Background: Hospitalists, rather than primary oncologists, are increasingly caring for hospitalized patients with cancer. High medical acuity, complex psycho-social issues, rapidly evolving cancer treatments, advanced care planning, and end-of-life care make management of this patient population especially challenging. The impact of the oncology hospitalist model of care delivery on clinical quality and oncologists’ work satisfaction [...]

Background: Successful hospitalist co-management programs address provider knowledge base as well as ongoing faculty skill development and education (1). With a growing liver transplant program, our institution has seen increased patient volume on the hospitalist liver service. Hospitalists and hepatologists co-manage this expanding population of high acuity patients with complex pathologies. In the past year, [...]

Case Presentation: The patient is a 58-year-old male with a past medical history of end-stage liver cirrhosis status post-liver transplantation in 1991 who was on tacrolimus (TAC) 1 mg twice a day. He was admitted for altered mental status, fever and respiratory distress. He was found to have bilateral pneumonia treated as community-acquired pneumonia. The [...]

Case Presentation: This patient was a 44-year-old female with a past medical history of localized scleroderma (morphea) of the breast diagnosed by punch biopsy. She presented to the emergency department with right upper quadrant pain and nausea. At that time, a CT scan showed a heterogeneous liver without a definitive underlying mass. Her workup revealed [...]

Case Presentation: A previously healthy 38-year-old man presented with 8 days of intermittent colicky RUQ pain and jaundice. He denied any OTC or illicit drug use but did report daily alcohol use. On admission HAV, HBV, HCV, and HIV 1 & 2 screening, urine drug screen, and autoimmune workup were negative. Ceruloplasmin, serum copper, serum [...]

Case Presentation: A 47- year-old man with a history of hypothyroidism presented to the emergency room (ER) for the evaluation of generalized body weakness and jaundice of a week duration. There was also associated intense generalized pruritus of about 6 months; subjective weight loss, recurrent fevers, nausea and vomiting. Physical examination was significant for an [...]

Case Presentation: A 45 y/o Asian Male from Vietnam with PMH of treated pulmonary tuberculosis 10 years ago upon immigration to the US, presented to the ED with 3-day history of fever, abdominal pain, nausea and vomiting. He denied recent travel or use of antibiotics. On exam he had fever 102.2, tachycardia, scleral icterus and [...]

Case Presentation: A 65 year old male with no significant medical history presented to an outside facility complaining of fatigue, weakness, nausea and vomiting. He had moderate alcohol history and significant weight loss over the past 6 months. Initial lab workup was notable for elevated liver transaminases with a hepatocellular pattern, Maddrey score of 53.6 [...]

Case Presentation: A 68-year-old Caucasian male with a history of stage IV follicular lymphoma treated with rituximab and bendamustine presented with generalized malaise, weakness, and acute encephalopathy of two weeks.He was hypotensive and his exam showed dry mucous membranes and poor skin turgor. Laboratory examination was remarkable for: creatinine 7.6 mg/dL, AST and ALT 691 [...]

Case Presentation: A 21-year-old male with end-stage renal disease for 3 years (cause unknown) presented to the hospital with a 19lb weight loss (10% of body weight) over 2 months. Exam was notable for jaundice, diffuse abdominal tenderness, and innumerable purple, papular lesions covering his body, which he had noticed for 8 months. Labs revealed [...]