fever, fatigue, night sweats, and dry cough of six-week duration. He had been on dolutegravir and emtricitabine-alafenamide for one month but was previously non-compliant. His admission CD4 cell count was 34 cells/μL and HIV RNA was 179 […]

Case Presentation: Vaping-induced organ injuries are increasingly seen in the clinical setting, as the use of vaporizers to smoke tobacco and marijuana has risen almost 150% in the past several years [1]. Cardiotoxicity from vaporizer use has not been reported, and thus the incidence of this phenomenon is unknown. Regular assessment of cardiac function may […]

Case Presentation: A 58-year-old right-handed, nonsmoker, otherwise healthy male presented with episodes of vertigo and slurred speech. Vital signs were within normal range and his initial labs were noncontributory. Imaging revealed multifocal acute and subacute infarcts in the postero-occipital areas. Extensive workup did not reveal any arrhythmias, valvular abnormalities, patent foramen ovale, aortic or carotid […]

Case Presentation: A 63-year-old female, otherwise healthy, initially presented to the hospital for acute onset of chest pain and weakness for several hours. She described it as the worst pain of her life, located in the midsternal chest, associated with shortness of breath and nausea. This pain and discomfort started during an interrogation from the […]