Background: Skin, soft tissue, and joint infections are common in pediatric patients and can require invasive procedures to drain purulent fluid. Atypical pathogens (fungal and acid-fast bacilli [AFB]) are important but rare causes of these infections with reported case rates as low as 0.6-1.6 cases/100,000 a year. Despite the rarity of these infections, costly atypical […]

Background: Peripherally inserted central catheters (PICCs) are frequently used to deliver intravenous (IV) antibiotic therapy. Infectious disease (ID) physicians are often consulted prior to PICC placement, but whether their engagement influences PICC appropriateness and complications is not known. Methods: Using data from the Michigan Hospital Medicine Safety Consortium on PICCs placed in hospitalized medical patients […]

Case Presentation: A 12-year-old healthy female presented for three weeks of abdominal pain, loose non-bloody stools accompanied by night sweats and an eight-pound weight loss. Initial exam was only significant for diffuse abdominal pain. An abdominal X-ray demonstrated a unique appearing paravertebral stripe which prompted a follow up MRI abdomen/pelvis. MRI imaging revealed a 5.8 […]

Case Presentation: A 21-year-old man with no previous medical history presented to the emergency department with nausea, vomiting and diarrhea for one week. Labs were significant for white blood cell (WBC) count 3.4 k/ul with decreased lymphocytes along with mild elevation of transaminases and lipase. He was thought to have viral gastroenteritis and was discharged. […]

Case Presentation: A 92-year-old women with a medical history of hypertension, type 2 diabetes, and surgical resection of colon and renal cancer presented to the emergency department with high-grade fever and purulent sputum. She visited her primary care physician with the complaint of fever 5 days prior to visiting our hospital and was prescribed antibiotics […]

Case Presentation: Talaromycosis (formerly known as Penicilliosis) is a rare fungal disease that predominantly affects immunocompromised patients, such as those with HIV and low CD4 cell counts, from endemic regions (e.g., Southeast Asia). There have been a limited number of cases reported worldwide, with a travel-related exposure. We present a case of an immunocompetent patient […]

Case Presentation: A 29-year-old woman presented to the emergency department for a 5-day history of persistent fever, sore throat, diffuse myalgias, and epigastric abdominal pain. The patient was recently diagnosed and treated for pelvic inflammatory disease after unprotected intercourse with a new sexual partner. On examination, she was tachycardic, hypotensive, afebrile and was noted to […]

Case Presentation: 81-year-old man initially presented to his primary care physician for a persistent cough of three weeks associated with new onset shortness of breath when climbing stairs. He had a normal chest X-Ray, but also a mild anemia. Initial work-up was targeted at evaluation for a gastrointestinal bleed. He underwent a CT abdomen/pelvis, upper […]

Case Presentation: A 62-year-old man with type 2 diabetes was hospitalized with a two-week history of fatigue, sore throat, diarrhea, and 18-pound weight loss. In the ED, he was hypotensive and tachycardic, which improved with IV fluids. Physical exam was significant for bilateral posterior cervical lymphadenopathy and splenomegaly. Labs showed leukocytosis (25.8K) with 18.2% lymphocytic […]

Case Presentation: A 63-year-old man was admitted to the hospital medicine service at a quaternary center for painful oral lesions that appeared 6 months prior. The lesions had started as multifocal soreness in the mouth floor 2 weeks after having undergone dental work. He was then evaluated by local oral surgery team who performed biopsies […]