Background: Severe alcohol withdrawal and delirium tremens (DTs) are challenging therapeutic dilemmas. To prevent complications and death, management requires close monitoring and intensive treatment, frequently in an ICU. Benzodiazepines are first line therapeutic agents, but optimal use and dosing has been limited, due to a lack of randomized double-blind trials. In lower acuity patients admitted […]

Case Presentation: A 76-year-old man with seropositive RA treated with MTX 15-20mg weekly for at least four years presented to the hospital with worsening fatigue, generalized weakness, poor appetite, and dyspnea. Contrast-enhanced computed tomography of chest abdomen and pelvis (CT CAP) demonstrated numerous pulmonary nodules, centrally hypodense left retroperitoneal soft tissue masses which may represent […]

Case Presentation: 65-year-old male with chronic alcoholism, hepatitis C, prior GI bleed, and coronary disease was found unresponsive for unknown duration and was evaluated in the ED for alcohol intoxication. Patient was admitted to the hospitalist service for acute encephalopathy, acute renal failure, and alcohol withdrawal. Vital signs were stable on admission and laboratory studies […]

Case Presentation: A 69-year-old woman presented for an elective multi-level lumbar laminotomy for the treatment of chronic back pain secondary to spinal canal stenosis. Her medical history included hypertension and hypercholesterolemia. She reported a history of depression, which was well controlled on paroxetine. She denied using drugs, stated she quit tobacco decades prior, and reported […]

Case Presentation: 53-year-old man with history of alcohol abuse, cirrhosis (with preserved liver function) presented with complaints of bilateral hand tremors and hallucinations for one day. He was unable to provide history due to confusion. Computed tomography scan of the brain revealed microvascular ischemic changes and an old lacunar infarct. Patient was delirious and actively […]