Background: The latest guidelines on parapneumonic effusion (PPE) management1 recommend immediate evaluation of PPE with ultrasound. Recognizing that bedside procedure services (BPSs) staffed with procedural hospitalists (proceduralists) are becoming the first point of ultrasound contact for many patients admitted with PPE our study sought to demonstrate that proceduralists can reliably agree with radiologists (viewed as [...]

Case Presentation: A 73 year-old man with type 2 diabetes mellitus (hemoglobin A1c 7.5), hypertension, hyperlipidemia, chronic renal failure stage 3a, and a distant 10 pack year smoking history presented with 2 weeks of substernal chest tightness and dyspnea on exertion. He was hemodynamically stable without tachypnea at rest. Examination revealed a grade 2/6 holosystolic [...]

Case Presentation: A 26-year-old female with lymphangiomatosis presented to the emergency department with fever and malaise of one day duration. She denied headache, cough, nausea, dysuria, or rash. Vitals were notable for elevated heart and respiratory rate. Initial lab work revealed a WBC of 5.9 with a neutrophilic predominance of 99%. This neutrophilia led to [...]

Case Presentation: The patient is a 51 year old female with a history of acute cholecystitis status post cholecystectomy who presented to the hospital for acute on chronic abdominal pain. Since her cholecystectomy five months prior, she had recurrent episodes of nausea, vomiting, and abdominal pain with persistently elevated LFTs and bilirubin. Liver biopsy and [...]

Case Presentation: A 50-year-old gentleman was admitted to the hospital medicine service for workup and evaluation of 3 days of epigastric abdominal pain. His history was significant for two recent admissions for episodes of acute pancreatitis within the preceding 2 months and alcohol use disorder (4 weeks sober) without cirrhosis. Physical exam was remarkable for [...]

Case Presentation: A 3-year-old previously healthy male was admitted with a five-day history of fevers up to 104 F, decreased oral intake, and decreased activity. He had been seen by his pediatrician on day three of illness, at which time he was noted to have leukocytosis with a white blood cell count of 30,200/µL and [...]