Background: In 2016, the Sepsis-3 taskforce posited that acute organ failure is the defining feature of sepsis. Accordingly, they recommended that an acute rise in the Sequential Organ Failure Assessment (SOFA) score by 2 points over baseline should replace the Systemic Inflammatory Response Syndrome (SIRS) score as the sepsis criteria (1). As a justification, they […]

Case Presentation: A 74 year old male, a nursing home resident was admitted to the hospital for fever and chills for 3 days. His history was significant for end stage renal disease. Patient had an episode of clostridium difficile (C diff) within 3 months prior to this admission. 3 weeks ago he was started on […]

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 70-year-old male with a medical history significant for transurethral resection of bladder tumor and lung adenocarcinoma presented with diaphoresis and subjective fever 4 days after undergoing an uncomplicated aortic extension cuff placement for an abdominal aortic aneurysm. The patient was hemodynamically stable. Labs notable for leukocytosis of 18.4X10E9 cells/liter. CT abdomen demonstrated […]

Case Presentation: This is a case of a 53 year old man with past medical history of Hodgkin’s disease s/p chemoradiation, intraabdominal desmoid tumor s/p resection, GERD, Chronic Kidney Disease and penicillin allergy who was admitted to the hospital with complaints of shortness of breath worsening over a period of 2 weeks. On admission he […]

Case Presentation: A 42-year-old female presented to the emergency department with a 2-week history of jaundice, intermittent abdominal pain, hip pain, and fevers. Her past medical history was significant for ankylosing spondylitis. She was on chronic immunosuppression with prednisone, Plaquenil and Infliximab. Initial evaluation was remarkable for abnormal liver function and thrombocytopenia (Table 1). The […]

Case Presentation: A 39‐year old man with type 1 diabetes mellitus and end stage renal disease status post a living‐unrelated renal and pancreas transplant two years prior presented with a diffuse, constant headache for 2 weeks, refractory to medications. He developed photophobia, nausea, vomiting and abdominal pain, prompting him to seek medical care. He denied […]

Case Presentation: A 79-year-old woman with hypertension and rheumatoid arthritis presented with generalized fatigue and decline in her functional status over 6 months. Her symptoms progressed in the month preceding admission to nausea, vomiting, right upper quadrant pain, and intolerance to solids and liquids for several days. An outpatient abdominal ultrasound revealed only hepatic steatosis. […]

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 […]