Background: It is important to understand knowledge about diagnostic error, such as cognitive bias and heuristics, for preventing a diagnostic error. However, it is unclear whether Japanese residents learn this knowledge. We aimed to assess diagnostic error knowledge in residents throughout Japan and compare it to the benchmark of the previous US score. In addition, [...]

Case Presentation: A 60-year-old man with type 2 diabetes presented with dyspnea and chest pain for 5 days during the COVID-19 pandemic. He arrived in acute hypoxic respiratory failure, with an oxygen saturation of 45% on room air. Physical exam revealed coarse lung sounds bilaterally and accessory muscle use. Initial labs were notable for leukocytosis [...]

Case Presentation: A 56-year-old male with a history of 45 pack-year smoking, peptic ulcer, and cholecystectomy 5 months ago presented with worsening epigastric pain and 70-pound weight loss over the last 3 months, associated with subjective fevers, drenching night sweat, and malaise. The patient was hospitalized a month ago for the same reason, when computed [...]

Case Presentation: A 70-year-old man with a history of bladder cancer treated with intravesical Bacillus Calmette-Guerin (BCG) therapy presented with acute on chronic back pain. Six months prior, he presented with lower back pain, was diagnosed with culture negative bacterial osteomyelitis, and underwent an L3-L5 laminectomy. He was discharged with an empiric 6-week antibiotic course [...]

Case Presentation: A 66-year-old male with history of type 1 Von Willebrand disease, colonic polyps, and gastric ulcer from naproxen use due to osteoarthritis presented with a 3-week history of lethargy and fatigue with walking short distances. He denied melena or hematemesis but did report consistent ibuprofen use for his osteoarthritis over the past few [...]

Case Presentation: 47-year-old African American incarcerated male presented with headache, new seizures, and blurry vision. Spinal fluid showed high protein, lymphocytes, mildly elevated adenosine deaminase, and low glucose. AFB, bacterial, fungal and viral studies were negative. MRI revealed severe basilar meningitis with enhancing nodular density. RIPE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol) was started, followed by RI [...]

Case Presentation: A 73-year-old man who had been under quarantine for a week prior to presumed COVID-19 presented to the emergency department (ED) with worsening malaise, fever, and loss of appetite. Two weeks prior, the patient presented to his primary care provider (PCP) with fevers, dry cough, exertional dyspnea, sweats, malaise, anorexia, anosmia, and dysgeusia. [...]

Case Presentation: A 69 year-old Mexican man with a history of polysubstance abuse presented to the hospital for fever and dysphagia of 4 weeks duration. CT of the chest taken at an outside facility showed a large esophageal mass with right hilar and left supraclavicular lymphadenopathy (Figure 1). Given concern for malignancy, an EGD with [...]

Case Presentation: A 83-year-old woman of Chinese origin with remote history of breast cancer and pulmonary fibrosis of unknown etiology presented to care with one month of fevers, night sweats, malaise, and cough. After three negative acid-fast bacillus (AFB) smears and CT chest showing chronic right apical scarring during hospital admission, she was discharged on [...]

Case Presentation: A 33-year-old man presented to the emergency department with sudden onset, severe abdominal pain radiating toward the back. Medical history included bipolar disorder treated with bupropion, sertraline, and lamotrigine. Surgical history included prior appendectomy. There was no history of sick contacts, alcohol use, gallstones, or peptic ulcer disease. On exam he was tachycardic [...]