Case Presentation: A 40-year-old woman with a history of anxiety presented with one week of diffuse abdominal pain, associated with constipation, decreased oral intake, nausea, and bilious emesis three times a day. She was admitted to an outside hospital one month prior with similar symptoms and treated for pneumonia. The patient lives alone and denied [...]

Case Presentation: This is a previously healthy 41-year-old man who presented with fevers, headache, and neck stiffness for 5 days. He also reported photophobia, anorexia, insomnia, nausea but no vomiting. He denied any recent travel and was not aware of any insect bites. The patient had a faint macular rash on his upper chest and [...]

Case Presentation: A 7-month-old former term female with congenital hypothyroidism was admitted for the third time with a diagnosis of bronchiolitis. Her first admission at 7 weeks of age involved an ICU stay requiring intubation and chest tube placement after a chest X-ray showed a right tension pneumothorax. She suffered no other major complications and [...]

Case Presentation: This is a 32 year old male with no pertinent medical history who presented to the emergency department with complaints of headache, body aches, vomiting, diarrhea, fevers and chills for 4 days. The patient also admits to generalized weakness and poor appetite. The patient denies any chest pain, dyspnea, shortness of breath. The [...]

Case Presentation: A 15-year-old female with a past medical history of acne vulgaris on topical Dapsone and anxiety on Sertraline presented to the ER with severe shortness of breath. She was recently hospitalized for a left knee meniscal repair one month prior. She went to a theme park on the day of admission where she [...]

Background: An important duty of every hospitalist is to detect the earliest signs of imminent clinical deterioration. Breathing motion patterns can convey early warnings of respiratory instability (1). Normal breathing appears regular, effortless, well-coordinated and comfortable (2). In patients at high risk of respiratory deterioration, breathing appears labored (3). Well-established signs of labored breathing include: [...]