Case Presentation: Spontaneous spinal epidural hematoma (SSEH) is a hematoma that happens without an insult. Although a rare entity, it can result in spinal cord compression. Etiologies include anticoagulant therapies, coagulopathies, blood dyscrasias, pregnancy, and vascular malformations (1). We present a case of SSEH in the setting of heparin and clopidogrel use during a vascular [...]

Case Presentation: 19 month old female with a history of unspecified T- cell immunodeficiency presented with a 10 day history of cough, fatigue, and persistent fevers. The patient had just returned from Mexico and reportedly was diagnosed with influenza there. Previously the patient had been on Bactrim prophylaxis, but ran out of it while in [...]

Case Presentation: A 17 y.o. female with systemic lupus erythematosus (SLE) presented with several weeks of worsening migratory polyarthralgia, as well as sporadic fevers, night sweats, and chills. Prednisone was begun 3 weeks prior for a presumed SLE flare, given elevated anti double-stranded DNA (anti-dsDNA) and erythrocyte sedimentation rate (ESR) and hematuria, but provided no [...]

Background: Although many older adults will be hospitalized in their lifetime, most do not consider or plan ahead for their post-hospitalization support needs. When older adults experience a hospitalization, families often must react to the crisis leaving the older adult out of the decision process (e.g. choosing a skilled nursing facility, caregivers). With PCORI funding, [...]

Background: Physicians are increasingly using the social media outlet, Twitter, as a medium to connect and engage. Specifically, Twitter-based journal clubs have created a space for clinicians, educators and researchers to disseminate and discuss recent research. Recognizing this developing landscape, the Journal of Hospital Medicine (JHM) began producing a CME-accredited Twitter-based journal club, called #JHMChat [...]

Case Presentation: A 60-year-old woman with no past medical history presented for evaluation of progressive dizziness with associated right-sided hearing loss. On exam, a fluctuant right occipital scalp abscess was noted. CT of the head was suspicious for mastoiditis. She underwent incision and drainage and was subsequently discharged with oral Amoxicillin-clavulanate. Her symptoms persisted for [...]

Case Presentation: A 61 year old female presented to the emergency department with 1 day of nausea, vomiting, and fever. The day prior to her symptom onset, she had undergone a colonoscopy for colon cancer screening that was normal. Her medical history was notable for splenectomy in 2000 for a hamartoma.On presentation, her temperature was [...]

Case Presentation: The patient was a 27 year old male who presented to the ED in July 2016 with persistent left sided chest pain and a lump over his sternum of several weeks in duration. Pain was exacerbated by touch and exertion. Other symptoms included occasional episodes of scant hemoptysis. Patient denied SOB, fevers, chills, [...]

Case Presentation: A 60-year-old, Guatemalan female without prior medical history presented with a transient, erythematous, burning, rash involving her extremities and torso (Figure 1). Additional symptoms included fatigue, chills, joint pain, early satiety and weight loss. Blood counts, metabolic panel and serum protein electrophoresis were normal. C-reactive protein (13 mg/L, normal (N)

Case Presentation: A 88-year-old female presented to an outpatient office with 3 weeks history of severe progressive bruising and ecchymosis which initially developed on left wrist and then spread to bilateral upper extremities, upper trunk and bilateral breast. Patient was recently diagnosed with intraductal adenocarcinoma of right breast (T2,N2,M0, Stage IIB). She declined surgery and tamoxifen (20 [...]