Case Presentation: A 47‐year‐old white man with a history of multiple sclerosis (MS) presented to the emergency room with complaints of headache, chest discomfort, and cough with frothy bloody secretions approximately 30 minutes after subcutaneous injection of glatiramer acetate. For the past 5 years, the patient had reported occasional hot flashes, headache, and palpitations after […]

Background: Hematopoietic stem cell transplantation (HSCT) can be a life-saving and curative therapy in hematological malignancies. Pre-transplant evaluation for HSCT is a multidisciplinary process that can be complicated, time-consuming, and expensive for patients to navigate. The process requires coordination between several medical subspecialties including pulmonary, cardiology, and mental health, in addition to social workers and […]

Background: Myelofibrosis is a chronic myeloproliferative neoplasm characterized by progressive bone marrow fibrosis and extramedullary hematopoiesis leading to splenomegaly. Progressive splenomegaly is common in advanced myelofibrosis, and spleen volume is a predictor of survival. The oral selective small-molecule JAK 1/2 inhibitor ruxolitinib is used for symptomatic management of intermediate-2 and high-risk myelofibrosis, and leads to […]

Case Presentation: A 30‐year‐old woman was admitted with fever and headache. On physical examination temperature was 101.5°F; the jolt accentuation test was positive. Routine laboratory studies and head CT were normal. CSF analysis showed 220 WBC (98% lymphocytes), normal protein and glucose. Laboratory test results are summarized in the table. The patient was treated with […]

Case Presentation: A 78‐year‐old man with hypertension, atrial fibrillation, hypercholesterolemia, and gastroesophageal reflux disease presented to the hospital with confusion, new‐onset ascites, hypotension (BP 90/50), and hypothermia (temperature, 93.9°F). He underwent a paracentesis that did not reveal infection. Laboratory parameters including a complete metabolic profile and complete blood count were normal. CT of the head […]

Background: Successful hospitalist co-management programs address provider knowledge base as well as ongoing faculty skill development and education (1). With a growing liver transplant program, our institution has seen increased patient volume on the hospitalist liver service. Hospitalists and hepatologists co-manage this expanding population of high acuity patients with complex pathologies. In the past year, […]

Case Presentation: A 63‐year‐old male Vietnam War veteran noted a 6‐month history of watery diarrhea; he was admitted for volume depletion. The patient had been in Vietnam for 1 year in 1970; there were no recent travels. Vital signs demonstrated a BP of 85/41 mm Hg and a pulse of 101 beats/minute; the physical examination […]

Background: Patients with transplanted organs often have longer lengths of stay and readmissions compared to general internal medicine patients. Atypical presentations may result in unnecessary tests, missed diagnoses and incomplete treatment. Nephrologists and hospitalists bring different strengths and experiences to the management of such patients. Here we present an analysis of quality metrics as well […]

Case Presentation: A 32-year-old South Asian woman with history of IgA nephropathy complicated by end stage renal disease status post renal transplant (CMV/EBV positive), latent tuberculosis infection, C. Diff colitis, and recurrent urinary tract infections presented with two days of fevers and diarrhea. One week prior to admission she was seen at a local ED […]

Case Presentation: A 32-year-old South Asian woman with history of IgA nephropathy complicated by end stage renal disease status post renal transplant (CMV/EBV positive), latent tuberculosis infection, C. Diff colitis, and recurrent urinary tract infections presented with two days of fevers and diarrhea. One week prior to admission she was seen at a local ED […]