Background: Approximately 5-10% of the US population reports a Penicillin (PCN) allergy. Only 1 in 10 of these patients are found to have a positive reaction to PCN. This label comes at a grave cost, with higher incidences of multidrug-resistant nosocomial infections reported among these patients. With the lack of novel antibiotics and the alarming [...]

Background: Approximately 5-10% of the US population reports a Penicillin (PCN) allergy. Only 1 in 10 of these patients are found to have a positive reaction to PCN. This label comes at a grave cost, with higher incidences of multidrug-resistant nosocomial infections reported among these patients. With the lack of novel antibiotics and the alarming [...]

Case Presentation: Patient is a 45-year-old female with a history of esophageal reflux and dysmotility, asthma, depression/anxiety, and recent SARS-2-CoV infection (COVID-19) who presented to our hospital 9 months after initial and 3 months after recurrent COVID-19 with headache, dyspnea, and home blood pressures (BP) > 180/100. Patient reported intermittent symptoms for the last 3 [...]

Background: The subset of admitted Major Depressive Disorder (MDD) patients with treatment-resistant depression (TRD) may be associated with incremental economic burden compared with other MDD patients. This study aimed to characterize and evaluate healthcare resource use, admission measures, and costs in these two groups. Methods: Patients aged ≥18 years with a diagnosis of MDD admitted [...]

Background: The hands of hospitalists are often the source for transmitting multidrug resistant organisms (MDROs), and as such are the target of numerous hand hygiene interventions. Despite this focus, the prevalence of various MDROs on healthcare personnel (HCP) hands during routine patient care has not been well established. Therefore, we conducted a systematic review to: [...]

Background: Guidelines by the Society of Critical Care Medicine and the Infectious Disease Society of America recommend empiric antibiotics active against Methicillin-resistant Staphylococcus aureus (MRSA) for certain patient groups but do not base their recommendations on systematic review or attempt to quantify the benefit on mortality. Methods: A systematic literature search was conducted using Embase, [...]

Case Presentation: A 47-year-old previously healthy male was referred from another hospital with fever, dry cough, abdominal pain and diarrhea for about one month. He also had unintentional weight loss of 33 lbs and abdominal distention over 2 months. He was originally from Nigeria and had moved to Japan 10 years ago. A physical exam [...]

Case Presentation: This patient is a 74-year old male with CAD, HFpEF, HTN, Type 2 DM, CKD3, and obesity admitted for sepsis secondary to bilateral lower extremity purulent cellulitis, complicated by acute decompensated heart failure. He was started on cefepime 2 g twice daily and on vancomycin (vanco), dosed daily by level. After receiving only two doses of vanco 1g, the patient was found to have persistently elevated [...]

Case Presentation: A 55-year-old woman with no known past medical issues is admitted with a 1-week history of weakness and two days of fever and chills. Workup showed WBC count was 15600/µL, C-reactive protein of 14.3 mg/dL, procalcitonin of less than 0.05 ng/mL, and lactate of 0.7 mmol/L. Since procalcitonin was negative and there was [...]

Case Presentation: A 36-year-old Laotian female with a history of hypothyroidism presented with 3 days of worsening symmetrical proximal muscle weakness and anasarca. She was recently seen at another hospital and presented with one day of worsening throat swelling and diffuse anasarca. Over the next 2 months, she developed dysphagia requiring gastrostomy tube and was [...]