Case Presentation: A 52‐year‐old man with a history of psoriasis presented with a 1‐week of gradually worsening and throbbing headache over both his temples. He found little relief from nonsteroidal anti‐inflammatory drugs, and his headache was different from prior headaches. The pain did not radiate. He did not experience any neck pain, photophobia, phonophobia, rigors, […]

Background: Identification of pathogens causing community-acquired pneumonia (CAP) in hospitalized patients has improved with the utilization of nasopharyngeal (NP) polymerase chain reaction (PCR). Literature shows that 20-25% of pathogens are identified when using urine antigens, sputum and blood cultures, and can improve up to 70% when adding NP PCR for viruses, Staphylococcus aureus and Streptococcus […]

Case Presentation: A 49‐year‐old largely healthy woman was admitted to the hospital for hypercalcemia. She complained of fatigue, weight loss and anorexia for several months. She was not on any medications or supplements. She was afebrile, not dyspneic, with a heart rate of 57/minute, blood pressure of 118/60 mm HG. The remainder of her physical […]

Background: Procalcitonin (PCT) testing has been shown in randomized trials to decrease antibiotic exposure and be a reliable predictor of clinical response to antibiotics in lower respiratory tract infection (LRTI) and sepsis. Although studied to guide antibiotic discontinuation in LRTI and sepsis, optimal strategies for introducing PCT into “real-world” clinical use are unknown. Our study […]

Case Presentation: A 22‐year‐old El Salvadoran man presented with 2 months of fevers, night sweats, fatigue, cough with scant hemoptysis, hoarseness and a 60‐pound weight loss. Over the next month, he developed progressive dysphagia, odynophagia, and dyspnea. On presentation, he had a temperature of 103.3°F oxygen saturation of 94% on room air and respiratory rate […]

Background: The utility of procalcitonin (PCT) in pediatrics is debated. Proposed diseases in which PCT elevation is thought to be suggestive of a bacterial process include meningitis, urinary tract infection, pneumonia, neonatal fever, and sepsis of unknown source. However, elevated PCT is non-specific for bacterial infection and the strength of the test is generally felt […]