Case Presentation: A 48-year-old female with spina bifida was admitted for sepsis secondary to sacral osteomyelitis. She improved with broad-spectrum antibiotics, and her antibiotic regimen was narrowed to Zosyn (piperacillin + tazobactam) to complete a 6-week course. On hospital day 12, discharge was delayed pending insurance approval of an air mattress for home. Three days […]

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: A 64-year-old Middle-Eastern man with a history of rheumatic heart disease status post mechanical mitral Starr-Edwards ball-in-cage valve (in 1968), atrial flutter on coumadin and prior ischemic stroke with residual blindness presented with 4 days of “bloody” urine. Physical exam was significant for scleral icterus, an unchanged holosystolic murmur, and the observation of […]

Case Presentation: Few spider bites are medically significant. A 24-year-old African American woman presented with malaise, fever, nausea, and myalgias. She reported a sharp pain on her lower back the night prior that at first felt like burning before progressing to pain. Her initial vitals were T 101, HR 120, BP 141/117. Physical exam revealed […]

Case Presentation: 81 year-old man with a history of atrial fibrillation on Warfarin and bioprosthetic aortic and mitral valves presented with dark urine and shortness of breath. He described progressive shortness of breath and reduced exercise tolerance, unable to walk upstairs to his apartment. His urine had become “the color of eggplant”. On exam, he […]

Case Presentation: A 17yo female with sickle cell disease (SCD; HbSS genotype) presented with pain crisis and acute chest syndrome. She was treated with appropriate antibiotics (ceftriaxone/cefdinir and azithromycin). During the first few days of her hospitalization, she required 2 pRBC transfusions for down trending hemoglobin (Hb) and low reticulocyte count. On hospital day 11, […]

Case Presentation: A 35-year-old male with past-medical-history significant for cerebral palsy and ventriculoperitoneal shunt for ventriculomegaly was admitted with fever. Patient had completed a course of levofloxacin before admission. Patient was started on azithromycin and meropenem, for possible aspiration pneumonia, because of penicillin allergy. He continued to be febrile with elevated leukocytes despite antibiotics. Considering […]