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: Pneumonia in an immunocompromised individual has a broad differential; the initial work-up and selection of antimicrobials can be challenging. We present a case of concomitant pulmonary nocardiosis and Pneumocystis jirovecii pneumonia (PJP). A 60-year-old male with hepatitis C infection status-post treatment with a negative viral load and chronic kidney disease (CKD) due to [...]

Case Presentation: A 55-year-old woman with a remote history of renal transplant complicated by stage 4 chronic kidney disease (CKD) presented to the emergency room with a week history of progressive fatigue, fever, dry cough and exertional dyspnea. Outpatient medications were tacrolimus 2.5mg BID, mycophenolate mofetil 500mg BID, prednisone 5mg daily, and vitamin D 1000 [...]

Case Presentation: A 63-year-old man with significant history of deceased donor transplant (18 months prior to presentation), hypertension, diabetes mellitus, who presented with two weeks of fevers and malaise. His other symptoms included drenching night sweats, shortness of breath, and diffuse pleuritic chest pain, however he denied cough. A recent exposure was a renovation of [...]

Case Presentation: A 33-year-old man with end-stage renal disease status post renal transplant was readmitted to the hospital with recurrent acute kidney injury (AKI).During his first admission, he reported a few weeks of nonproductive cough, dyspnea, congestion, chills, and recent nausea with vomiting. He was afebrile with normal vital signs and normal SpO2. Respiratory panel [...]

Case Presentation: 36-year-old male presented to ID clinic with painful left neck lump of 4 months duration worsening with pain and size for 2 months. Patient has h/o AIDS 2 years ago with cryptococcal meningitis, finished course of antibiotics and in remission with recent VL < 20, CD4 count 322, on daily Biktarvy. He also [...]

Case Presentation: A 50-year-old female was admitted with shortness of breath, cough and fevers. Her past medical history was significant for breast cancer undergoing active neoadjuvant chemotherapy with doxorubicin and cyclophosphamide. She was hypoxic requiring 2L of oxygen via nasal cannula and febrile to 39.0°C. Labs revealed a WBC of 12.0 x 109/L (4.5-11.0 x [...]