Background: There is literature to suggest there is a subtype of COPD patients in which eosinophils may play an important role. Data suggests that this subset of patient are more prone to develop exacerbations, but also have a higher likelihood of responding to inhaled corticosteroid therapy. The objective of this study is to determine if [...]

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 78-year-old woman with severe persistent asthma on a maximum dose of inhaled corticosteroids (ICS) was admitted for lethargy and skin nodules on her thighs. She had three hospital admissions in the past two months for reported pneumonia. She was found to have fever, left basilar crackles, and multiple violaceous, firm, tender subcutaneous [...]

Case Presentation: A 20-year-old male with past history of asthma presented initially with bloody diarrhea and subjective fever of one day’s duration. Upon evaluation vital signs revealed temperature of 103 F, and tachycardia. On physical examination there was generalized abdominal tenderness with normal bowel sounds. Thrombocytopenia was present with platelet count of 46 k/ul. Antibiotics [...]

Case Presentation: A previously healthy 38-year-old man presented with 8 days of intermittent colicky RUQ pain and jaundice. He denied any OTC or illicit drug use but did report daily alcohol use. On admission HAV, HBV, HCV, and HIV 1 & 2 screening, urine drug screen, and autoimmune workup were negative. Ceruloplasmin, serum copper, serum [...]

Case Presentation: A 63-year-old man with lung adenocarcinoma with multiple rib metastases and lytic spinal lesions was receiving palliative radiation treatment when computed tomography (CT) incidentally revealed a fluid collection along the anterior cecum with pneumatosis. Cultures taken during CT-guided abscess drainage were positive for piperacillin-tazobactam-sensitive enterococcus, and the patient was started on antibiotics. His [...]

Case Presentation: A 36-year-old Laotian female with a history of hypothyroidism presented with 3 days of worsening symmetrical proximal muscle weakness and anasarca. She was recently seen at another hospital and presented with one day of worsening throat swelling and diffuse anasarca. Over the next 2 months, she developed dysphagia requiring gastrostomy tube and was [...]

Case Presentation: A 62yo female with history of Combined Variable Immunodeficiency (CVID), Cirrhosis and Immune Mediated Colitis presented to the hospital with a 7-10 days history of confusion, ataxia, polyuria, and polydipsia. Her medications included Budesonide (9mg po once daily). Patient had no history of diabetes, and non-fasting blood glucose where in normal range 3 [...]

Case Presentation: 54-year-old male patient diabetes mellitus type II presented with pain and swelling involving small joints of bilateral hands with wrists. Synovitis involving bilateral interphalangeal, metacarpo-phalangeal were noted.Labs revealed leukocytosis to 15.7K/microL. Hemoglobin was 7.7 g/dL. Anemia work up revealed low serum iron level of 23 µg/dL, low TIBC at 167ug/dL with saturation of [...]

Case Presentation: A 60-year-old man with a history of bilateral adrenalectomy for Cushing’s disease, who received hydrocortisone replacement (hydrocortisone 20 mg/day; 15 mg after breakfast and 5 mg in the afternoon) for 50 years, visited our emergency department with epigastric pain and palpitations. The symptoms manifested without any obvious cause when the patient was at [...]