Background: Increased Emergency Department (ED) boarding has been linked to worse patient outcomes, including delays in treatment (Jiraporn et al 2014), increased length of stay (Singer et al 2011), and increased mortality (Singer et al 2011; Sun et al 2013). Patients who meet time zero (T-0) for diagnosis with severe sepsis while boarding in the [...]

Background: People who inject drugs (PWID) are at high-risk for developing serious injection related infections requiring long-term IV antibiotic therapy. For infective endocarditis, current guidelines recommend at least 4 to 6 weeks of IV antibiotic therapy. In PWID, it is recommended this be completed in a supervised setting because discharge home with a PICC line [...]

Case Presentation: A healthy 61-year-old woman residing in New York City presented with fever, fatigue, and decreased urinary output for four days. She was ill-appearing, jaundiced and hypotensive. Laboratory results were notable for WBC of 5.2/µl, hemoglobin 9 g/dl, platelet count 46,000/mm3, BUN 43 mg/dl, creatinine 4.36 g/dl, total bilirubin 4.6 mg/dl, direct bilirubin 1.5 [...]