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: A 41 year‐old man with a past medical history of AIDS CD4 count of 2 cells/ml was found in the subway complaining of generalized weakness and a tender lesion on his left leg. He denied recent trauma, insect bites or exposure to seawater or animals. His only recent travel was to Boston and […]

Case Presentation: Patient presented to the ED in June 2019 with 6 month history of progressive proximal bilateral upper and lower extremity weakness, swallowing difficulty and 100 lbs. weight loss over 3 months. Exam was significant for decreased strength of bilateral hip flexors, knee flexors and knee extensors with intact reflexes. Labs were significant for […]

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: Patient is a middle-aged African-American female with a history of hypertension and hyperlipidemia, for which she had been on atorvastatin for approximately four years. She originally presented to her primary care physician for evaluation of a one month history of progressive myalgias and proximal muscle weakness. Creatine phosphokinase (CPK) level was elevated to […]

Case Presentation: A 24-year-old man with a history of hidradenitis suppurativa and acne developed increasing pain and malodorous drainage from his chronic nodular lesions involving his axillae, groin, face, and buttocks as well as new rapidly progressive ulcers on his legs. He was first diagnosed with hidradenitis suppurativa at age 13. His skin lesions have […]