Case Presentation: A 47-year-old Caucasian woman presented with severe vomiting and abdominal pain for three days. Her past medical history revealed that she was diagnosed in 2010 with ulcerative colitis proctitis and was recently started on azathioprine. In the past, she had received a short course of steroids, but was complicated by an increase in [...]

Case Presentation:  A 35 year-old Chinese male with a known history of Crohn’s disease was diagnosed in 2014 and treated with nine doses of infliximab. He had normalization of his colon on follow up colonoscopy, but without complete resolution of the patient’s symptoms.  He was started on azathioprine and his symptoms worsened. Repeat colonoscopy showed [...]

Case Presentation: A 70 year old male with psoriatic arthritis on infliximab, hypertension, and chronic low back pain complained of three weeks of intermittent fevers, headaches and worsening back pain after returning from the Dominican Republic. He reported contact with a box turtle and a non-traumatic bird bite but denied sick contacts. In addition to [...]

Case Presentation: A 28-year-old female with a history of ulcerative colitis (UC) was hospitalized for surgical evaluation in the setting of refractory colitis. Seven weeks prior to presentation, she developed diffuse proctocolitis (Mayo score 2-3) that progressed despite treatment escalation from oral to intravenous steroids, followed by infliximab induction and mercaptopurine initiation three weeks prior [...]

Case Presentation: Coccidioidomycosis is a fungal infection caused by the dimorphic organism Coccidioides commonly reported in the Southwest of the United States. Tumor necrosis factors inhibitors (TNFi) have become widely used to treat autoimmune and inflammatory conditions. But patients using TNFi are at increased risk of developing several infections, including coccidioidomycosis in endemic areas. Nevertheless, [...]

Case Presentation: A 38 year-old female with Crohn’s disease on infliximab presented to the ED with 3 weeks of fever, cough, and shortness of breath (SOB) unresponsive to a 10-day course of levofloxacin for presumed community acquired pneumonia (CAP). She emigrated from Ecuador in 2001 and was employed as a medical assistant in a private [...]

Case Presentation: Many patients are being treated with biologic therapies for autoimmune diseases in the outpatient setting. It is critical for the hospitalist to recognize these patients as immunosuppressed and generate a broad differential when they are admitted to the hospital. The patient in this case was a 35-year-old male with a past medical history [...]

Case Presentation: A 66-year-old female with a history of Crohn’s disease (CD) and Stage IV chronic kidney disease presented with a 2-day history of acute-onset numbness and tingling of bilateral hands and feet. The patient has a long-standing history of CD and underwent a right hemicolectomy with end ileostomy at the age of 13. She [...]

Case Presentation: A 49-year-old man with a history of ulcerative colitis presented to the emergency department (ED) with progressive symptoms of fever, myalgias, night sweats, and diffuse abdominal pain. He recently completed a course of ciprofloxacin, metronidazole, and prednisone after developing fever following his infliximab infusion. In ED, his physical exam was unrevealing. Laboratory results [...]