Case Presentation: A 61-year-old male with a past medical history of pancreatic and renal transplants on chronic immunosuppression presented with a six-day history of watery diarrhea. He also reported fever, abdominal pain, and noted a family member also developed a similar diarrhea after a pork dinner. His vital signs were remarkable for fever (101.8 F) [...]

Case Presentation: The diagnosis of a sexually active young male who presents with fevers, night sweats, weight loss with opportunistic infections and then found to have an acquired immunodeficiency is going to be HIV except when it isn’t. We present a patient with a presumptive diagnosis of HIV but a negative comprehensive HIV laboratory testing [...]

Background: Observations units commonly serve as an intermediate stage between the emergency department and inpatient hospitalization where patients of appropriate acuity are managed, however many observation units exist serving diverse patient populations ranging from peripartum or post-op surgical. Patients in observation units typically have lower-acuity health concerns and have an average length of stay of [...]

Case Presentation: A 51-year-old man was brought in by family for confusion and unsteady gait for a few days. Medical history was significant for alcoholic cirrhosis and prior (2018) cardioembolic strokes with no deficits. Social history was pertinent for drinking multiple beers daily for years. In ED, patient was oriented to name only, tachycardic otherwise [...]

Case Presentation: A 36 year old male from Central America who immigrated to the United States ten years ago presented with cough and headache accompanied with fevers. He did not have any past medical conditions. On admission his vitals were T 39.1 C, HR 114, RR 20, BP 129/85 mmHg. He was noted to have oral [...]

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 40-year-old man with inconsistently treated HIV infection presented with a progressive cough, dyspnea, and pleuritic chest pain over a two-week period which were associated with fevers, chills, night sweats, and a 40-pound weight loss. He emigrated from Mexico 10 years prior and had traveled to the central valley of California. On physical [...]

Case Presentation: The patient is a 59-year-old male with chronic heart failure found to have cardiac sarcoidosis and subsequently treated inpatient with high-dose steroids. In addition, computed tomography imaging revealed pulmonary nodules. Due to a suspected infection, empirical antibiotics and antifungals were administered, however, treatment failed to clear the nodules. Further, weeks of antibiotic therapy [...]

Case Presentation: A 73-year-old man with a history of atrial fibrillation on apixaban and panhypopituitarism secondary to resection of a pituitary adenoma in the 1980s presented to our hospital for chest pain. His recent history is notable for recurrent cystitis and Clostridium difficile infections requiring stress-doses of glucocorticoids; his endocrinologist had been attempting to taper [...]

Case Presentation: An 18-year-old man presented with 2 weeks of fever, non-productive cough, and sore throat, as well as nausea, emesis, and unintentional weight loss of ~5kg. He was an undocumented immigrant but had not traveled outside of the country in the past 18 months and reported no sick contacts. He worked in landscaping but [...]