Background: Hyperthyroidism is a recognized risk factor for atrial fibrillation(AFib). Consequently, current recommendations include screening patients with new onset AFib for thyroid dysfunction by analyzing TSH, T3, and T4 levels. However, the yield of routine testing of patients hospitalized with Afib is less certain. In this study, we evaluated the testing and prevalence of thyroid [...]

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 73-year-old male with history of type 2 diabetes and one-month prior admission for acute renal failure in the setting of stage IV chronic kidney disease presented with symptomatic anemia found to have splenomegaly. A renal biopsy revealed features of membranoproliferative glomerulonephritis and necrotizing crescentic lesions with IgM kappa deposition, suspicious for cryoglobulinemic glomerulonephritis. Immunofixation [...]

Background: Infectious gastroenteritis is a common cause of morbidity and mortality worldwide. The FilmArray GI panel (GIP) is a multiplex PCR assay that can rapidly detect 21 gastrointestinal pathogens, including 13 bacteria, 5 viruses, and 4 parasites. The GIP has high sensitivity and specificity for most targets and has been widely adopted in clinical practice. [...]

Case Presentation: 42 year old male with history of alcoholism and chronic tophaceous gout on allopurinol, presented with acute left elbow pain and swelling. Exam showed synovitis of left wrist and elbow, distal interphalangeal joint (DIJ) and right knee and tophi  on left DIJ.  Arthrocentesis of left elbow revealed purulent fluid with leukocytosis (5000,000/mm3) and [...]

Case Presentation: A 66-year-old female with a history of stage IV non-small cell lung cancer (NSCLC) (90% PD-L1 +) on pembrolizumab (status post cycle 9) with metastasis to the left adrenal gland presented with a two-week history of malaise, nausea, and vomiting. Vital signs were stable and physical exam was euvolemic, with mild epigastric tenderness. [...]

Background: Choroidal melanoma, the most common primary intraocular malignancy in adults, is a dangerous cancer which can lead to blindness. Diagnosed at an average age of 65 & lacking identifiable environmental or genetic factors, melanoma of the eye can affect anyone. Commonly found on routine ophthalmological screening, patients are sent to quaternary hospitals for further [...]

Background: Consensus supports the use of corticosteroids in acute exacerbation of COPD (AECOPD), but route of administration and dosage still vary considerably. In one study comparing lower dose oral (PO) prednisone to higher dose intravenous (IV) methylprednisolone, the prednisone regimen was associated with comparable improvement in lung function and oxygenation but a trend toward significantly [...]

Case Presentation: The patient was a 27 year old male who presented to the ED in July 2016 with persistent left sided chest pain and a lump over his sternum of several weeks in duration. Pain was exacerbated by touch and exertion. Other symptoms included occasional episodes of scant hemoptysis. Patient denied SOB, fevers, chills, [...]

Case Presentation: A 21-year-old Hispanic male with recently diagnosed Acquired Immunodeficiency Syndrome (AIDS) was admitted to the hospital for evaluation of persistent periorbital edema, lower extremity edema, and worsening rash. He was diagnosed with AIDS about three months prior and had been on combination dolutegravir/lamivudine since diagnosis. His most recent CD4 count two weeks ago [...]