Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection associated with lymphopenic conditions including HIV/AIDS, hematologic malignancy1, organ transplantation2, and lymphocyte-suppressive therapies such as high dose glucocorticoids3,4. PJP prophylaxis, which is highly effective, is indicated when the incidence of PJP exceeds the rate of adverse events due to prophylaxis.4,7 Guidelines from the American Thoracic Society […]

Case Presentation: A 71‐year‐old man with stage IV chronic lymphocytic leukemia (CLL), hypertension, and diabetes mellitus was admitted to the hospital medicine service for the evaluation of 2 weeks of generalized weakness, anorexia, and mild abdominal pain. He was found to have a lactate level of 10.4. The medical team began to investigate the etiology […]

Case Presentation: A 63-year-old man with significant history of deceased donor transplant (18 months prior to presentation), hypertension, diabetes mellitus, who presented with two weeks of fevers and malaise. His other symptoms included drenching night sweats, shortness of breath, and diffuse pleuritic chest pain, however he denied cough. A recent exposure was a renovation of […]

Case Presentation: A 39-year-old African-American male with a history of chronic kidney disease (baseline creatinine 3), congestive heart failure, hypertension, diabetes initially presented to the hospital with chest pain and found to have hypertensive emergency with BP 202/138 and pulse 112. New echocardiogram showed severe mitral regurgitation with reduced ejection fraction of 45%. He received […]

Case Presentation: A 30‐year‐old Guatemala‐born man presented with severe, nonradiating epigastric and right upper quadrant abdominal pain, intermittent for the past 2 years, requiring several prior hospitalizations. Pain was accompanied by moderate nausea, vomiting, and his “skin turning yellow.” He also reported several episodes of his 4‐year‐old son turning yellow when sick. Physical examination revealed […]

Case Presentation: A 50-year-old female was admitted with shortness of breath, cough and fevers. Her past medical history was significant for breast cancer undergoing active neoadjuvant chemotherapy with doxorubicin and cyclophosphamide. She was hypoxic requiring 2L of oxygen via nasal cannula and febrile to 39.0°C. Labs revealed a WBC of 12.0 x 109/L (4.5-11.0 x […]