Case Presentation: A 79-year-old African American male patient with a past medical history of prostate cancer presented with progressive weakness, headache, and confusion. Free and total PSA levels were within normal limits. Brain MRI showed a 4.1×3.3×4.1 cm left frontal lesion at the surface of the left lateral ventricle with vasogenic edema and midline shift. […]

Background: Venous thromboembolism (VTE) accounts for more than 100,000 deaths per year and costs the health care system about $15,000 per event. Methods to increase appropriate prophylaxis have included computerized physician order entry (CPOE) with decision support, dashboards, and pay‐for‐performance (P4P) programs. In this study, we sequentially examined CPOE‐based decision support alone, group and individualized […]

Case Presentation: A 50‐year old Asian man presented to ER with abdominal pain nausea and numerous episodes of vomiting of one day duration. Pt denied any fever, bloody stools, diarrhea or constipation. Patient has lost 100pounds in one year. His past medical history was significant for diabetes mellitus, hypertension, latent tuberculosis and recurrent episodes of […]

Case Presentation: 47-year-old African American incarcerated male presented with headache, new seizures, and blurry vision. Spinal fluid showed high protein, lymphocytes, mildly elevated adenosine deaminase, and low glucose. AFB, bacterial, fungal and viral studies were negative. MRI revealed severe basilar meningitis with enhancing nodular density. RIPE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol) was started, followed by RI […]

Case Presentation: A 32-year old woman at 17 weeks gestation presented with subacute headaches, parotid swelling, oral and perioral paresthesias, dysgeusia, and bilateral jaw pain. Her headaches began 3 months prior to presentation followed by left facial droop. She received prednisone and valacyclovir for presumed Bell’s palsy with resolution of symptoms. The headaches recurred and […]

Case Presentation: An 89 year-old man presented after being found down at home. His history included hypertension and hyperlipidemia. His exam was notable for an irregularly irregular rhythm at a rate of 150 beats per minute. EKG showed new coarse atrial fibrillation which was rate controlled with metoprolol prior to his spontaneous conversion to sinus […]

Case Presentation: A 57 year old female presented to the ER with complaints of worsening dyspnea for three weeks. Immediate arterial blood gas revealed: pH 7.26 PO2 79.5 PCO2 55 HCO3 30.5 with Sa02 87% on 6L O2. There was a massive fat pad around her neck (image 1). CTA performed did not show any pulmonary emboli. Her past medical […]

Case Presentation: A 76 year old male with a history of hypertension and hyperlipidemia presented with acute onset ascending weakness, perioral tingling, and loss of temperature sensation. The patient’s profound weakness progressed over the course of a few days, with subsequent diplopia, hallucinations, and confusion. He received the influenza vaccine a few weeks prior, and […]

Case Presentation: A 32-year old female with complicated past medical history of intravenous drug use, mitral valve endocarditis status/post repair, and recent diagnosis of Immune thrombocytopenia (ITP) was transferred from another hospital for management of severe thrombocytopenia refractory to Intravenous Immunoglobulin (IVIG) and steroids. She had initially presented with intermittent high-grade fevers and fatigue without […]

Case Presentation: 45-year-old Asian male with a history of IgG4 related disease presented with a three-day history of fevers, fatigue, and a severe, bilateral, temporal headache. The patient was diagnosed with IgG4 related disease one year prior, which was confirmed with a liver biopsy with positive stain for IgG4 disease; patient had only been on […]