Background: National guidelines recommend sampling unilateral pleural effusions to characterize the fluid as either transudative or exudative.  Currently, the only method to characterize pleural fluid is by collecting a sample through an invasive drainage procedure that has risks of complications and is uncomfortable for the patient.  Few noninvasive methods have been studied to differentiate exudative [...]

Case Presentation: A 29 year old male with HIV/AIDS only intermittently taking antiretroviral therapy (ART), Pneumocystis jirovecii (PJP) pneumonia actively being treated with trimethoprim-sulfamethoxazole (TMP-SMX) and prednisone, and cutaneous Kaposi sarcoma all diagnosed one month ago at an outside clinic presented to the hospital with worsening cough and shortness of breath. Initial vitals were notable [...]

Case Presentation: A 58-year-old man with a medical history of recurrent acute on chronic pancreatitis due to alcohol use disorder presented with a 3-day history of right-sided pleuritic chest pain and dyspnea. Chest X-ray revealed a new large right-sided pleural effusion.   Analysis of the aspirated serosanguinous exudative pleural fluid yielded a total amylase of 24,600 [...]

Case Presentation: A 41-year-old male with a past medical history of chronic alcoholic pancreatitis and right-sided pancreatic pseudocyst presented with shortness of breath and right-sided chest pain that began three days prior. Chest X-ray showed near-complete opacification of the right hemithorax. A diagnostic thoracentesis revealed an exudative pleural effusion with a pleural amylase level of [...]

Case Presentation: An elderly male with a pertinent past medical history of carpal tunnel syndrome, and chronic diarrhea, presents with complaints of progressively worsening anasarca and associated dyspnea. He has had multiple hospitalizations for dyspnea over the last six months, thought to be due to transudative pleural effusions. Outpatient work-up, including echocardiogram and subspecialty consultation [...]

Case Presentation: A 73 year old female with a PMH of CKD 3a, GERD, and laryngeal cancer s/p total laryngectomy presented with epigastric pain for one day, radiating to bilateral upper abdominal quadrants, nausea, and vomiting.On exam the patient was hypertensive (240/90s), but otherwise hemodynamically stable. Lab work was unremarkable. A HIDA scan showed acute [...]

Case Presentation: A thirty-three year old woman with a history of alcohol-induced chronic pancreatitis and sphincter of Oddi dysfunction presented with dyspnea and a non-productive cough. She was admitted to the intensive care unit for acute hypoxic respiratory failure. On arrival, she was febrile and hypoxic, saturating 80% on room air. Labs were notable for [...]

Case Presentation: An 80-year-old Caucasian male with a history of recently diagnosed transitional cell carcinoma, diastolic heart failure (EF 65%), BPH, and CKD stage III presented with dysuria, hematuria, fever, and dyspnea one-month after cystoscopy with left ureteral stent exchange and palliative laser ablations of his ureteral and bladder lesions. Chest radiograph and CT abdomen [...]

Case Presentation: A 51-year-old male with a past medical history of alpha-1 antitrypsin deficiency with severe emphysema status post bilateral lung transplantation presented to the pulmonary transplant clinic for follow up. On evaluation, he was found to have declining FEV1 and FVC levels. A chest x-ray was performed to evaluate underlying abnormalities and revealed bilateral [...]

Case Presentation: A 73 year-old man with type 2 diabetes mellitus (hemoglobin A1c 7.5), hypertension, hyperlipidemia, chronic renal failure stage 3a, and a distant 10 pack year smoking history presented with 2 weeks of substernal chest tightness and dyspnea on exertion. He was hemodynamically stable without tachypnea at rest. Examination revealed a grade 2/6 holosystolic [...]