Background: Acute respiratory illness is the most common reason for hospitalization in children. Antibiotics are recommended for hospitalized children with community‐acquired pneumonia despite an inability to distinguish bacterial from the more common viral etiologies. Chest x‐rays are also frequently ordered in children with asthma and bronchiolitis to look for concomitant pneumonia. As a result, antibiotics […]

Background: Heparin-induced thrombocytopenia (HIT) syndrome is an immune-mediated disorder producing thrombocytopenia and thrombosis, with or without prior exposure to heparin. Although avoidance of heparin products and non-heparin anticoagulants are used, immune-based therapies including intravenous immunoglobulin have been tried when the thrombocytopenia persists or there is breakthrough thrombosis. We sought to systematically review and analyze the […]

Case Presentation: A 75 year old woman with past medical history of hypothyroidism presented with weakness and the sensation of “large folds of skin” on the bottom of her feet. Pertinent physical exam findings included conjunctival pallor, nonspecific diffuse abdominal tenderness, and hyperpigmented macules of the dorsal finger tips and soles, which were also new […]

Case Presentation: 53 year‐old Hispanic male with history of recently diagnosed coronary artery disease, hypertension and diabetes mellitus presented with one day of abdominal pain followed by painful hematochezia. The abdominal pain was described as intermittent and colicky followed by tenesmus. The initial bloody stool had mixed bright blood and was followed by smaller bowel […]

Case Presentation: A 59‐year‐old gentleman was admitted with three‐weeks of unremitting, episodic fevers after returning from a recent visit to India. He endorsed associated drenching night sweats, chills, shortness of breath and generalized fatigue. During his travels, he visited a hospitalized family member, drank unfiltered water, and stayed in a house with reported mold growth. […]

Case Presentation: A 59-year-old previously healthy man presented with subacute fatigue, back pain, and fevers. He developed gradual exertional intolerance in the preceding months which had progressively worsened prior to seeking medical attention. On the day of his presentation, he developed significant abdominal and atraumatic midline back pain. Vital signs at presentation were notable for […]

Case Presentation: A 32 year-old African American man with a history of Kikuchi-Fujimoto’s Disease (KFD), presented with 2 weeks of fever, cervical lymphadenopathy and cough. Laboratory tests showed pancytopenia, elevated ESR, positive double stranded DNA and ANA titer. Complement 3 and 4 levels were low. His fever persisted despite broad spectrum antibiotics. Computed tomography (CT) […]

Case Presentation: 70 year old male with no significant medical history except for glaucoma who was functioning independently at baseline was brought in to the hospital by family as patient reported seeing “diminutive ninjas” inside his house. He was awake, alert and oriented and was able to carry a normal conversation. The patient was initially […]

Case Presentation: A 53-year-old gentleman with metastatic adrenocortical carcinoma with liver and lung metastases, was recently started on pazopanib, a non-specific tyrosine kinase inhibitor. He was brought to the hospital by family for increasing confusion and decreased oral intake. He was hemodynamically stable and afebrile on presentation. Initial labs were significant for low platelet count […]

Case Presentation: An 18 year old man presented to a California hospital emergency department with six weeks of right lower back pain and one week of pain and swelling in the skin over the right mid‐back. This area, thought to represent an abscess, was opened by I & D, and the patient was then prescribed […]