Case Presentation: 65 year old man with history of end stage renal disease, ischemic cardiomyopathy, paroxysmal atrial fibrillation, diabetes presented with complaints of rash in his bilateral legs for four days. Few days later, he noticed petechial rash involving bilateral ankles and feet that started on the left side and did spread to involve bilateral [...]

Background: Burnout among hospital medicine physicians has been reported to be 50-60%, with prevalence likely increasing during the COVID-19 pandemic (1-3). Prior studies suggest burnout may be lower in the Veterans Administration (VA) compared to non-VA healthcare settings (4, 5). However, specific data examining burnout in VA Hospital Medicine (HM) physicians are lacking. To address [...]

Case Presentation: Lymphangioleiomyomatosis (LAM) is a rare multisystemic disease of uncertain etiology that can have a dramatic presentation with spontaneous pneumothorax. We describe the management of a case of LAM in a healthy individual in the setting of a community hospital.A 44-year-old female with a history of smoking and vaping presented with acute onset shortness [...]

Case Presentation: A 34-year-old male with history of complicated otitis media with bilateral facial palsy presented to the emergency department (ED) with a 1-week history of dry cough, bilateral eye redness and epistaxis. The patient had recurrent episodes of bilateral purulent otitis media over the past 4 months, failing treatment with anti-histamines and antibiotics, and [...]

Case Presentation: Case I:A 45-year-old male with a past medical history of vaping marijuana and nicotine presented with a four-day history of progressive dyspnea associated with cough, fevers, fatigue, weight loss, and diarrhea. He was found to be hypoxic to 72% oxygen saturation with a new 15-liter (L) oxygen requirement and febrile to 38.5 Celsius. [...]

Case Presentation: A 79-year-old male with a past medical history of non-small cell lung cancer and squamous cell carcinoma of the left tonsil presented with right hip pain for the past couple of months. The pain had been progressively increasing and was associated with swelling around the joint. The patient had a bilateral hip replacement [...]

Case Presentation: A 54-year-old female presented with abdominal pain and bloody diarrhea for three weeks associated with fever, chills, nausea and multiple bouts of vomiting. On exam, she was hemodynamically stable and had left lower quadrant abdominal tenderness. Laboratory studies were significant for a left shift with a normal white blood cell count. Her chest [...]

Case Presentation: A 58-year-old male presented to the hospital with several days of fatigue and shortness of breath. His vitals were initially stable, and labs showed a hemoglobin of 4.2 (normal 13.5—17.5), white blood cell count WBC 20.1 (4.5—11.0), and platelet count 43 (160—420), BNP 617 (0—900 pg/ml). He received one unit of packed red [...]

Case Presentation: A 43-year-old African-American female with a history of multiple sclerosis complicated by paraplegia, neurogenic bladder, and seizures presented to the hospital with a syncopal episode and was found to have a hemoglobin of 2.9 (12.0 to 16.0 gm/dL) with red blood cell count RBC 0.96 (4.00 – 5.20×10^6/uL), lactate dehydrogenase 639 (

Case Presentation: A 40 year old female with a medical history of pancreatitis and gastroesophageal reflux initially presented with cough and viral cold symptoms. She was initially febrile to 102 F, with labs significant for WBC 3,900 (normal 4,500-11,000 WBC/uL), hemoglobin 9.1 (12.0-15.5 g/dL), and platelet count 35,000 (150,000-450,000 /uL). She quickly deteriorated with new [...]