To learn more about this meeting, visit https://shmannualconference.org/

Abstract Number: 1086

ALL STARS ALLIGNED – HEPARIN INDUCED THROMBOCYTOPENIA AND THROMBOSIS LEADING TO STROKE AND BILATERAL ADRENAL HEMORRHAGES IN A MALE WITH AN UNDIAGNOSED PATENT FORAMEN OVALE.

Case Presentation: 65 year old male presented to the ED with acute abdominal pain, nausea and vomiting. 10 days prior, he underwent left total knee replacement and was discharged home on low molecular weight heparin. [...]

By | 2019-03-18T17:52:53+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ALL STARS ALLIGNED – HEPARIN INDUCED THROMBOCYTOPENIA AND THROMBOSIS LEADING TO STROKE AND BILATERAL ADRENAL HEMORRHAGES IN A MALE WITH AN UNDIAGNOSED PATENT FORAMEN OVALE.

Abstract Number: 986

A RENDEZVOUS IN THE FRENCH QUARTER – INTERNAL BILIARY DRAINAGE FOR BILIARY STRICTURES DUE TO PANCREAS DIVISUM CHRONIC PANCREATITIS

Case Presentation: A 51-year-old gentleman with a history of chronic pancreatitis likely secondary to alcohol, presented with two to three weeks of nonspecific right sided abdominal pain and jaundice. On his initial admission his total [...]

By | 2019-03-18T17:51:26+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RENDEZVOUS IN THE FRENCH QUARTER – INTERNAL BILIARY DRAINAGE FOR BILIARY STRICTURES DUE TO PANCREAS DIVISUM CHRONIC PANCREATITIS

Abstract Number: 946

IF PSORIASIS ISN’T ENOUGH – A CASE OF ERYTHRODERMIC PSORIASIS

Case Presentation: A 65-year-old female with a 1-year history of psoriasis presents with a worsening rash and associated chills, arthralgias, weight loss, and diarrhea. Initially the erythematous and scaly rash was localized to her arms [...]

By | 2019-03-18T17:56:37+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on IF PSORIASIS ISN’T ENOUGH – A CASE OF ERYTHRODERMIC PSORIASIS

Abstract Number: 945

A CASE OF ERYTHEMA NODOSUM – HOW TO RESIST THE MILLION-DOLLAR WORKUP

Case Presentation: A 53-year-old female with a history of mild pancytopenia presented to the ED with fatigue, chills, decreased appetite, myalgias, non-productive cough, and a frontal headache that began 3 days prior. Shortly after symptom [...]

By | 2019-03-18T17:50:40+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF ERYTHEMA NODOSUM – HOW TO RESIST THE MILLION-DOLLAR WORKUP

Abstract Number: 898

CEFEPIME ENCEPHALOPATHY VS. UREMIC ENCEPHALOPATHY – A DIAGNOSTIC CHALLENGE IN ACUTE RENAL FAILURE ON PROLONGED ANTIBIOTIC THERAPY

Case Presentation: A 69 year old male was brought to the emergency department from a rehabilitation facility with altered mental status. Two months ago, he had been admitted for lumbar osteomyelitis for which he was [...]

By | 2019-03-18T17:53:12+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CEFEPIME ENCEPHALOPATHY VS. UREMIC ENCEPHALOPATHY – A DIAGNOSTIC CHALLENGE IN ACUTE RENAL FAILURE ON PROLONGED ANTIBIOTIC THERAPY

Abstract Number: 655

LEVAMISOLE ADULTERATED COCAINE INDUCED DIFFUSE SKIN NECROSIS – AN EMERGING CONCERN AND A DIAGNOSTIC CHALLENGE

Case Presentation: 29 y.o. female with a history of autoimmune hepatitis presented with worsening lower extremities ulceration. The onset of rash was four months ago during which she visited dermatology clinic. Vitals signs were within [...]

By | 2019-03-18T17:58:24+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on LEVAMISOLE ADULTERATED COCAINE INDUCED DIFFUSE SKIN NECROSIS – AN EMERGING CONCERN AND A DIAGNOSTIC CHALLENGE

Abstract Number: 638

A TALE OF TWO CITIES … DIVIDED BY A GEOPOLITICAL BORDER

Case Presentation: The logistical complexity of hospital-to-hospital transfer of care in the United States is well-documented. However, little is known about the processes involved in cross-border hospital transfer. This case illustrates the challenges and complexities [...]

By | 2019-03-18T18:55:25+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A TALE OF TWO CITIES … DIVIDED BY A GEOPOLITICAL BORDER

Abstract Number: 633

A STORM IS BREWING – THE LIFE-THREATENING POWER OF OUR IMMUNE SYSTEM

Case Presentation: A 70-year-old man with PMH of chronic lymphocytic leukemia (with good hematologic response to Ibrutinib, stopped three months ago due to persistent fevers of unknown etiology), nephrolithiasis (with recent ureteral stent placement), presented [...]

By | 2019-03-18T17:52:00+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A STORM IS BREWING – THE LIFE-THREATENING POWER OF OUR IMMUNE SYSTEM

Abstract Number: 440

CHOOSING WISELY: “INPATIENT THYROID FUNCTION TESTING – A COST-EFFECTIVENESS ANALYSIS”

Background: In the US, thyroid stimulating hormone (TSH) is the 4th most commonly ordered laboratory test with thyroxine measurement being the 10th commonest. In 2016, Medicare alone spent $482 million on 21.5 million performed TSH [...]

By | 2019-03-18T17:43:29+00:00 March 18th, 2019|Hospital Medicine 2019, Research, Value in Hospital Medicine|Comments Off on CHOOSING WISELY: “INPATIENT THYROID FUNCTION TESTING – A COST-EFFECTIVENESS ANALYSIS”

Abstract Number: 385

THE GLYCEMIC CONTROL CLINICAL ANDON BOARD – A PUBLICLY DISPLAYED, REAL-TIME, ALGORITHM DRIVEN SIGNAL TO PROMOTE EVIDENCE BASED INSULIN PRESCRIBING PRACTICES

Background: Diabetes is common, present in up to one third of hospitalized patients and up to 50% of critically ill patients. Studies have shown that hyperglycemia among hospitalized patients leads to worse clinical outcomes and [...]

By | 2019-03-18T17:59:15+00:00 March 18th, 2019|Hospital Medicine 2019, Innovations, Technology in Hospital Medicine|Comments Off on THE GLYCEMIC CONTROL CLINICAL ANDON BOARD – A PUBLICLY DISPLAYED, REAL-TIME, ALGORITHM DRIVEN SIGNAL TO PROMOTE EVIDENCE BASED INSULIN PRESCRIBING PRACTICES

Abstract Number: 362

ENSURING JUDICIOUS PPI USE THROUGH AN ACTIVE SURVEILLANCE STRATEGY OF WITHDRAWAL AND DOSE – REDUCTION IN INPATIENTS IS SAFE AND STABLE OVER 90 DAYS POST-DISCHARGE

Background: Proton pump inhibitors (PPI’s) are a commonly used class of medications, whose optimal use is important. Aim: To assess if proactive surveillance in inpatients can reduce PPI use for unapproved indications and their effect [...]

By | 2019-03-18T17:55:17+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on ENSURING JUDICIOUS PPI USE THROUGH AN ACTIVE SURVEILLANCE STRATEGY OF WITHDRAWAL AND DOSE – REDUCTION IN INPATIENTS IS SAFE AND STABLE OVER 90 DAYS POST-DISCHARGE

Abstract Number: 360

UTILIZING HIGH VALUE CARE – REDUCING INPATIENT PHLEBOTOMY WITH USE OF THE VETERAN’S AFFAIRS NATIONAL UTILIZATION MANAGEMENT DATABASE

Background: The Society of Hospital Medicine (SHM) identifies repetitive CBC & chemistry testing as low-value, and they selected this as a Choosing Wisely Recommendation. Overuse of phlebotomy is associated with hospital-acquired anemia, decreased patient satisfaction [...]

By | 2019-03-18T18:00:19+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on UTILIZING HIGH VALUE CARE – REDUCING INPATIENT PHLEBOTOMY WITH USE OF THE VETERAN’S AFFAIRS NATIONAL UTILIZATION MANAGEMENT DATABASE

Abstract Number: 300

DOES EHR EFFICIENCY AFFECT QUALITY OF CARE FOR HOSPITAL MEDICINE PHYSICIANS?

Background: Hospitalists balance efficiency and quality in their daily practice. How a physician’s time management affects care quality is unknown. Accordingly, we aimed to compare the EHR efficiency of hospitalists, as measured by their time [...]

By | 2019-03-18T17:55:39+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on DOES EHR EFFICIENCY AFFECT QUALITY OF CARE FOR HOSPITAL MEDICINE PHYSICIANS?

Abstract Number: 296

PATIENTS’ PERSPECTIVES ON WHITEBOARDS AS BEDSIDE VISUAL TOOLS TO ENHANCE COMMUNICATION – A MIXED METHODS STUDY

Background: Inpatient bedside whiteboards enhance patient-provider communication and satisfaction with care, but little is known about patients’ perspectives on the whiteboards. Our objectives were to understand patients’ views on the usability and design/content of these [...]

By | 2019-03-18T17:58:54+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PATIENTS’ PERSPECTIVES ON WHITEBOARDS AS BEDSIDE VISUAL TOOLS TO ENHANCE COMMUNICATION – A MIXED METHODS STUDY

Abstract Number: 186

UTILIZATION OF WEATHER AND CALENDER DATA IN PREDICTING DAILY NUMBER OF HOSPITALIZED PATIENTS-APPLICATION OF CONVENTIONAL REGRESSION ANALYSIS AND MACHINE LEARNING.

Background: The number of hospitalized patients varies significantly throughout the year. Fine prediction of the number of hospitalized patients is essential to provide adequate staffing and quality care. We aimed to identify the factors affecting [...]

By | 2019-03-18T17:59:41+00:00 March 18th, 2019|Hospital Medicine 2019, Outcomes Research, Research|Comments Off on UTILIZATION OF WEATHER AND CALENDER DATA IN PREDICTING DAILY NUMBER OF HOSPITALIZED PATIENTS-APPLICATION OF CONVENTIONAL REGRESSION ANALYSIS AND MACHINE LEARNING.

Abstract Number: 171

LENGTH OF HOSPITAL STAY AND DISCHARGE OUTCOMES AMONG PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS-ASSOCIATED PULMONARY ARTERIAL HYPERTENSION (HIV-PAH) IN THE UNITED STATES

Background: Though the advent of highly active anti-retroviral medications has improved survival in HIV infection, mortality from non-infectious complications such as pulmonary arterial hypertension (PAH) has increased. Also, studies have shown that PAH is the [...]

By | 2019-03-18T17:58:04+00:00 March 18th, 2019|Hospital Medicine 2019, Outcomes Research, Research|Comments Off on LENGTH OF HOSPITAL STAY AND DISCHARGE OUTCOMES AMONG PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS-ASSOCIATED PULMONARY ARTERIAL HYPERTENSION (HIV-PAH) IN THE UNITED STATES

Abstract Number: 112

K.I.S.S. (KEEP IT SIMPLE … SCHEDULES): HOW STANDARDIZATION AND SIMPLIFICATION CAN IMPROVE SCHEDULING AND PHYSICIAN SATISFACTION

Background: Control over work hours and schedule flexibility are important predictors of clinicians’ career satisfaction, work-life balance, and burnout, which are in turn linked to quality of patient care, recruitment, and retention. Additionally, several recent [...]

By | 2019-03-18T18:56:04+00:00 March 18th, 2019|Hospital Medicine 2019, Innovations, Other|Comments Off on K.I.S.S. (KEEP IT SIMPLE … SCHEDULES): HOW STANDARDIZATION AND SIMPLIFICATION CAN IMPROVE SCHEDULING AND PHYSICIAN SATISFACTION

Abstract Number: 102

CO-MANAGEMENT IMPLEMENTATION WITH AGS COCARE: ORTHO™ IMPROVES HIP FRACTURE OUTCOMES

Background: More than 300,000 older adults are hospitalized in the US annually for hip fracture. While operative repair is recommended in most individuals, perioperative complications account for significant morbidity and mortality. Co-management programs for hip [...]

By | 2019-03-18T17:53:41+00:00 March 18th, 2019|Geriatrics, Hospital Medicine 2019, Innovations|Comments Off on CO-MANAGEMENT IMPLEMENTATION WITH AGS COCARE: ORTHO™ IMPROVES HIP FRACTURE OUTCOMES

Abstract Number: 50

INNOVATION IN COMMUNICATION: WRITING NOTES TO PATIENTS – NOT ABOUT THEM

Background: 1 in 4 patients on the Acute Care of the Elder (ACE) unit at a tertiary care center state that their physicians do not communicate well “all of the time.” Purpose: To enhance physician-patient [...]

By | 2019-03-18T17:56:57+00:00 March 18th, 2019|Communication, Hospital Medicine 2019, Innovations|Comments Off on INNOVATION IN COMMUNICATION: WRITING NOTES TO PATIENTS – NOT ABOUT THEM

Abstract Number: Oral

DERIVATION AND VALIDATION OF A COPD READMISSION RISK PREDICTION TOOL

Background: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of hospital readmissions in America. Over one-third of patients admitted for COPD exacerbations are readmitted within 90 days, with readmissions costing $15 billion. Medicare [...]

By | 2019-03-12T15:46:24+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Research, Technology in Hospital Medicine|Comments Off on DERIVATION AND VALIDATION OF A COPD READMISSION RISK PREDICTION TOOL

Abstract Number: Oral

ANALYZE THIS: A CLINICAL PATHWAY FOR SOMATIC SYMPTOM AND RELATED DISORDERS

Background: Somatic Symptom and Related Disorders (SSRD) is an umbrella term for a wide variety of disorders commonly encountered in the inpatient pediatric setting, including conversion disorder, amplified pain syndrome, and psychogenic non-epileptiform seizures. These [...]

By | 2019-03-12T15:46:37+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Oral Presentations, Pediatrics|Comments Off on ANALYZE THIS: A CLINICAL PATHWAY FOR SOMATIC SYMPTOM AND RELATED DISORDERS

Abstract Number: Oral

COPD AUTOSUBSTITUTION OF INHALERS TO NEBULIZER THERAPY EFFECT IN HOSPITALIZED PATIENTS

Background: COPD is associated with high morbidity and mortality. It is the third-ranked cause of death in the United States, killing more than 120,000 individuals each year. As a consequence of its high prevalence and [...]

By | 2019-03-12T15:46:54+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Quality Improvement, Research|Comments Off on COPD AUTOSUBSTITUTION OF INHALERS TO NEBULIZER THERAPY EFFECT IN HOSPITALIZED PATIENTS

Abstract Number: Oral

ACUITY-BASED NIGHTTIME VITAL SIGN ASSESSMENTS: A RANDOMIZED CONTROLLED TRIAL

Background: Sleep disruptions for routine care, such as vital sign assessments, are common during hospitalization and are associated with negative health outcomes and patient satisfaction. While higher risk patients may benefit from increased monitoring at [...]

By | 2019-03-12T15:47:11+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Outcomes Research, Research|Comments Off on ACUITY-BASED NIGHTTIME VITAL SIGN ASSESSMENTS: A RANDOMIZED CONTROLLED TRIAL

Abstract Number: Oral

PHYSICIANS IMMIGRATION BACKLOG AND ITS IMPACT ON AMERICAN RURAL HEALTHCARE

Background: Physician shortage and healthcare access is a serious issue in rural America with reports estimating a shortage of more than 45,000 physicians by 2025. The rural and the underserved communities are predominantly served by [...]

By | 2019-03-12T15:51:51+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Other, Research|Comments Off on PHYSICIANS IMMIGRATION BACKLOG AND ITS IMPACT ON AMERICAN RURAL HEALTHCARE

Abstract Number: Oral

EFFECTS OF COMPREHENSIVE CARE PHYSICIANS ON PATIENT EXPERIENCE, OUTCOMES AND HOSPITALIZATION: PRELIMINARY RESULTS OF A RANDOMIZED CONTROLLED TRIAL

Background: Coordination of inpatient and outpatient care is an important challenge in improving population health but evidence examining the effectiveness of existing care coordination programs is mixed. The Comprehensive Care Physician (CCP) Program at the [...]

By | 2019-04-17T09:36:53+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Outcomes Research, Research, Winner, Research|Comments Off on EFFECTS OF COMPREHENSIVE CARE PHYSICIANS ON PATIENT EXPERIENCE, OUTCOMES AND HOSPITALIZATION: PRELIMINARY RESULTS OF A RANDOMIZED CONTROLLED TRIAL

Abstract Number: Plenary

DECREASING ADMISSIONS, READMISSIONS AND LENGTH OF STAY WHILE IMPROVING PATIENT SAFETY FOR ALCOHOL WITHDRAWAL SYNDROME

Background: There were nearly 33,000 admissions to Department of Veterans Affairs hospitals for alcohol withdrawal syndrome (AWS) in fiscal year 2017. Symptom-triggered management is the standard of care and, when employed effectively, the number of [...]

By | 2019-03-12T15:33:25+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Plenary Presentations, Quality Improvement|Comments Off on DECREASING ADMISSIONS, READMISSIONS AND LENGTH OF STAY WHILE IMPROVING PATIENT SAFETY FOR ALCOHOL WITHDRAWAL SYNDROME

Abstract Number: Oral

THE PREVALENCE OF DIAGNOSTIC ERROR IN SEVEN-DAY READMISSIONS OF GENERAL MEDICAL PATIENTS

Background: Diagnostic errors have been cited as a potential contributor to hospital readmissions, particularly early readmissions (e.g. within 7 days), but little is known about their frequency and characteristics. We performed structured chart review of [...]

By | 2019-03-12T15:50:33+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Patient Safety, Research|Comments Off on THE PREVALENCE OF DIAGNOSTIC ERROR IN SEVEN-DAY READMISSIONS OF GENERAL MEDICAL PATIENTS

Abstract Number: Oral

IMPLEMENTING STRUCTURED RADIOLOGY REPORTING TO CREATE CLINICAL DECISION SUPPORT TOOLS

Background: Deep vein thrombosis (DVT) is typically diagnosed from ultrasound (US) Doppler evaluation and anticoagulation therapy is the standard treatment to prevent life threatening pulmonary embolism (PE). In our hospital, the treating provider is alerted [...]

By | 2019-04-17T09:42:46+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Oral Presentations, Technology in Hospital Medicine, Winner, Innovations|Comments Off on IMPLEMENTING STRUCTURED RADIOLOGY REPORTING TO CREATE CLINICAL DECISION SUPPORT TOOLS

Abstract Number: Plenary

EFFECTS OF A REFINED EVIDENCE-BASED TOOLKIT ON MEDICATION RECONCILIATION QUALITY AND SAFETY AT MULTIPLE HOSPITALS: RESULTS OF THE MARQUIS2 STUDY

Background: The first Multicenter Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in 5 hospitals. Incorporating lessons learned from MARQUIS1, we implemented [...]

By | 2019-03-12T15:43:39+00:00 March 11th, 2019|Hospital Medicine 2019, Plenary Presentations, Quality Improvement, Research|Comments Off on EFFECTS OF A REFINED EVIDENCE-BASED TOOLKIT ON MEDICATION RECONCILIATION QUALITY AND SAFETY AT MULTIPLE HOSPITALS: RESULTS OF THE MARQUIS2 STUDY

Abstract Number: Oral

DEVELOPMENT AND VALIDATION OF A RISK ASSESSMENT MODEL FOR VTE IN HOSPITALIZED MEDICAL PATIENTS

Background: Venous thromboembolism (VTE) is the leading cause of preventable hospital death. National guidelinesrecommend VTE prophylaxis for all medical patients not at low risk. Several VTE risk prediction models have been developed, but no US [...]

By | 2019-03-12T15:50:05+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Outcomes Research, Research|Comments Off on DEVELOPMENT AND VALIDATION OF A RISK ASSESSMENT MODEL FOR VTE IN HOSPITALIZED MEDICAL PATIENTS

Abstract Number: Oral

THE B-TEAM (BUPRENORPHINE): MEDICATION-ASSISTED TREATMENT FOR PATIENTS WITH OPIOID USE DISORDER IN THE HOSPITAL

Background: Despite a public health crisis - over 500,000 individuals have died from opioid overdoses since 2000 – and the availability of effective therapies, most patients with Opioid Use Disorder (OUD) are not offered treatment. [...]

By | 2019-03-12T15:49:45+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Oral Presentations, Quality Improvement|Comments Off on THE B-TEAM (BUPRENORPHINE): MEDICATION-ASSISTED TREATMENT FOR PATIENTS WITH OPIOID USE DISORDER IN THE HOSPITAL

Abstract Number: Plenary

MULTI-DISCIPLINARY AND COMPREHENSIVE DELIRIUM CARE PATHWAY IS ASSOCIATED WITH REDUCTIONS IN LENGTH OF STAY, COST, AND READMISSIONS IN HOSPITALIZED ADULTS

Background: Hospital-acquired delirium is serious, leading to increased falls, pressure ulcers, length of stay, cost, patient institutionalization, and patient and caregiver distress. In addition, it is associated with mortality rates as high as 35-40% within [...]

By | 2019-03-12T15:44:56+00:00 March 11th, 2019|Hospital Medicine 2019, Plenary Presentations, Quality Improvement, Research|Comments Off on MULTI-DISCIPLINARY AND COMPREHENSIVE DELIRIUM CARE PATHWAY IS ASSOCIATED WITH REDUCTIONS IN LENGTH OF STAY, COST, AND READMISSIONS IN HOSPITALIZED ADULTS

Abstract Number: Oral

CAN MULTIPLE PROVIDERS RELIABLY TRACK THE INFERIOR VENA CAVA ACROSS HANDOFFS WITH POINT-OF-CARE ULTRASOUND?

Background: Point-of-care ultrasound (POCUS) of the inferior vena cava (IVC) can help to noninvasively predict the effectiveness of treatment for volume-sensitive conditions, such as acute heart failure and shock. Recently POCUS-IVC has also been used [...]

By | 2019-03-12T15:49:23+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Other, Research|Comments Off on CAN MULTIPLE PROVIDERS RELIABLY TRACK THE INFERIOR VENA CAVA ACROSS HANDOFFS WITH POINT-OF-CARE ULTRASOUND?

Abstract Number: Oral

REACHING ACROSS TOWN TO ENHANCE REGIONAL INPATIENT ACCESS

Background: Like all large academic medical centers (AMCs), we face capacity challenges. On most days, bed occupancy is often greater than 90% and long boarding times in the Emergency Department (ED) leads to poor patient [...]

By | 2019-03-12T15:49:09+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Oral Presentations, Value in Hospital Medicine|Comments Off on REACHING ACROSS TOWN TO ENHANCE REGIONAL INPATIENT ACCESS

Abstract Number: Oral

USING PREDICTIVE MODELING TO IDENTIFY EXCESS VITAL SIGN ASSESSMENT IN HOSPITALIZED PATIENTS

Background: Clinically stable inpatients may receive potentially unnecessary care, such as overnight vital sign assessment. Nighttime vital signs can disrupt sleep and adversely affect patient satisfaction and contribute to delirium. However, it may be difficult [...]

By | 2019-03-12T15:48:40+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Oral Presentations, Technology in Hospital Medicine|Comments Off on USING PREDICTIVE MODELING TO IDENTIFY EXCESS VITAL SIGN ASSESSMENT IN HOSPITALIZED PATIENTS

Abstract Number: 1092

A MATTER CLOSE TO THE HEART: A CASE OF INTENTIONAL CHEST WALL PENETRATION WITH SEWING NEEDLE THAT TRACKED TO THE LEFT VENTRICLE

Case Presentation: A 35-year-old male with a history of schizophrenia, bipolar disorder, and methamphetamine abuse presented to the ED with chest pain. The patient had a long history of inserting 5cm long sewing needles into [...]

By | 2019-03-11T14:45:17+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A MATTER CLOSE TO THE HEART: A CASE OF INTENTIONAL CHEST WALL PENETRATION WITH SEWING NEEDLE THAT TRACKED TO THE LEFT VENTRICLE

Abstract Number: 1090

A CARTILAGINOUS AFFAIR

Case Presentation: A 73-year-old male with saddle nose deformity, sensorineural hearing loss, and chronic nonproductive cough was referred for workup of possible granulomatosis with polyangiitis (GPA). His main concerns included longstanding polyarthralgia, ocular pain, fatigue, [...]

By | 2019-03-11T14:45:15+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CARTILAGINOUS AFFAIR

Abstract Number: 1089

NORMAL LIPASE IN ACUTE PANCREATITIS, A CASE REPORT AND LITERATURE REVIEW

Case Presentation: A 52-year-old female presented with epigastric abdominal pain started two days ago. Her past medical history was significant for Hepatitis C. She denied a history of acute pancreatitis. Her initial laboratory tests, including [...]

By | 2019-03-11T14:45:13+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NORMAL LIPASE IN ACUTE PANCREATITIS, A CASE REPORT AND LITERATURE REVIEW

Abstract Number: 1088

HELMINTHIC CHOLANGITIS WITHOUT OBVIOUS SOURCE OF TRANSMISSION

Case Presentation: A 61-year-old woman with uncontrolled type 2 diabetes mellitus presented with progressive right upper quadrant (RUQ) abdominal pain of 1 month’s duration. The pain was sharp, intermittent without radiation, and not exacerbated with [...]

By | 2019-03-11T14:45:12+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HELMINTHIC CHOLANGITIS WITHOUT OBVIOUS SOURCE OF TRANSMISSION

Abstract Number: 1087

MEROPENEM-INDUCED HEMOLYTIC ANEMIA

Case Presentation: Drug-induced immune hemolytic anemia is a rare condition in which exposure to a specific medication induces an intravascular hemolysis via an immune-mediated reaction. Although reactions are variable, they can be life-threatening. The estimated [...]

By | 2019-03-11T14:45:10+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MEROPENEM-INDUCED HEMOLYTIC ANEMIA

Abstract Number: 1085

‘ISABEL’ TO THE RESCUE!

Case Presentation: A female of 70-years with a history of osteoarthritis presented with four weeks of fever, weight loss, night sweats, and fatigue. She was hypotensive, febrile, tachycardic and tachypneic. She was initially managed per [...]

By | 2019-03-11T14:45:06+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ‘ISABEL’ TO THE RESCUE!

Abstract Number: 1084

HOW CAN YOU MEND A BROKEN HEART? RIGHT CORONARY ECTASIA PRESENTING AS INFERIOR WALL MYOCARDIAL INFARCTION

Case Presentation: Coronary artery ectasia (CAE) is the diffuse dilatation of the coronary artery with a diameter of 1.5 times the adjacent normal coronary artery. It is an uncommon and mostly incidental finding in 0.3%-6% [...]

By | 2019-03-11T14:45:04+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HOW CAN YOU MEND A BROKEN HEART? RIGHT CORONARY ECTASIA PRESENTING AS INFERIOR WALL MYOCARDIAL INFARCTION

Abstract Number: 1083

WHAT A FLUKE!: THE FIRST DOCUMENTED CASE OF CHOLECYSTIC VARICES CAUSING BILIARY OBSTRUCTION AS A SEQUELAE OF SCHISTOSOMIASIS

Case Presentation: A 53-year-old Sierra Leonean man with schistosomiasis presented with two months of jaundice and abdominal distension. Two years earlier, he was diagnosed with schistosomiasis complicated by non-cirrhotic portal hypertension, splenomegaly, and esophageal and [...]

By | 2019-03-11T14:45:02+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WHAT A FLUKE!: THE FIRST DOCUMENTED CASE OF CHOLECYSTIC VARICES CAUSING BILIARY OBSTRUCTION AS A SEQUELAE OF SCHISTOSOMIASIS

Abstract Number: 1082

CRYSTALS AND THE KIDNEY: RASBURICASE AS A TREATMENT FOR SEVERE HYPERURICEMIA IN ACUTE KIDNEY INJURY

Case Presentation: This is a case of a 69 year old female diagnosed with stage IV colon adenocarcinoma; initially treated with chemotherapy and right hemicolectomy with diverting ileostomy. Her chemotherapy regimen was changed to irinotecan [...]

By | 2019-03-11T14:45:00+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CRYSTALS AND THE KIDNEY: RASBURICASE AS A TREATMENT FOR SEVERE HYPERURICEMIA IN ACUTE KIDNEY INJURY

Abstract Number: 1081

MIRACULOUS BUG FROM FAUCET TO THE HEART : A RARE CAUSE OF INFECTIVE ENDOCARDITIS

Case Presentation: A 30-year-old Caucasian male with a past medical history of shoulder impingement, remote intravenous drug use presents as a transfer from outside hospital with 2 weeks of fever and sweats. He was febrile [...]

By | 2019-03-11T14:44:58+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MIRACULOUS BUG FROM FAUCET TO THE HEART : A RARE CAUSE OF INFECTIVE ENDOCARDITIS

Abstract Number: 1080

ACUTE KIDNEY INJURY AND HYPERCALCEMIA FROM GRANULOMATOUS INTERSTITIAL NEPHRITIS

Case Presentation: A 49-year-old woman with spondyloarthropathy was admitted with hypercalcemia and acute kidney injury (AKI). Two months prior, she had stopped adalimumab due to progressive dyspnea, palpitations, and fatigue that she attributed to the [...]

By | 2019-03-11T14:44:56+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ACUTE KIDNEY INJURY AND HYPERCALCEMIA FROM GRANULOMATOUS INTERSTITIAL NEPHRITIS

Abstract Number: 1079

NOT YOUR TYPICAL ANGINA

Case Presentation: A 67 year-old-man with a history of hepatitis C cirrhosis and a recent diagnosis of hepatocellular carcinoma (HCC) presented with six months of worsening dyspnea on exertion and one month of progressive typical [...]

By | 2019-03-11T14:44:54+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NOT YOUR TYPICAL ANGINA

Abstract Number: 1077

A CASE OF DIARRHEA THAT TURNS INTO A REAL HEARTACHE: MYOCARDITIS SECONDARY TO CAMPYLOBACTER INFECTION

Case Presentation: A 19-year-old female with no significant past medical history presented to the hospital with abdominal pain, fevers and diarrhea after returning from Europe the day prior. Stool studies were positive for campylobacter jejuni. [...]

By | 2019-03-11T14:44:53+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF DIARRHEA THAT TURNS INTO A REAL HEARTACHE: MYOCARDITIS SECONDARY TO CAMPYLOBACTER INFECTION

Abstract Number: 1076

PREVENTABLE PERIL OF PARACENTESIS: INCARCERATED UMBILICAL HERNIA

Case Presentation: A 34-year-old man with decompensated cirrhosis secondary to chronic hepatitis C (MELD 21) presented with a chief complaint of severe abdominal pain. He routinely received outpatient paracentesis weekly, which was last performed 4days [...]

By | 2019-03-11T14:44:51+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PREVENTABLE PERIL OF PARACENTESIS: INCARCERATED UMBILICAL HERNIA

Abstract Number: 1074

VERTIGO HERALDING DISCOVERY OF AN UNUSUAL UNDERLYING ETIOLOGY OF NUMEROUS PRIMARY CANCERS

Case Presentation: A 78-year-old woman presented with the sudden onset of vertigo and nausea. She had history of endometrial cancer, melanoma, breast cancer, and recent diagnosis of squamous cell carcinoma of her right lower leg. [...]

By | 2019-03-11T14:44:47+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on VERTIGO HERALDING DISCOVERY OF AN UNUSUAL UNDERLYING ETIOLOGY OF NUMEROUS PRIMARY CANCERS

Abstract Number: 1073

IT’S NOT A (MALIGNANT) TUMOR: REPORT OF AN UNUSUAL ETIOLOGY OF INTRA-ABDOMINAL MASS, WITH ASSOCIATED ABSCESS

Case Presentation: A 50-year-old man with hypothyroidism and dyslipidemia presented with one week of bilateral upper abdominal pain; subjective fevers; chills; sweats; and anorexia. His abdominal pain was constant, aching, relieved with lying supine, and [...]

By | 2019-03-11T14:44:45+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on IT’S NOT A (MALIGNANT) TUMOR: REPORT OF AN UNUSUAL ETIOLOGY OF INTRA-ABDOMINAL MASS, WITH ASSOCIATED ABSCESS

Abstract Number: 1072

CLOGGED DRAIN: DESCRIPTION OF AN UNUSUAL CAUSE OF DUODENAL OBSTRUCTION

Case Presentation: A 69-year-old man with coronary artery disease and prior myocardial infarction; cryptogenic cirrhosis; hypertension; end-stage renal disease; and insulin-requiring diabetes mellitus presented with five days of nausea and non-bloody, non-bilious emesis; abdominal distention; [...]

By | 2019-03-11T14:44:43+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CLOGGED DRAIN: DESCRIPTION OF AN UNUSUAL CAUSE OF DUODENAL OBSTRUCTION

Abstract Number: 1071

THERE WILL BE BLOOD: THE DILEMMA OF TREATING PAROXYSMAL NOCTURNAL HEMOGLOBINURIA IN THE PRESENCE OF NEW DRUG-ELUTING STENTS

Case Presentation: A 58-year-old Caucasian woman with HIV on HAART, hyperthyroidism with radioiodine ablation, Hepatitis B and C, past IV drug use, former smoker, HTN, and HLD, initially presented with chest pain and was found [...]

By | 2019-03-11T14:44:41+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THERE WILL BE BLOOD: THE DILEMMA OF TREATING PAROXYSMAL NOCTURNAL HEMOGLOBINURIA IN THE PRESENCE OF NEW DRUG-ELUTING STENTS

Abstract Number: 1069

DUSTY CONNECTION IN THE IMMUNOCOMPETENT: A RARE CASE OF DISSEMINATED NOCARDISOSIS

Case Presentation: A 63 y/o male presented with complaint of nonproductive cough and syncope for 1 month prior to arrival. He was without fever, chills or recent sick contacts. The syncope was non-positional and was [...]

By | 2019-03-11T14:44:36+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DUSTY CONNECTION IN THE IMMUNOCOMPETENT: A RARE CASE OF DISSEMINATED NOCARDISOSIS

Abstract Number: 1068

‘CLOSE ENCOUNTER OF THE TICK KIND’: A CASE OF ANAPLASMOSIS MIMICKING SEPTIC SHOCK

Case Presentation: An 87-year-old man with a history of osteoarthritis with recent knee injection presented with malaise, chills, and fever to 102.2°F for three days. He described an abrupt onset of chills and fever at [...]

By | 2019-03-11T14:44:34+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ‘CLOSE ENCOUNTER OF THE TICK KIND’: A CASE OF ANAPLASMOSIS MIMICKING SEPTIC SHOCK

Abstract Number: 1067

DIABETIC KETOACIDOSIS COMPLICATED BY ACUTE ESOPHAGEAL NECROSIS: A CASE REPORT

Case Presentation: A 29-year-old woman with poorly-controlled type I diabetes presented to the emergency department with nausea, vomiting, lethargy, and odynophagia for two days prior to admission. Her physical exam was notable for dry mucus [...]

By | 2019-03-11T14:44:32+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DIABETIC KETOACIDOSIS COMPLICATED BY ACUTE ESOPHAGEAL NECROSIS: A CASE REPORT

Abstract Number: 1066

ACANTHAMOEBA ENCEPHALITIS IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED MALE PRESENTING WITH HEADACHE AND NEW-ONSET SEIZURES: A CASE REPORT

Case Presentation: A 27-year-old man with Acquired Immune Deficiency Syndrome (with a CD4+ cell count of 5 cells/mm3) presented with new-onset seizures and headache in September 2018 in Atlanta, Georgia. Notably, the patient was admitted to [...]

By | 2019-03-11T14:44:30+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ACANTHAMOEBA ENCEPHALITIS IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED MALE PRESENTING WITH HEADACHE AND NEW-ONSET SEIZURES: A CASE REPORT

Abstract Number: 1065

FROM MOUTH TO THE LIVER: JOURNEY OF A FUSOBACTERIUM

Case Presentation: A 76-year-old male with past medical history of GERD, hypothyroidism, and pre-diabetes presented with fever, chills, lethargy and 5-pound unintentional weight loss for 2 weeks. He denied abdominal pain, nausea or vomiting. No [...]

By | 2019-03-11T14:44:29+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on FROM MOUTH TO THE LIVER: JOURNEY OF A FUSOBACTERIUM

Abstract Number: 1063

DIFFUSE CORONARY ARTERY ECTASIA: AN UNUSUAL CAUSE OF ST-ELEVATION MYOCARDIAL INFARCTION

Case Presentation: A 58 year old male with no previous cardiac history presented to the emergency department (ED) with acute onset of substernal chest pain. An electrocardiogram (ECG) showed inferior ST-segment depressions, and cardiac troponins [...]

By | 2019-03-11T14:44:24+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DIFFUSE CORONARY ARTERY ECTASIA: AN UNUSUAL CAUSE OF ST-ELEVATION MYOCARDIAL INFARCTION

Abstract Number: 1062

A CASE OF PARAGANGLIOMA CRISIS CAUSING TRANSIENT CARDIOMYOPATHY

Case Presentation: A 46-year-old man with history of hypertension and no prior history of heart failure presented with acute hypoxic respiratory failure and was subsequently intubated. Chest imaging revealed pulmonary edema and echocardiography showed an [...]

By | 2019-03-11T14:44:19+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF PARAGANGLIOMA CRISIS CAUSING TRANSIENT CARDIOMYOPATHY

Abstract Number: 1061

B12 DEFICIENCY: AN OVERLOOKED CASE OF MICROANGIOPATHIC HEMOLYTIC ANEMIA

Case Presentation: A 32-year-old female with a history of untreated sarcoidosis and gastric bypass surgery with partially treated B12 deficiency in the past, was admitted for shortness of breath with a primary diagnosis of pancytopenia. [...]

By | 2019-03-11T14:44:17+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on B12 DEFICIENCY: AN OVERLOOKED CASE OF MICROANGIOPATHIC HEMOLYTIC ANEMIA

Abstract Number: 1060

NIACIN, THE COVER UP DRUG

Case Presentation: A 19 year old male with occasional marijuana and alcohol use, presented to an outside hospital with abdominal pain, nausea, vomiting, and facial flushing that developed 18 hours after he consumed 7.5g of [...]

By | 2019-03-11T14:44:15+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NIACIN, THE COVER UP DRUG

Abstract Number: 1059

TWO VALVES AND A BROKEN HEART: A RARE CASE OF GRANULICATELLA INFECTIVE ENDOCARDITIS

Case Presentation: A 60 year-old man with a history of coronary artery disease, hypertension, and asthma presented to the emergency department with worsening intermittent fever and cough over six months. The cough was productive and [...]

By | 2019-03-11T14:44:13+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TWO VALVES AND A BROKEN HEART: A RARE CASE OF GRANULICATELLA INFECTIVE ENDOCARDITIS

Abstract Number: 1058

THE SHEAR STRESS OF IT ALL

Case Presentation: A 53-year-old woman with a history of bioprosthetic aortic valve (AV) placement in 2014 presented with three weeks of exertional dyspnea and dark stools. On presentation stool guaiac was positive and her hemoglobin [...]

By | 2019-03-11T14:44:11+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THE SHEAR STRESS OF IT ALL

Abstract Number: 1057

A CURIOUS CASE OF CARDIAC CARCINOID ORIGINATING FROM AN OVARIAN TUMOR

Case Presentation: A 49 year old female with history of polysubstance abuse, recent diagnosis of diastolic heart failure, and COPD who initially presented to an outside hospital with progressive dyspnea on exertion and volume overload. [...]

By | 2019-03-11T14:44:09+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CURIOUS CASE OF CARDIAC CARCINOID ORIGINATING FROM AN OVARIAN TUMOR

Abstract Number: 1055

AN UNLIKELY CULPRIT: RENAL CELL CARCINOMA MASKED AS ACUTE ABDOMINAL PAIN

Case Presentation: A 37-year old male with a history of hypertension presented for acute left sided flank pain while watching television. Additional symptoms included nausea, vomiting, and diaphoresis. He noticed dark-colored urine about 3 weeks [...]

By | 2019-03-11T14:44:05+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN UNLIKELY CULPRIT: RENAL CELL CARCINOMA MASKED AS ACUTE ABDOMINAL PAIN

Abstract Number: 1054

NOT ALL LYTIC BONE LESIONS ARE CANCER

Case Presentation: Coccidioidomycosis is a fungal infection caused by dimorphic fungus of Coccidioides species, endemic to the Southwest dry regions of the United States. Its usual presentation is community-acquired pneumonia. Less than 1% of cases [...]

By | 2019-03-11T14:44:03+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NOT ALL LYTIC BONE LESIONS ARE CANCER

Abstract Number: 1053

DO NOT IGNORE A VESICLE ON THE EYELID OF A DIABETIC PATIENT- A PRESENTATION OF RHINO-ORBITAL AND PRESUMPTIVE CEREBRAL MUCORMYCOSIS

Case Presentation: Rhino-orbital-cerebral mucormycosis is an uncommon invasive fungal infection associated with high mortality. The disease has been described in immunosuppressed patients with malignancy, neutropenia, iron overload, as well as among patients with uncontrolled diabetes [...]

By | 2019-03-11T14:44:01+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DO NOT IGNORE A VESICLE ON THE EYELID OF A DIABETIC PATIENT- A PRESENTATION OF RHINO-ORBITAL AND PRESUMPTIVE CEREBRAL MUCORMYCOSIS

Abstract Number: 1052

DISSEMINATED NOCARDIA IN A HEART TRANSPLANT PATIENT ON A CALCINEURIN INHIBITOR

Case Presentation: A 72 year-old male with a history of cardiomyopathy s/p cardiac transplant in 2000, pituitary adenoma s/p resection and radiation therapy in 2001, and secondary panhypopituitarism presented for progressive full body weakness. He [...]

By | 2019-03-11T14:43:59+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DISSEMINATED NOCARDIA IN A HEART TRANSPLANT PATIENT ON A CALCINEURIN INHIBITOR

Abstract Number: 1050

RARE CASE PRESENTATION OF ACUTE CALCIFIC LONGUS COLLI TENDINITIS

Case Presentation: Acute calcific tendinitis of the Longus colli is a rare and likely underdiagnosed inflammatory response caused by deposition of calcium hydroxyapatite crystals in the Longus colli tendon, typically anterior to the C1-C2 vertebral [...]

By | 2019-03-11T14:43:56+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on RARE CASE PRESENTATION OF ACUTE CALCIFIC LONGUS COLLI TENDINITIS

Abstract Number: 1049

CAN YOU HEAR ME NOW? A CASE OF 7TH AND 8TH CRANIAL NERVE PALSIES FROM DUAL CHECK POINT INHIBITOR THERAPY

Case Presentation: A 65 year old Caucasian male with a history of B cell lymphoma on dual anti-checkpoint inhibitor therapy with Pembrolizumab (anti-PD1 antibodies) and IDO(indolamine 2,3-dioxygenase) presented with complaints of left side facial droop, [...]

By | 2019-03-11T14:43:54+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CAN YOU HEAR ME NOW? A CASE OF 7TH AND 8TH CRANIAL NERVE PALSIES FROM DUAL CHECK POINT INHIBITOR THERAPY

Abstract Number: 1048

A CASE OF PRIMARY ANGIITIS OF THE CNS

Case Presentation: A 58-year-old right-handed, nonsmoker, otherwise healthy male presented with episodes of vertigo and slurred speech. Vital signs were within normal range and his initial labs were noncontributory. Imaging revealed multifocal acute and subacute [...]

By | 2019-03-11T14:43:52+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF PRIMARY ANGIITIS OF THE CNS

Abstract Number: 1047

THE IMPACT OF PERNICIOUS ANEMIA ON CHRONIC LYMPHOCYTIC LEUKEMIA

Case Presentation: A 56-year-old man with a history of diabetes presented to the ED with confusion and generalized lymphadenopathy. Labs were significant for severe macrocytic anemia (Hemoglobin of 3.5 g/dL, MCV of 134), low reticulocyte [...]

By | 2019-03-11T14:43:50+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THE IMPACT OF PERNICIOUS ANEMIA ON CHRONIC LYMPHOCYTIC LEUKEMIA

Abstract Number: 1046

CALCIPHYLAXIS: BE AWARE OF HIGH RISK MEDICATIONS, DON’T ALWAYS BLAME KIDNEYS

Case Presentation: A 52-year-old female with a history of hypertension and atrial fibrillation presented with a painful ulcer on her right leg. The patient noted that it started as a small bump six months ago [...]

By | 2019-03-11T14:43:49+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CALCIPHYLAXIS: BE AWARE OF HIGH RISK MEDICATIONS, DON’T ALWAYS BLAME KIDNEYS

Abstract Number: 1045

ACQUIRED VON WILLEBRAND DISEASE IN A PATIENT WITH POLYCYTHEMIA VERA AND ESSENTIAL THROMBOCYTOSIS

Case Presentation: A 53 year old female with a history of JAK2 positive polycythemia vera, managed with frequent phlebotomies (most recently 1 month prior to admission), 8 ischemic strokes and myocardial infarction status post percutaneous [...]

By | 2019-03-11T14:43:47+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ACQUIRED VON WILLEBRAND DISEASE IN A PATIENT WITH POLYCYTHEMIA VERA AND ESSENTIAL THROMBOCYTOSIS

Abstract Number: 1044

A GOOD RUN OF BAD LUCK: A CASE OF OSTEOMYELITIS OF THE PUBIC SYMPHYSIS IN A YOUNG ATHLETE

Case Presentation: Patient is a 20-year-old female with no significant past medical history who presented with groin pain and fever. She is a college athlete who runs ten miles daily. Two weeks prior to presentation, [...]

By | 2019-03-11T14:43:45+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A GOOD RUN OF BAD LUCK: A CASE OF OSTEOMYELITIS OF THE PUBIC SYMPHYSIS IN A YOUNG ATHLETE

Abstract Number: 1043

PLASMACYTOID UROTHELIAL CELL CARCINOMA IN A PATIENT WITH POST-9/11 WORLD TRADE CENTER EXPOSURE

Case Presentation: A 67-year-old never-smoker male with no medical or surgical history presented to his primary care physician with progressive malaise. He was referred to the hospital when blood work returned with hypercalcemia. On evaluation, [...]

By | 2019-03-11T14:43:43+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PLASMACYTOID UROTHELIAL CELL CARCINOMA IN A PATIENT WITH POST-9/11 WORLD TRADE CENTER EXPOSURE

Abstract Number: 1042

CONCURRENT BABESIOSIS AND EHRLICHIOSIS IN AN IMMUNOCOMPETENT HOST IN PENNSYLVANIA

Case Presentation: A 76 y/o Korean American man presented with fever, chills, poor appetite, fatigue and dark colored urine. He often hikes in the woods but does not remember any tick or insect bites. He [...]

By | 2019-03-11T14:43:41+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CONCURRENT BABESIOSIS AND EHRLICHIOSIS IN AN IMMUNOCOMPETENT HOST IN PENNSYLVANIA

Abstract Number: 1041

I HAVE A FEVER AND THE ONLY CURE IS THE RIGHT DIAGNOSIS

Case Presentation: A 64-year-old male with a history of aortic valve stenosis status post bioprosthetic valve replacement nine months prior, paroxysmal atrial fibrillation on warfarin, and extremely poor oral hygiene presented to the hospital with [...]

By | 2019-03-11T14:43:39+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on I HAVE A FEVER AND THE ONLY CURE IS THE RIGHT DIAGNOSIS

Abstract Number: 1039

“URINE” FOR A SHOCKING DIAGNOSIS: PIGMENT NEPHROPATHY AS AN UNCOMMON COMPLICATION OF SULFADIAZINE IN TREATMENT FOR CNS TOXOPLASMOSIS

Case Presentation: A 35-year-old HIV positive gentleman presented to the hospital with acute bilateral flank pain associated with dysuria and “sandy pink” urine. He was diagnosed and treated for central nervous system (CNS) Toxoplasma gondii [...]

By | 2019-03-11T14:43:35+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on “URINE” FOR A SHOCKING DIAGNOSIS: PIGMENT NEPHROPATHY AS AN UNCOMMON COMPLICATION OF SULFADIAZINE IN TREATMENT FOR CNS TOXOPLASMOSIS

Abstract Number: 1038

A RARE CASE OF BACTERIAL PERITONITIS DUE TO ACHROMOBACTER XYLOSOXIDANS WITH POTENTIAL INDUCIBLE RESISTANCE TO PREFERRED ANTIMICROBIAL AGENTS

Case Presentation: A 65 year-old male with a history of chronic alcoholism presented to a regional hospital with progressive fatigue and epigastric pain. The patient was diagnosed with decompensated alcoholic cirrhosis with gallstone pancreatitis, which [...]

By | 2019-03-11T14:43:33+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF BACTERIAL PERITONITIS DUE TO ACHROMOBACTER XYLOSOXIDANS WITH POTENTIAL INDUCIBLE RESISTANCE TO PREFERRED ANTIMICROBIAL AGENTS

Abstract Number: 1036

DON’T GET TOO CHILLY WITH HEPATITIS C: CRYOGLOBULINEMIC LEUKOCYTOCLASTIC VASCULITIS

Case Presentation: A 54-year-old female with hepatitis C, liver cirrhosis, and history of intravenous heroin use presented with bilateral lower extremity swelling, weakness, multiple aphthous ulcers and a progressive, painful rash for 1 month. Physical [...]

By | 2019-03-11T14:43:30+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DON’T GET TOO CHILLY WITH HEPATITIS C: CRYOGLOBULINEMIC LEUKOCYTOCLASTIC VASCULITIS

Abstract Number: 1035

A DANGEROUS DUO: HUMAN IMMUNODEFICIENCY VIRUS AND HUMAN HERPESVIRUS-8

Case Presentation: A 57-year-old male with HIV/AIDS and Kaposi sarcoma (KS) was admitted to the hospital with intermittent fever, fatigue, night sweats, and dry cough of six-week duration. He had been on dolutegravir and emtricitabine-alafenamide [...]

By | 2019-03-11T14:43:28+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A DANGEROUS DUO: HUMAN IMMUNODEFICIENCY VIRUS AND HUMAN HERPESVIRUS-8

Abstract Number: 1034

CHRONIC RECURRENT PRIAPISM: A HIGH FLOW STATE SECONDARY TO A TRAUMATIC ARTERIOVENOUS FISTULA OF THE CORPUS CAVERNOSUM

Case Presentation: 37-year-old Hispanic male presented with an episode of painful priapism with history of a car accident in 2005 which resulted in spinal injury. Since then, he has had more than 20 recurrent episodes [...]

By | 2019-03-11T14:43:27+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CHRONIC RECURRENT PRIAPISM: A HIGH FLOW STATE SECONDARY TO A TRAUMATIC ARTERIOVENOUS FISTULA OF THE CORPUS CAVERNOSUM

Abstract Number: 1033

STATIN-INDUCED NECROTIZING AUTOIMMUNE MYOPATHY: AN EXTREMELY RARE SIDE EFFECT FROM STATIN USE

Case Presentation: A 71-year-old-male presented with recurrent falls due to extreme bilateral lower extremity weakness following revision surgery for infected right knee prosthesis. He denied any pain or sensory changes in his extremities. He denied [...]

By | 2019-03-11T14:43:25+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on STATIN-INDUCED NECROTIZING AUTOIMMUNE MYOPATHY: AN EXTREMELY RARE SIDE EFFECT FROM STATIN USE

Abstract Number: 1031

THE SHIFTY BARR-TENDER: SEEKING AN ALTERNATIVE TO ALCOHOLIC CIRRHOSIS

Case Presentation: A 68-year-old man with history of alcohol use and rheumatoid arthritis (RA) treated with methotrexate (MTX), hydroxychloroquine, and infliximab since 2006 presented with recurrent fevers, unintentional weight loss and weakness. When symptoms started [...]

By | 2019-03-11T14:43:20+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THE SHIFTY BARR-TENDER: SEEKING AN ALTERNATIVE TO ALCOHOLIC CIRRHOSIS

Abstract Number: 1030

DISSEMINATED INTRAVASCULAR COAGULATION AND LUNG ADENOCARCINOMA: A CASE REPORT

Case Presentation: An 81-year-old female with history of atrial fibrillation and bioprosthestic mitral valve replacement on warfarin presented after INR was reported as 6.3 and increased dyspnea. Physical exam was non-significant but lab findings showed [...]

By | 2019-03-11T14:43:18+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DISSEMINATED INTRAVASCULAR COAGULATION AND LUNG ADENOCARCINOMA: A CASE REPORT

Abstract Number: 1029

AN EMERGING DRUG RESISTANT ORGANISM: ELIZABETHKINGIA MENINGOSEPTICA

Case Presentation: An 80-year-old female with a history of hypoxic encephalopathy, chronic respiratory failure on mechanical ventilation through tracheostomy, End stage renal disease on hemodialysis through right arm arterio-venous fistula who presented immediately after dialysis [...]

By | 2019-03-11T14:43:16+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN EMERGING DRUG RESISTANT ORGANISM: ELIZABETHKINGIA MENINGOSEPTICA

Abstract Number: 1027

ATYPICAL HEMOLYTIC UREMIC SYNDROME INDUCED BY ACUTE PANCREATITIS

Case Presentation: A 30 year old woman with history of sickle cell disease presented with complaints of nausea, vomiting and diarrhea for 2-3 days. She was tachycardic and hypotensive on presentation. Pertinent laboratory findings were [...]

By | 2019-03-11T14:43:12+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ATYPICAL HEMOLYTIC UREMIC SYNDROME INDUCED BY ACUTE PANCREATITIS

Abstract Number: 1026

ANTERIOR NODULAR SCLERITIS AND ERYTHEMA NODOSUM AS POOR PROGNOSITC INDICATORS IN ULCERATIVE COLITIS

Case Presentation: A 21-year old female presented with fever, abdominal pain, diarrhea and hematochezia. Her past medical history was significant for ulcerative colitis and recurrent clostridium difficile infection. On exam, she had tender abdomen and [...]

By | 2019-03-22T10:04:32+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ANTERIOR NODULAR SCLERITIS AND ERYTHEMA NODOSUM AS POOR PROGNOSITC INDICATORS IN ULCERATIVE COLITIS

Abstract Number: 1025

A RARE ASSOCIATION OF DRUG INDUCED EOSINOPHELIC PNEUMONIA WITH COMMON VARIABLE IMMUNODEFICIENCY

Case Presentation: 49-year-old female with a history of hypothyroidism, hypertension, depression, and insomnia was admitted for the evaluation of recurrent pneumonia. Her home medications include antihypertensives, levothyroxine, citalopram and trazodone. She reported that she had [...]

By | 2019-03-22T10:07:50+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE ASSOCIATION OF DRUG INDUCED EOSINOPHELIC PNEUMONIA WITH COMMON VARIABLE IMMUNODEFICIENCY

Abstract Number: 1024

SITAGLIPTIN-INDUCED LEUKOCYTOCLASTIC VASCULITIS

Case Presentation: A fifty-seven-year-old man with multiple comorbidities including type 2 diabetes on oral hypoglycemic agents who presented to our emergency department for left lower extremity edematous and warm erythema with fever. The symptoms started [...]

By | 2019-03-11T14:43:07+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SITAGLIPTIN-INDUCED LEUKOCYTOCLASTIC VASCULITIS

Abstract Number: 1022

MYCOBACTERIUM BOVIS PUBIC SYMPHYSIS OSTEOMYELITIS IN THE SETTING OF INTRAVESICAL BCG THERAPY

Case Presentation: The patient is a 70 year-old male with history of superficial transitional cell bladder cancer status post transurethral resection of bladder tumor, chemotherapy, and multiple courses of intravesical BCG (Bacillus Calmette-Guerin) therapy-- most [...]

By | 2019-03-11T14:43:03+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MYCOBACTERIUM BOVIS PUBIC SYMPHYSIS OSTEOMYELITIS IN THE SETTING OF INTRAVESICAL BCG THERAPY

Abstract Number: 1021

THYROTOXIC PERIODIC PARALYSIS: AN UNUSUAL PRESENTATION OF SUBTLE HYPERTHYROIDISM

Case Presentation: A 22-year-old Hispanic male with no significant past medical history, presented to ED with acute onset of bilateral lower extremity weakness. The patient stated that weakness was episodic lasting minutes to hours, usually [...]

By | 2019-03-11T14:43:01+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THYROTOXIC PERIODIC PARALYSIS: AN UNUSUAL PRESENTATION OF SUBTLE HYPERTHYROIDISM

Abstract Number: 1020

RIGHT TREATMENT- BUT WRONG SEQUENCE: CASE OF SCHMIDT SYNDROME

Case Presentation: 37 year old Hispanic male with Hyperlipidemia presented with diffuse abdominal pain and cramping for 2 days duration. Physical exam showed facial hyper pigmentation, soft palate - 2x2 mm hyper pigmented macules, hyper [...]

By | 2019-03-11T14:42:59+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on RIGHT TREATMENT- BUT WRONG SEQUENCE: CASE OF SCHMIDT SYNDROME

Abstract Number: 1018

ACCELERATED VITAMIN D CONVERSION: AN ATYPICAL ETIOLOGY OF HYPERCALCEMIA OF MALIGNANCY

Case Presentation: 52-year-old male presented with six-week history of unintentional weight loss, decreased appetite and non-radiating dull suprapubic pain. Review of systems was notable for constipation, polyuria, polydipsia, nausea, and left leg swelling. No family [...]

By | 2019-03-11T14:42:56+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ACCELERATED VITAMIN D CONVERSION: AN ATYPICAL ETIOLOGY OF HYPERCALCEMIA OF MALIGNANCY

Abstract Number: 1017

DOUBLE STRIKE: LYME AND BABESIA COINFECTION PRESENTING LETHALLY AS SEPTIC SHOCK IN A HEALTHY MALE

Case Presentation: A 60-year old male gardener presented with generalized body aches, night sweats, chills, malaise, fevers and headache (frontal and occipital) intermittently for a month. He reported abdominal pain, dyspnea, joint stiffness and myalgia. [...]

By | 2019-03-11T14:42:54+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DOUBLE STRIKE: LYME AND BABESIA COINFECTION PRESENTING LETHALLY AS SEPTIC SHOCK IN A HEALTHY MALE

Abstract Number: 1016

U-T-I DON’T THINK SO

Case Presentation: A 70-year-old male presented with a low-grade fever, progressive weakness and urinary frequency. Prior to this admission, he had a diagnosis of recurrent urinary tract infection (UTI) that was treated with antibiotics. A [...]

By | 2019-03-11T14:42:52+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on U-T-I DON’T THINK SO

Abstract Number: 1015

THE GREAT IMITATOR: A CASE OF INTRAVASCULAR LYMPHOMA-INDUCED PARAPLEGIA

Case Presentation: A 73-year-old woman with a history of coronary artery disease and remote cervical cancer presented to the hospital with a two-month history of progressive leg weakness and confusion. Over the course of six [...]

By | 2019-03-11T14:42:50+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THE GREAT IMITATOR: A CASE OF INTRAVASCULAR LYMPHOMA-INDUCED PARAPLEGIA

Abstract Number: 1014

CEREBRAL CHAGAS DISEASE IN AN HIV-NEGATIVE INDIVIDUAL

Case Presentation: An 88-year-old female from Peru with history of hypothyroidism, rheumatoid arthritis treated with oral methotrexate, and multiple recent transient ischemic attacks presented with altered mental status, difficulty speaking, and right sided weakness. The [...]

By | 2019-03-11T14:42:49+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CEREBRAL CHAGAS DISEASE IN AN HIV-NEGATIVE INDIVIDUAL

Abstract Number: 1013

THE PERFECT STORM: SEVERE ACIDOSIS, CARDIOMYOPATHY, CARDIOGENIC SHOCK, AND EXTRACORPOREAL MEMBRANE OXYGENATION

Case Presentation: A 38-year-old female with past medical history significant for poorly controlled, insulin dependent, type two diabetes mellitus presented with shortness of breath, abdominal pain, polyuria, and polydipsia for two days. Patient had been [...]

By | 2019-03-11T14:42:47+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THE PERFECT STORM: SEVERE ACIDOSIS, CARDIOMYOPATHY, CARDIOGENIC SHOCK, AND EXTRACORPOREAL MEMBRANE OXYGENATION

Abstract Number: 1012

A NOT SO BENIGN RASH

Case Presentation: A 50-year-old African American man with a sixteen year history of skin rash presents with worsening skin lesions and joint pain. The rash is diffuse, scaly, and pruritic, and the joints in all [...]

By | 2019-03-11T14:42:45+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A NOT SO BENIGN RASH

Abstract Number: 1011

A TIGHT SPOT CAUSES UNBEARABLE PRESSURE: A CASE OF RENAL ARTERY STENOSIS

Case Presentation: A 40-year-old woman with history of persistent severe hypertension despite multiple antihypertensive agents, chronic renal dysfunction due to single functional kidney , and calcific arterial disease (coral reef aorta) requiring previous aortobifemoral bypass [...]

By | 2019-03-11T14:42:44+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A TIGHT SPOT CAUSES UNBEARABLE PRESSURE: A CASE OF RENAL ARTERY STENOSIS

Abstract Number: 1010

GROUND GLASS OPACITIES AS INDOLENT STAGE IV LUNG ADENOCARCINOMA

Case Presentation: AH is a 46-year-old female originally from Senegal with a history of unexplained syncope post loop recorder placement who presented with a two-week history of a nonproductive cough and two months of shortness [...]

By | 2019-03-11T14:42:42+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on GROUND GLASS OPACITIES AS INDOLENT STAGE IV LUNG ADENOCARCINOMA

Abstract Number: 1009

BENIGN GASTRO-COLIC FISTULA OCCURRING AS A LATE COMPLICATION OF WHIPPLE’S PROCEDURE IN A 61-YEAR-OLD MALE

Case Presentation: The patient is a 61-year-old male theatre director who presented with chronic diarrhea associated with a 50-pound weight loss, fatigue, and weakness. His past surgical history was notable of a Whipple’s procedure done [...]

By | 2019-03-11T14:42:40+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on BENIGN GASTRO-COLIC FISTULA OCCURRING AS A LATE COMPLICATION OF WHIPPLE’S PROCEDURE IN A 61-YEAR-OLD MALE

Abstract Number: 1008

TERMINATOR OUT OF OFFICE

Case Presentation: A 53 year-old woman with Type 2 Diabetes Mellitus presented with six days of painful rashes that began on her arms then spread to her face, scalp, and tongue. She reported fever of [...]

By | 2019-03-11T14:42:38+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TERMINATOR OUT OF OFFICE

Abstract Number: 1007

PERSISTENT REFRACTORY HYPOKALEMIA: A TALE OF TWO DRUGS

Case Presentation: Case 1: A 56 year old female with history of metastatic adenocarcinoma of lung on cycle 1 day 8 of carboplatin/permetrexed/pembrolizumab therapy presented with fever, headache and altered mental status. She was diagnosed [...]

By | 2019-03-11T14:42:37+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PERSISTENT REFRACTORY HYPOKALEMIA: A TALE OF TWO DRUGS

Abstract Number: 1006

PARANEOPLASTIC CEREBELLAR DEGENERATION WITH NO PRIMARY TUMOR

Case Presentation: An 89 year-old female with hyperlipidemia presented with diplopia, vertigo, and dysarthria. Seven weeks prior to presentation, she developed horizontal diplopia. Four weeks prior, she noted vertigo with no hearing loss, tinnitus, or [...]

By | 2019-03-11T14:42:35+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PARANEOPLASTIC CEREBELLAR DEGENERATION WITH NO PRIMARY TUMOR

Abstract Number: 1005

MARIJUANA INDUCED BRADYARRHYTHMIA – A BENIGN BUT RARE CAUSE OF SYNCOPE

Case Presentation: A 24-year-old gentleman gentleman presented to the emergency room complaining of left precordial discomfort and syncopal event at work. His system review was negative. He acknowledged using marijuana with the last usage being [...]

By | 2019-03-11T14:42:33+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MARIJUANA INDUCED BRADYARRHYTHMIA – A BENIGN BUT RARE CAUSE OF SYNCOPE

Abstract Number: 1004

HEMATURIA AS A PRESENTING MANIFESTATION OF ACUTE LYMPHOID LEUKEMIA – A RARELY REPORTED ENTITY

Case Presentation: A 64 yr old gentleman presented to the emergency department of our hospital with abdominal pain and hematuria. Initial laboratory evaluation revealed unremarkable metabolic profile and mild anemia (Hgb -9.3 g/dl). Urinalysis was [...]

By | 2019-03-11T14:42:31+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HEMATURIA AS A PRESENTING MANIFESTATION OF ACUTE LYMPHOID LEUKEMIA – A RARELY REPORTED ENTITY

Abstract Number: 1003

EPSTEIN BARR VIRUS (EBV) ASSOCIATED PRIMARY INTRAMEDULLARY LEIOMYOSARCOMA – A RECHERCHE DILEMMA

Case Presentation: We report a 32 yr old HIV positive lady who presented with acute onset right thoracic multi-dermatomal herpes zoster and ipsilateral upper and lower limb weakness. She had been on HAART since 2002 [...]

By | 2019-03-11T14:42:30+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on EPSTEIN BARR VIRUS (EBV) ASSOCIATED PRIMARY INTRAMEDULLARY LEIOMYOSARCOMA – A RECHERCHE DILEMMA

Abstract Number: 1002

CASE REPORT: AN 18-YEAR-OLD WITH SEVERE RHABDOMYOLYSIS IN THE SETTING OF VIRAL INFECTION

Case Presentation: 18-year-old female college student with a past medical history of polycystic kidney disease, febrile seizures and treated Kawasaki’s disease presented with bilateral lower extremity muscle weakness, which was acute and uniform without any [...]

By | 2019-03-11T14:42:28+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CASE REPORT: AN 18-YEAR-OLD WITH SEVERE RHABDOMYOLYSIS IN THE SETTING OF VIRAL INFECTION

Abstract Number: 1000

A RARE CASE OF BILATERAL PAINFUL LEG PARALYSIS

Case Presentation: Severe peripheral disease with arterial thrombosis can present as bilateral leg paralysis and extreme pain. Caution must be exercised to exclude vascular pathology ( in addition to neurologic differentials), to avoid premature closure [...]

By | 2019-03-11T14:42:24+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF BILATERAL PAINFUL LEG PARALYSIS

Abstract Number: 999

A CASE OF UNEXPLAINED COAGULOPATHY

Case Presentation: Use of synthetic illicit drugs, including marijuana, is on the rise. Commonly these drugs are laced with additives, many of which can have severe hematologic effects, to enhance the drugs’ euphoric effects. Here [...]

By | 2019-03-11T14:42:22+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF UNEXPLAINED COAGULOPATHY

Abstract Number: 998

GETTING TO THE HEART OF THE MATTER: A CASE OF SERONEGATIVE ANTIPHOSPHOLIPID SYNDROME

Case Presentation: A 52-year-old gentleman with past medical history of lupus nephritis, non-ST-elevation myocardial infarction, venous thromboembolism (on anticoagulation), and peripheral vascular disease requiring arterial bypass grafting presented to the hospital with left toe pain [...]

By | 2019-03-11T14:42:18+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on GETTING TO THE HEART OF THE MATTER: A CASE OF SERONEGATIVE ANTIPHOSPHOLIPID SYNDROME

Abstract Number: 997

RECURRENT RESPIRATORY PAPILLOMATOSIS IN AN IMMUNOCOMPETENT ADULT

Case Presentation: A 53-year-old male with a history of coronary artery disease, chronic obstructive pulmonary disease (COPD) on 3 L oxygen and tobacco abuse presented to the emergency department of an outside hospital with complaints [...]

By | 2019-03-11T14:42:12+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on RECURRENT RESPIRATORY PAPILLOMATOSIS IN AN IMMUNOCOMPETENT ADULT

Abstract Number: 996

DISSECTING THE CASE: DIAGNOSING SPONTANEOUS CORONARY ARTERY DISSECTION

Case Presentation: A 42 year-old man with remote tobacco history and no other cardiac risk factors presented after an episode of substernal chest pain. One day prior to presentation, he ran three miles without chest [...]

By | 2019-03-11T14:42:11+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DISSECTING THE CASE: DIAGNOSING SPONTANEOUS CORONARY ARTERY DISSECTION

Abstract Number: 995

BRAIN ABSCESS: A RARE COMPLICATION OF ESOPHAGOGASTRODUODENOSCOPY

Case Presentation: A 54 year old male developed acute encephalopathy and unilateral paralysis. He had a history of lung adenocarcinoma for which in1998 he underwent open resection of both lung tumor and brain metastases followed [...]

By | 2019-03-11T14:42:09+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on BRAIN ABSCESS: A RARE COMPLICATION OF ESOPHAGOGASTRODUODENOSCOPY

Abstract Number: 994

NOT JUST YOUR DIABETES ANTIBODY: A CASE OF ANTI-GLUTAMATE DECARBOXYLASE ASSOCIATED LIMBIC ENCEPHALOPATHY

Case Presentation: TW is a 43-year-old woman with history of complex partial epilepsy who presented with recurrent seizures and poor memory. She has poor medication compliance and multiple emergent visits for seizures. Past workup included [...]

By | 2019-03-11T14:42:07+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NOT JUST YOUR DIABETES ANTIBODY: A CASE OF ANTI-GLUTAMATE DECARBOXYLASE ASSOCIATED LIMBIC ENCEPHALOPATHY

Abstract Number: 993

PENILE CALCIPHYLAXIS ASSOCIATED WITH HEMODIALYSIS INITIATION

Case Presentation: A 62 year-old man was admitted to the hospital with hypervolemia. His past medical history included chronic kidney disease stage V not on hemodialysis and type-2 diabetes mellitus. He reported bilateral lower extremity [...]

By | 2019-03-11T14:42:05+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PENILE CALCIPHYLAXIS ASSOCIATED WITH HEMODIALYSIS INITIATION

Abstract Number: 991

ISCHEMIC COLITIS IN POLYCYTHEMIA VERA

Case Presentation: A 63-year-old female with a history of polycythemia vera (JAK2 mutation), subarachnoid hemorrhage with previous vasospasm, hypertension presented with diffuse colicky abdominal pain and hematochezia for one-day duration. She had no weight loss, [...]

By | 2019-03-11T14:42:02+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ISCHEMIC COLITIS IN POLYCYTHEMIA VERA

Abstract Number: 990

HYPERKALEMIA WITH SUCCINYLCHOLINE USE IN ACUTE RENAL FAILURE DURING PERITONEAL DIALYSIS CATHETER PLACEMENT — T WAVE PEAKING AND EARLY SINE WAVES ON AN EKG

Case Presentation: A 39-year-old African-American male with a history of chronic kidney disease (baseline creatinine 3), congestive heart failure, hypertension, diabetes initially presented to the hospital with chest pain and found to have hypertensive emergency [...]

By | 2019-03-11T14:42:00+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HYPERKALEMIA WITH SUCCINYLCHOLINE USE IN ACUTE RENAL FAILURE DURING PERITONEAL DIALYSIS CATHETER PLACEMENT — T WAVE PEAKING AND EARLY SINE WAVES ON AN EKG

Abstract Number: 989

HYPERAMMONEMIC ENCEPHALOPATHY IN ROUX-EN-Y GASTRIC BYPASS WITH AFFERENT LOOP SYNDROME

Case Presentation: A 33-year-old female with liver fibrosis, elective gastric bypass surgery 10 years prior (Roux-en-Y, complicated by afferent loop syndrome requiring subsequent small bowel resection), untreated Hepatitis C (but persistently negative RNA titers), bipolar [...]

By | 2019-03-11T14:41:58+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HYPERAMMONEMIC ENCEPHALOPATHY IN ROUX-EN-Y GASTRIC BYPASS WITH AFFERENT LOOP SYNDROME

Abstract Number: 987

DUODENAL VARICES — A DANGEROUS BLEED FIXED WITH GLUE AND TIPS

Case Presentation: A 62 year old man with a past medical history of decompensated alcoholic cirrhosis, esophageal varices (no previous episode of hemorrhage), previous H. Pylori treatment, peptic ulcer disease was admitted to the intensive care unit for bright [...]

By | 2019-03-11T14:41:54+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DUODENAL VARICES — A DANGEROUS BLEED FIXED WITH GLUE AND TIPS

Abstract Number: 985

HONING OCCAM’S RAZOR AGAINST A CASE OF CARDIAC AMYLOID INVASION

Case Presentation: A 77 year-old Hispanic woman with a past medical history of heart failure with preserved ejection fraction (HFpEF), atrial fibrillation, and chronic kidney disease presented with progressive dyspnea and increased lower extremity swelling [...]

By | 2019-03-11T14:41:51+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HONING OCCAM’S RAZOR AGAINST A CASE OF CARDIAC AMYLOID INVASION

Abstract Number: 984

AMIODARONE: FRIEND OR FOE

Case Presentation: A 73 year old woman with known ischemic cardiomyopathy with reduced ejection fraction and atrial fibrillation on Amiodarone presented with decompensated heart failure. Work up revealed Thyroid Stimulating Hormone (TSH) 0.0008 UIU/ML, Free [...]

By | 2019-03-11T14:41:49+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AMIODARONE: FRIEND OR FOE

Abstract Number: 982

GABAPENTIN INDUCED ANASARCA IN A YOUNG PATIENT: AN UNDER-RECOGNIZED SIDE EFFECT OF A COMMON MEDICATION

Case Presentation: 47-year-old male presented with complaint of generalized body swelling after three days of starting Gabapentin therapy (600 mg twice daily). Lower extremity edema gradually progressed to abdomen and upper extremity within this short [...]

By | 2019-03-11T14:41:46+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on GABAPENTIN INDUCED ANASARCA IN A YOUNG PATIENT: AN UNDER-RECOGNIZED SIDE EFFECT OF A COMMON MEDICATION

Abstract Number: 980

AN UNCOMMON CASE OF ACUTE LIVER FAILURE FROM HEPATITIS A WITH SUCCESSFUL LIVER TRANSPLANTATION

Case Presentation: 28 year old male with history of HIV (since 2015, well controlled with last CD4 > 1,000 on Genvoya) presents with non-specific complaints of fevers, chills, headache, nausea and vomiting for several days. [...]

By | 2019-03-11T14:41:42+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN UNCOMMON CASE OF ACUTE LIVER FAILURE FROM HEPATITIS A WITH SUCCESSFUL LIVER TRANSPLANTATION

Abstract Number: 979

A RARE CASE OF NEUROSYPHILIS PRESENTING WITH MENINGITIS AND OCULAR INVOLVEMENT IN AN HIV PATIENT WITH NEW ONSET SYPHILIS

Case Presentation: A 47-year-old male presented with a five-day history of intermittent frontal and retro-orbital headaches, blurry vision, photophobia associated with redness, tearing and pain of the left eye. His medical history was remarkable for [...]

By | 2019-03-11T14:41:40+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF NEUROSYPHILIS PRESENTING WITH MENINGITIS AND OCULAR INVOLVEMENT IN AN HIV PATIENT WITH NEW ONSET SYPHILIS

Abstract Number: 978

SINGLE MALT OR BLENDED?

Case Presentation: S.G. is a 51-year-old woman originally from Ethiopia without past medical history who presented with two weeks of abdominal distention, lower extremity swelling and 10 lbs of weight loss. On presentation, her exam [...]

By | 2019-03-11T14:41:38+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SINGLE MALT OR BLENDED?

Abstract Number: 977

UTILITY OF MEASURING THE TRANSTUBULAR POTASSIUM GRADIENT IN ASSESSING HYPERKALEMIA

Case Presentation: We discuss two cases where a transtubular potassium gradient (TTKG) was utilized to distinguish low aldosterone vs tubular resistance to aldosterone as the etiology of hyperkalemia. Case 1: A 71-year-old man presented with [...]

By | 2019-03-11T14:41:35+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on UTILITY OF MEASURING THE TRANSTUBULAR POTASSIUM GRADIENT IN ASSESSING HYPERKALEMIA

Abstract Number: 976

ROCKET FUEL IN VINTAGE CAR: TREATING HYPOTHYROIDISM IN UNDIAGNOSED TYPE II POLYGLANDULAR SYNDROME

Case Presentation: A 44 year old Caucasian male with past history of Type 1 diabetes, hypothyroidism presented to emergency hospital with increased lethargy, lightheadedness, nausea and multiple episodes of vomiting. He also reported a 20 [...]

By | 2019-03-11T14:41:33+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ROCKET FUEL IN VINTAGE CAR: TREATING HYPOTHYROIDISM IN UNDIAGNOSED TYPE II POLYGLANDULAR SYNDROME

Abstract Number: 975

PLUMMETING PLATELETS: A RARE CASE OF CEFTRIAXONE INDUCED THROMBOCYTOPENIA

Case Presentation: A 71-year-old female with history of hypertension presented with 4 days of worsening headaches, confusion, photophobia, fevers, and fatigue. Initial vital signs were temperature 38.4C, HR 123/min, BP 164/97mm Hg, RR 16/min and [...]

By | 2019-03-11T14:41:31+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PLUMMETING PLATELETS: A RARE CASE OF CEFTRIAXONE INDUCED THROMBOCYTOPENIA

Abstract Number: 974

OH DEER! A CASE OF ACUTE HEPATITIS E SECONDARY TO VENISON CONSUMPTION

Case Presentation: A 54-year-old man presented with one week of fatigue, jaundice, pruritus, dark urine, and pale stools. He denied fever or chills but endorsed a ten pound weight loss over one month. He reported [...]

By | 2019-03-11T14:41:30+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on OH DEER! A CASE OF ACUTE HEPATITIS E SECONDARY TO VENISON CONSUMPTION

Abstract Number: 973

MESENTERIC ARTERIAL THROMBOSIS IN A PATIENT WITH CLOSTRIDIUM DIFFICILE COLITIS

Case Presentation: A 79-year-old man with a past medical history of congestive heart failure, hypertension, hyperlipidemia, prior Clostridium difficile ( C. difficile ) infection presents with multiple episodes of foul smelling diarrhea. Physical examination revealed [...]

By | 2019-03-11T14:41:28+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MESENTERIC ARTERIAL THROMBOSIS IN A PATIENT WITH CLOSTRIDIUM DIFFICILE COLITIS

Abstract Number: 972

GRANULOMATOSIS WITH POLYANGITIS PRESENTING AS A LARGE BLEEDING PLEURAL BASED MASS

Case Presentation: 69-year-old man presented to his PCP with complaints of acute onset abdominal pain. After admission he was initially managed conservatively but since the pain did not resolve a CT abdomen was obtained and [...]

By | 2019-03-11T14:41:26+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on GRANULOMATOSIS WITH POLYANGITIS PRESENTING AS A LARGE BLEEDING PLEURAL BASED MASS

Abstract Number: 970

APPROACHING THE TREATMENT CLIFF FOR C DIFF: A CASE OF RECURRENT REFRACTORY CLOSTRIDIUM DIFFICILE INFECTION TREATED WITH SERIAL FECAL MICROBIOTA TRANSPLANTATION & BEZLOTOXUMAB

Case Presentation: A 62 year old female with reported history of Crohn’s Colitis in non-biologic remission was administered oral amoxicillin 2.5g twice for two dental procedures. Subsequently, she developed 10-20 loose bowel movements with abdominal [...]

By | 2019-03-11T14:41:23+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on APPROACHING THE TREATMENT CLIFF FOR C DIFF: A CASE OF RECURRENT REFRACTORY CLOSTRIDIUM DIFFICILE INFECTION TREATED WITH SERIAL FECAL MICROBIOTA TRANSPLANTATION & BEZLOTOXUMAB

Abstract Number: 969

A CURIOUS CASE OF CATATONIA

Case Presentation: 58 year old male with a history of hypertension and type 2 diabetes mellitus sought medical care for new onset generalized weakness, gait instability, bradykinesia and aphasia for a one week duration. On [...]

By | 2019-03-11T14:41:21+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CURIOUS CASE OF CATATONIA

Abstract Number: 968

LIVER DISEASE IN PREGNANCY; A DIAGNOSTIC CHALLENGE AND NECESSARY COLLABORATION

Case Presentation: 33 yr old pregnant female with a history of choleycystectomy, presented at 17 weeks gestational age (GA) to the hospitalist service with epigastric pain, vomiting and transaminitis. She had no pruritus, jaundice or [...]

By | 2019-03-11T14:41:20+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on LIVER DISEASE IN PREGNANCY; A DIAGNOSTIC CHALLENGE AND NECESSARY COLLABORATION

Abstract Number: 967

CLASSIC PRESENTATION OF HEMOCHROMATOSIS IN A POST-MENOPAUSAL WOMAN

Case Presentation: A 43-year-old female presented with a three-week history of shortness of breath and abdominal pain. The patient denied alcohol use and stated that she previously had regular menstrual periods until 14 months ago [...]

By | 2019-03-11T14:41:18+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CLASSIC PRESENTATION OF HEMOCHROMATOSIS IN A POST-MENOPAUSAL WOMAN

Abstract Number: 966

DON’T GO BREAKING MY HEART: CO-MORBID MOOD DISORDERS IN PATIENTS WITH TAKOTSUBO CARDIOMYOPATHY

Case Presentation: A 72-year-old man with untreated generalized anxiety disorder, coronary artery disease, and a remote non-ST elevation myocardial infarction presents with non-exertional chest pressure for one day. The patient had multiple prior hospitalizations for [...]

By | 2019-03-11T14:41:16+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DON’T GO BREAKING MY HEART: CO-MORBID MOOD DISORDERS IN PATIENTS WITH TAKOTSUBO CARDIOMYOPATHY

Abstract Number: 965

WHY AM-I-O(DARONE) SO TIRED?

Case Presentation: A 75-year-old man with CLL, CAD s/p CABG, severe aortic stenosis s/p valve replacement, and atrial fibrillation on apixaban and amiodarone presented with two months of worsening fatigue, constipation, weakness, decreasing visual acuity [...]

By | 2019-03-11T14:41:14+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WHY AM-I-O(DARONE) SO TIRED?

Abstract Number: 964

TRICKY AND TENACIOUS, TUBERCULOSIS

Case Presentation: An 83 year old woman with chronic lymphocytic bronchiolitis and Sjogren’s disease managed for over a year with steroids and mycophenolate presented with fevers and right elbow pain. On exam, she appeared frail, [...]

By | 2019-03-11T14:41:12+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TRICKY AND TENACIOUS, TUBERCULOSIS

Abstract Number: 963

A PERPLEXING CASE OF ANEMIA

Case Presentation: Vitamin B12 (B12) deficiency is a commonly encountered clinical condition that frequently presents with either macrocytic anemia or neurological symptoms. The objective of this report is to describe a rare case of severe [...]

By | 2019-03-11T14:41:11+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A PERPLEXING CASE OF ANEMIA

Abstract Number: 962

WHY CAN’T SHE SPEAK? A CASE OF ACQUIRED MUTISM

Case Presentation: A 54-year-old female with history of hypothyroidism, surgically treated lumbar radiculopathy and neck sarcoma status post resection and radiochemotherapy was brought to the emergency department (ED) by the police. She was unwilling to [...]

By | 2019-03-11T14:41:09+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WHY CAN’T SHE SPEAK? A CASE OF ACQUIRED MUTISM

Abstract Number: 961

SUGAR? NO, PLEASE!

Case Presentation: A 53-year-old male with no history of diabetes was admitted to the hospital due to complaints of severe fatigue, dizziness, and abrupt weight loss. He was found to have a random blood glucose [...]

By | 2019-03-11T14:41:07+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SUGAR? NO, PLEASE!

Abstract Number: 959

‘HOW A WOMAN WITH RHEUMATOID ARTHRITIS FOUND HERSELF IN A PSYCH WARD’

Case Presentation: A 39 year old Indian female with a medical history of rheumatoid arthritis, maintained on bi-weekly Adalimumab for the past year, presented with anxiety and forgetfulness, which had progressed to extreme paranoia and [...]

By | 2019-03-11T14:41:04+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ‘HOW A WOMAN WITH RHEUMATOID ARTHRITIS FOUND HERSELF IN A PSYCH WARD’

Abstract Number: 958

‘WHEN THE STORM COMES BEFORE THE CALM’ – FROM AN OBSCURE NECK MASS TO CORD COMPRESSION

Case Presentation: A 34 year old Filipino male with a past medical history of recently diagnosed Human Immunodeficiency Virus (HIV) and Tuberculosis (TB), presents to the emergency room on October 30th 2018, complaining of intermittent [...]

By | 2019-03-11T14:41:02+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ‘WHEN THE STORM COMES BEFORE THE CALM’ – FROM AN OBSCURE NECK MASS TO CORD COMPRESSION

Abstract Number: 957

PLATYPNEA ORTHODEOXIA SYNDROME

Case Presentation: A 65 year old lady with recent 70 pound weight gain presented with severe hypoxemia not corrected with supplemental oxygen. She complained of severe shortness of breath on sitting upright which resolved completely [...]

By | 2019-03-11T14:41:00+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PLATYPNEA ORTHODEOXIA SYNDROME

Abstract Number: 956

GEMELLA MORBILLORUM ENDOCARDITIS UNMASKING ADULT CONGENITAL HEART DISEASE

Case Presentation: We report a case of outflow tract ventricular septal defect (VSD) manifesting in adulthood with aortic and pulmonary valve infective endocarditis (IE) from Gemella morbillorum. A 33-year-old male presented with fever, night sweats, [...]

By | 2019-03-11T14:40:58+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on GEMELLA MORBILLORUM ENDOCARDITIS UNMASKING ADULT CONGENITAL HEART DISEASE

Abstract Number: 954

SPONTANEOUS CELIAC ARTERY DISSECTION IN A HEALTHY ADULT

Case Presentation: A 52-year-old man with past medical history of GERD and Gilbert's syndrome presented with acute onset abdominal pain for 1 day. He had sudden onset epigastric pain, radiating into his left upper quadrant and his left lower [...]

By | 2019-03-11T14:40:55+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SPONTANEOUS CELIAC ARTERY DISSECTION IN A HEALTHY ADULT

Abstract Number: 952

ADRENAL INSUFFICIENCY MASQUERADING AS MENINGO-ENCEPHALITIS: A CASE REPORT

Case Presentation: A 64 year old female presented with fever, slurred speech and altered mental status. She had similar presentations twice in the past diagnosed as aseptic viral meningitis. Her past medical history included hypothyroidism, [...]

By | 2019-03-11T14:40:51+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ADRENAL INSUFFICIENCY MASQUERADING AS MENINGO-ENCEPHALITIS: A CASE REPORT

Abstract Number: 951

A CASE OF DELAYED DIAGNOSIS OF DIABETIC KETOACIDOSIS PRESENTING WITH EUGLYCEMIA

Case Presentation: A 71-year old female presented to the ED with weakness and back pain starting after a minor motor vehicular accident two days prior. Her past medical history included Type 2 diabetes mellitus and [...]

By | 2019-03-11T14:40:49+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF DELAYED DIAGNOSIS OF DIABETIC KETOACIDOSIS PRESENTING WITH EUGLYCEMIA

Abstract Number: 950

DIAGNOSIS BY GAMMA GAP

Case Presentation: Our case is a 55 year old male with past medical history of chronic headaches who presented to the hospital after his landlord found him confused in his car. He endorsed a 2 [...]

By | 2019-03-11T14:40:47+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DIAGNOSIS BY GAMMA GAP

Abstract Number: 947

IS IGNORANCE BLISS? THE BIOPSY DILEMMA IN CIRRHOTIC PATIENTS WITH GLOMERULONEPHRITIS

Case Presentation: A 54-year-old male with history of alcoholic cirrhosis (MELD 18 on admission) presented from an outside hospital with decompensation of his cirrhosis and a worsening acute kidney injury (AKI) likely from either hepatorenal [...]

By | 2019-03-11T14:40:41+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on IS IGNORANCE BLISS? THE BIOPSY DILEMMA IN CIRRHOTIC PATIENTS WITH GLOMERULONEPHRITIS

Abstract Number: 944

TWO TO FOUR ASPIRINS A DAY KEEP THE SURGEON AWAY: PERIOPERATIVE MANAGEMENT OF ASPIRIN-EXACERBATED RESPIRATORY DISEASE

Case Presentation: A 64-year old female with aspirin-exacerbated respiratory disease (AERD) with severe persistent asthma who had previously undergone aspirin desensitization now taking aspirin 650mg in the morning and 325mg at bedtime presented for total [...]

By | 2019-03-11T14:40:37+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TWO TO FOUR ASPIRINS A DAY KEEP THE SURGEON AWAY: PERIOPERATIVE MANAGEMENT OF ASPIRIN-EXACERBATED RESPIRATORY DISEASE

Abstract Number: 942

A UNIQUE CASE OF ANTICONVULSANT HYPERSENSITIVITY SYNDROME SECONDARY TO CARBAMAZEPINE

Case Presentation: A 63 year-old male with a history of seizure disorder recently started on Carbamazepine one month ago now presents with a total body rash for one week. He reports his symptoms started with [...]

By | 2019-03-11T14:40:33+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A UNIQUE CASE OF ANTICONVULSANT HYPERSENSITIVITY SYNDROME SECONDARY TO CARBAMAZEPINE

Abstract Number: 941

PAN POSITIVE DRUG INDUCED LUPUS

Case Presentation: A 60 year old female with hypertension treated with hydralazine and insulin dependent diabetes presented with 6 months of progressive symptoms that began with migratory joint pain leading to an initial outpatient diagnosis [...]

By | 2019-03-11T14:40:32+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PAN POSITIVE DRUG INDUCED LUPUS

Abstract Number: 940

(NEAR) DEATH BY CELIAC

Case Presentation: A 56 year old man with a history of colon cancer treated with partial colectomy complicated by chronic diarrhea presented with two weeks of progressive worsening watery diarrhea, weakness, lethargy and muscle soreness. [...]

By | 2019-03-11T14:40:30+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on (NEAR) DEATH BY CELIAC

Abstract Number: 939

RECURRENT SYNCOPE IN A YOUNG PATIENT: FROM A SIMPLE OUTPATIENT BIOPSY TO BRUGADA SYNDROME AND A DEFIBRILLATOR

Case Presentation: 21-year-old male patient was referred for muscle biopsy after experiencing severe rhabdomyolysis following exercise. He underwent this outpatient procedure uneventfully, but post-procedure, experienced four episodes of syncope and pre-syncope.Patient was orthostatic, and improved [...]

By | 2019-03-11T14:40:28+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on RECURRENT SYNCOPE IN A YOUNG PATIENT: FROM A SIMPLE OUTPATIENT BIOPSY TO BRUGADA SYNDROME AND A DEFIBRILLATOR

Abstract Number: 938

PML-IRIS: SEIZE THE OPPORTUNITY

Case Presentation: A 28-year-old male with perinatal acquired immunodeficiency syndrome (AIDS) prescribed highly active antiretroviral therapy (HAART), complicated by progressive multifocal leukoencephalopathy (PML), recurrent herpes, and Hodgkin's lymphoma in remission presented in status epilepticus. Seizure [...]

By | 2019-03-11T14:40:27+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PML-IRIS: SEIZE THE OPPORTUNITY

Abstract Number: 937

A LARGE LEFT VENTRICLE THROMBUS WITH VASCULAR SEQUELAE: A CASE REPORT

Case Presentation: A 50 year-old man presented with left sided weakness. His history was notable for type 2 diabetes mellitus, peripheral arterial disease, and prior unprovoked deep vein thrombosis (DVT) of his right femoral vein [...]

By | 2019-03-11T14:40:25+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A LARGE LEFT VENTRICLE THROMBUS WITH VASCULAR SEQUELAE: A CASE REPORT

Abstract Number: 936

PROFOUND THROMBOCYTOPENIA ASSOCIATED WITH CAMPYLOBACTER JEJUNI INFECTION IN A WOMAN WITH RHEUMATOID ARTHRITIS

Case Presentation: 63 year old female with RA on methotrexate presented with a 2 week history of fevers (Tmax of 102), nausea, and multiple episodes of diarrhea. The patient denied any recent travel, sick contacts, [...]

By | 2019-03-11T14:40:24+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PROFOUND THROMBOCYTOPENIA ASSOCIATED WITH CAMPYLOBACTER JEJUNI INFECTION IN A WOMAN WITH RHEUMATOID ARTHRITIS

Abstract Number: 935

TOO MUCH OF A GOOD THING: LAVAGE AWAY SURFACTANT IN PULMONARY ALVEOLAR PROTEINOSIS

Case Presentation: A 27 year ago male presented with progressive dyspnea on exertion and cough. Activities of daily living had become a struggle, and the previously dry cough transformed to one which produced thick, white [...]

By | 2019-03-11T14:40:22+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TOO MUCH OF A GOOD THING: LAVAGE AWAY SURFACTANT IN PULMONARY ALVEOLAR PROTEINOSIS

Abstract Number: 934

SUDDEN ALTERED MENTATION: A CASE OF NEUROCYSTICERCOSIS

Case Presentation: A 32-year-old male Mexican immigrant with no past medical history presented to the emergency department with sudden onset altered mentation. Four days prior to presentation, he had developed a headache, which had developed [...]

By | 2019-03-11T14:40:20+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SUDDEN ALTERED MENTATION: A CASE OF NEUROCYSTICERCOSIS

Abstract Number: 933

ACUTE KIDNEY INJURY AND ACTIVE URINARY SEDIMENT IN A PATIENT WITH SWEET SYNDROME

Case Presentation: Our patient is a 30 year old man with no significant medical history who presented with 4-day history of a diffuse painful erythematous nodular rash that started on his right knee and then [...]

By | 2019-03-11T14:40:18+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ACUTE KIDNEY INJURY AND ACTIVE URINARY SEDIMENT IN A PATIENT WITH SWEET SYNDROME

Abstract Number: 930

HOG HUNTING GONE WILD: A RARE ZOONOSIS CAUGHT CLOSE TO HOME

Case Presentation: A 57-year-old man with past medical history of hypertension and left partial nephrectomy for renal cell carcinoma presented to the emergency department with several days of fevers, diarrhea, and fatigue. On examination, the [...]

By | 2019-03-11T14:40:13+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HOG HUNTING GONE WILD: A RARE ZOONOSIS CAUGHT CLOSE TO HOME

Abstract Number: 929

BEWARE THE DANGERS OF HOME REMEDIES

Case Presentation: A 68-year-old African-American woman with known history of refractory IgG kappa multiple myeloma presented with fever, congestion, and purulent drainage from both ears that had been progressively worsening over the past week. She [...]

By | 2019-03-11T14:40:11+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on BEWARE THE DANGERS OF HOME REMEDIES

Abstract Number: 928

VORICONAZOLE INDUCED PERIOSTITIS MIMICKING RHEUMATOID ARTHRITIS

Case Presentation: One-year prior, the patient had left total knee replacement complicated by acute limb ischemia requiring revascularization followed by graft infection for which she was initially on caspofungin and later switched to maintenance voriconazole [...]

By | 2019-03-11T14:40:09+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on VORICONAZOLE INDUCED PERIOSTITIS MIMICKING RHEUMATOID ARTHRITIS

Abstract Number: 927

TAKE A CLOSER LOOK WITH THREE DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Case Presentation: 82 year old female with past medical history significant for coronary artery disease, rheumatic mitral valve disease status post mechanical mitral valve replacement on coumadin presented to the hospital with complaints of generalized [...]

By | 2019-03-11T14:40:07+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TAKE A CLOSER LOOK WITH THREE DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Abstract Number: 925

“JUST SOME DIZZINESS”, OR IS IT?

Case Presentation: IntroductionDizziness is one of the most frequent complaints encountered in the medical practice affecting 15-20% of adults yearly 1, and can be challenging to assess. Dizziness can be classified into vertigo, disequilibrium and [...]

By | 2019-03-11T14:40:01+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on “JUST SOME DIZZINESS”, OR IS IT?

Abstract Number: 924

NON-ALCOHOLIC WERNICKE ENCEPHALOPATHY IN THE SETTING OF HYPEREMESIS GRAVIDARUM AND POOR DIETARY INTAKE

Case Presentation: Introductions: Wernicke encephalopathy (WE) is an acute syndrome requiring emergent treatment to prevent death and neurologic morbidity. Although WE is most often associated with chronic alcoholism, it also occurs in other settings such [...]

By | 2019-03-11T14:39:59+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NON-ALCOHOLIC WERNICKE ENCEPHALOPATHY IN THE SETTING OF HYPEREMESIS GRAVIDARUM AND POOR DIETARY INTAKE

Abstract Number: 923

A CASE OF CREUTZFELDT-JAKOB DISEASE WITH ATYPICAL MRI FEATURES

Case Presentation: A 52-year-old woman presented following a two-month history of bizarre behavior and altered mental status. Prior to the onset of symptoms, the patient was at a normal level of neurological functioning, though she [...]

By | 2019-03-11T14:39:57+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF CREUTZFELDT-JAKOB DISEASE WITH ATYPICAL MRI FEATURES

Abstract Number: 922

COCAINE INDUCED PRIAPISM

Case Presentation: The Drug Abuse Warning Network estimated that in 2009 cocaine was involved in almost half a million of visits to United States emergency departments. We report a case of stuttering priapism, a urological [...]

By | 2019-03-11T14:39:55+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on COCAINE INDUCED PRIAPISM

Abstract Number: 921

HYPOTHERMIA- AN UNEXPECTED BUT SIGNIFICANT EFFECT OF A COMMONLY USED MEDICATION

Case Presentation: An elderly woman was admitted to the hospital after being brought from group home with fever and alteration in mental status. Her underlying medical history was significant for insulin dependent Diabetes Mellitus, Essential [...]

By | 2019-03-11T14:39:53+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HYPOTHERMIA- AN UNEXPECTED BUT SIGNIFICANT EFFECT OF A COMMONLY USED MEDICATION

Abstract Number: 920

A MASSIVE DISGUISE: A RARE PRESENTATION OF LIVER METASTASIS OF RENAL CELL CARCINOMA, SARCOMATOID SUBTYPE

Case Presentation: A 52 year old female with history significant for Stage IV Renal cell carcinoma (RCC) of pure sarcomatoid type (100%) on active chemotherapy with Lenvatinib and Everolimus, portal vein thrombosis, and sarcoidosis presented [...]

By | 2019-03-11T14:39:52+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A MASSIVE DISGUISE: A RARE PRESENTATION OF LIVER METASTASIS OF RENAL CELL CARCINOMA, SARCOMATOID SUBTYPE

Abstract Number: 917

A CASE OF RAPIDLY EXPANDING ABSCESSES IN A PATIENT WITH ULCERATIVE COLITIS

Case Presentation: A 39 year old man with history of inflammatory acne and ulcerative colitis on immunosuppressants vedolizumab and azathioprine presented to an outside hospital for evaluation of low back pain, bilateral axilla pain and [...]

By | 2019-03-11T14:39:45+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF RAPIDLY EXPANDING ABSCESSES IN A PATIENT WITH ULCERATIVE COLITIS

Abstract Number: 916

SPORADIC MEDULLARY THYROID CARCINOMA WITH PARANEOPLASTIC CUSHING SYNDROME

Case Presentation: A 74-year-old female presented with a history of chronic diarrhea of 3 years duration, weight loss, blood in the stool, and abdominal cramps. Past medical history was significant for hypertension, metabolic syndrome, and [...]

By | 2019-03-11T14:39:43+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SPORADIC MEDULLARY THYROID CARCINOMA WITH PARANEOPLASTIC CUSHING SYNDROME

Abstract Number: 915

FLECAINIDE-INDUCED BRUGADA PATTERN

Case Presentation: A 28-year-old gentleman with history of paroxysmal atrial fibrillation s/p pulmonary vein isolation presented with 2 days of dizziness. Patient described the dizziness as a lightheaded sensation accompanied by palpitations. He had experienced [...]

By | 2019-03-11T14:39:41+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on FLECAINIDE-INDUCED BRUGADA PATTERN

Abstract Number: 913

CONCURRENT PERNICIOUS ANEMIA AND WALDENSTRÖM MACROGLOBULINEMIA IN A PATIENT PRESENTING WITH ANEMIA

Case Presentation: A 61-year-old female with hypertension was sent to the hospital after anemia was noted on routine outpatient blood tests. Her hemoglobin was 6.8 g/dL with an MCV of 97.1 fL/red cell and an [...]

By | 2019-03-11T14:39:38+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CONCURRENT PERNICIOUS ANEMIA AND WALDENSTRÖM MACROGLOBULINEMIA IN A PATIENT PRESENTING WITH ANEMIA

Abstract Number: 912

A RARE CASE OF STAPHYLOCOCCAL-ASSOCIATED GLOMERULONEPHRITIS

Case Presentation: A 71 year old Caucasian man with uncontrolled diabetes mellitus, stage III chronic kidney disease, hypertension, hyperlipidemia, sick sinus syndrome, and osteomyelitis of the right 2nd metatarsal s/p amputation, was transferred from an [...]

By | 2019-03-11T14:39:36+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF STAPHYLOCOCCAL-ASSOCIATED GLOMERULONEPHRITIS

Abstract Number: 911

THROMBOTIC RISK ASSESSMENT PRIOR TO LAPAROSCOPIC GASTRIC SLEEVE SURGERY: A CASE REPORT OF PORTAL AND SPLENIC VEIN THROMBOSIS

Case Presentation: A 39 year old female presented on day 10, status post (s/p) laparoscopic gastric sleeve, with nausea, vomiting, abdominal pain and loose mucoid stools intermittently since surgery. She had history of rheumatoid arthritis, [...]

By | 2019-03-11T14:39:34+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THROMBOTIC RISK ASSESSMENT PRIOR TO LAPAROSCOPIC GASTRIC SLEEVE SURGERY: A CASE REPORT OF PORTAL AND SPLENIC VEIN THROMBOSIS

Abstract Number: 910

AN ATYPICAL CASE OF MILLER-FISHER SYNDROME PRESENTING WITH SEVERE DYSPHAGIA AND WEIGHT LOSS

Case Presentation: A 71-year-old male presented to the emergency department (ED) complaining of a 3-week history of dysphagia and ~30lb weight loss. He had been transferred to the ED after a failed formal swallow evaluation, [...]

By | 2019-03-11T14:39:32+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN ATYPICAL CASE OF MILLER-FISHER SYNDROME PRESENTING WITH SEVERE DYSPHAGIA AND WEIGHT LOSS

Abstract Number: 909

ACUTE EOSINOPHILIC PNEUMONIA AFTER RESUMPTION OF TOBACCO SMOKING

Case Presentation: A 40-year-old Bosnian male presented with five days of subjective fevers and dry cough associated with dyspnea. Patient stated he started smoking cigarettes again 10 days prior to admission after quitting for 7 [...]

By | 2019-03-11T14:39:31+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ACUTE EOSINOPHILIC PNEUMONIA AFTER RESUMPTION OF TOBACCO SMOKING

Abstract Number: 908

A DOUBLE HIT: POSTERIOR SKULL BASE OSTEOMYELITIS CAUSED BY STREPTOCOCCUS ANGINOSUS AND EIKENELLA CORRODENS

Case Presentation: We describe a case in which a healthy patient presented with acute sinusitis. He developed posterior skull base osteomyelitis from coinfection with Streptococcus anginosus and Eikenella corrodens. We hope to add to the [...]

By | 2019-03-11T14:39:29+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A DOUBLE HIT: POSTERIOR SKULL BASE OSTEOMYELITIS CAUSED BY STREPTOCOCCUS ANGINOSUS AND EIKENELLA CORRODENS

Abstract Number: 907

A CASE OF ASCENDING SENSORY NEUROPATHY DUE TO ACUTE ONSET THIAMINE DEFICIENCY AFTER INTRAGASTRIC BALLOON PLACEMENT

Case Presentation: Thiamine deficiency is a known complication of bariatric surgery presenting commonly as Wernicke encephalopathy or dry beriberi. Pure sensory ascending neuropathy as a presenting complaint, however, is rare, which we describe here in [...]

By | 2019-03-11T14:39:27+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF ASCENDING SENSORY NEUROPATHY DUE TO ACUTE ONSET THIAMINE DEFICIENCY AFTER INTRAGASTRIC BALLOON PLACEMENT

Abstract Number: 905

HIGH-DEGREE ATRIOVENTRICULAR BLOCK WITH SUPERIMPOSED SINOATRIAL NODE EXIT BLOCK SECONDARY TO INCREASED INTRACRANIAL PRESSURE

Case Presentation: An 80-year-old female with a history of type 2 diabetes mellitus presented with progressively worsening ataxia and left-sided weakness for 6 months. She had no symptoms attributable to bradycardia and was not taking AV nodal [...]

By | 2019-03-11T14:39:24+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HIGH-DEGREE ATRIOVENTRICULAR BLOCK WITH SUPERIMPOSED SINOATRIAL NODE EXIT BLOCK SECONDARY TO INCREASED INTRACRANIAL PRESSURE

Abstract Number: 904

YOUNG AT HEART: CARDIOMYOPATHY AND CORONARY VASOSPASM CAUSING VENTRICULAR FIBRILLATION

Case Presentation: A 28-year-old man with Stage IV colon adenocarcinoma presented to the emergency department with nausea, vomiting, dyspnea on exertion, and generalized weakness. Two weeks ago, he experienced similar symptoms during his first cycle [...]

By | 2019-03-11T14:39:22+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on YOUNG AT HEART: CARDIOMYOPATHY AND CORONARY VASOSPASM CAUSING VENTRICULAR FIBRILLATION

Abstract Number: 903

‘STUCK IN A BAD PLACE’: A RARE CAUSE OF SMALL BOWEL OBSTRUCTION

Case Presentation: A 78-year-old male with a past medical history of atrial fibrillation presented with abdominal pain, nausea, and vomiting. His surgical history includes hernia repair, appendectomy, and cholecystectomy. He endorsed symptoms of anorexia and [...]

By | 2019-03-11T14:39:20+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ‘STUCK IN A BAD PLACE’: A RARE CAUSE OF SMALL BOWEL OBSTRUCTION

Abstract Number: 902

ACUTE TOXIN-MEDIATED RHABDOMYOLYSIS FROM SULFAMETHOXAZOLE-TRIMETHOPRIM THERAPY

Case Presentation: A 41-year-old African American male with a past medical history of overactive bladder and benign prostatic hyperplasia presented to the emergency department (ED) with increasing proximal bilateral lower extremity muscle pain for five [...]

By | 2019-03-11T14:39:19+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ACUTE TOXIN-MEDIATED RHABDOMYOLYSIS FROM SULFAMETHOXAZOLE-TRIMETHOPRIM THERAPY

Abstract Number: 901

POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME AFTER 5-FLUOROURACIL THERAPY FOR COLON CANCER PRESENTING AS STATUS EPILEPTICUS

Case Presentation: A 43-year-old Caucasian woman with stage IV rectal adenocarcinoma metastatic to liver and lung presented with new onset generalized tonic clonic seizures. She was receiving her second line treatment with 5-FU continuous infusion [...]

By | 2019-03-11T14:39:17+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME AFTER 5-FLUOROURACIL THERAPY FOR COLON CANCER PRESENTING AS STATUS EPILEPTICUS

Abstract Number: 900

DON’T BE ‘PESS’IMISTIC: AN INTRIGUING CASE OF SEVERE NEW-ONSET HYPONATREMIA IN AN ASYMPTOMATIC SEPTUAGENARIAN

Case Presentation: 71-year-old male with extensive smoking history was referred to the hospital by his PCP for new-onset severe hyponatremia of 117mMol/L. He denied any active complaints and initial physical examination showed an euvolemic male. [...]

By | 2019-03-11T14:39:15+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DON’T BE ‘PESS’IMISTIC: AN INTRIGUING CASE OF SEVERE NEW-ONSET HYPONATREMIA IN AN ASYMPTOMATIC SEPTUAGENARIAN

Abstract Number: 899

A VARIANT RADIOLOGICAL PRESENTATION OF LEGIONELLA PNEUMONIA IN AN IMMUNOCOMPROMISED HOST

Case Presentation: 71-year-old male with multiple myeloma being treated with dexamethasone, elotuzumab and bortezomib, prior mediastinal plasmacytoma s/p chest radiation therapy and Crohn's disease was admitted with high-grade fever, chills, productive cough. Labs revealed pancytopenia [...]

By | 2019-03-11T14:39:13+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A VARIANT RADIOLOGICAL PRESENTATION OF LEGIONELLA PNEUMONIA IN AN IMMUNOCOMPROMISED HOST

Abstract Number: 897

AN UNUSUAL ETIOLOGY OF HEART BLOCK

Case Presentation: A 47-year-old African-American man with obstructive sleep apnea presented to the emergency department after being called-back due to evidence of complete atrioventricular (AV) block on routine electrocardiogram. Patient reported a 6-month history of [...]

By | 2019-03-11T14:39:10+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN UNUSUAL ETIOLOGY OF HEART BLOCK

Abstract Number: 896

AN UNUSUAL CAUSE OF NSTEMI

Case Presentation: A 66-year-old female presented to the hospital with two days of acute chest pressure which occurred at rest. It was intermittent in nature but had persisted over the past two days which prompted [...]

By | 2019-03-11T14:39:08+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN UNUSUAL CAUSE OF NSTEMI

Abstract Number: 895

FOLLOW THE FLUID: A CASE OF SPONTANEOUS THORACIC DUCT RUPTURE

Case Presentation: Thoracic duct rupture can be seen in traumatic injuries to the mediastinum, or as a potential complication of thoracic surgical procedures. Rarely, thoracic duct rupture has been associated with severe systemic infections. There [...]

By | 2019-03-11T14:39:06+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on FOLLOW THE FLUID: A CASE OF SPONTANEOUS THORACIC DUCT RUPTURE

Abstract Number: 893

A NEARLY-MISSED OPPORTUNITY: DIAGNOSING EPIDURAL ABSCESS DURING RESOLVING ENCEPHALOPATHY

Case Presentation: A 59 year-old woman with uncontrolled diabetes mellitus and end-stage kidney disease on hemodialysis presented with altered mental status and a suprapatellar abscess. Following irrigation and debridement, her course was complicated by septic [...]

By | 2019-03-11T14:39:03+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A NEARLY-MISSED OPPORTUNITY: DIAGNOSING EPIDURAL ABSCESS DURING RESOLVING ENCEPHALOPATHY

Abstract Number: 892

ADULT-ONSET IGA VASCULITIS

Case Presentation: IgA Vasculitis, formerly known as Henoch-Shönlein Purpura, is a systemic vasculitis most often seen in children. We present a case of a 28 yo obese man who presented to his primary care physician [...]

By | 2019-03-11T14:39:01+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ADULT-ONSET IGA VASCULITIS

Abstract Number: 891

CLINICAL RESPONSE OF HEPATOPULMONARY SYNDROME TO TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTING

Case Presentation: A 68-year-old man who initially presented about 2 years prior with complaints of melanotic stools and coffee ground emesis. On his initial presentation, he was found to have elevated liver enzymes - AST/ALT/ALK [...]

By | 2019-03-11T14:38:59+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CLINICAL RESPONSE OF HEPATOPULMONARY SYNDROME TO TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTING

Abstract Number: 890

NEUROSARCOIDOSIS: THE LESS THAN 1%

Case Presentation: 39 year-old African-American male presented with dizziness, worse with movement and short-term memory loss, remaining oriented, without visual changes, and no focal deficits. He complained of chronic sinusitis for the past year. CT [...]

By | 2019-03-11T14:38:58+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NEUROSARCOIDOSIS: THE LESS THAN 1%

Abstract Number: 889

LEGIONELLA PNEUMONIA COMPLICATED BY RHABDOMYOLYSIS AND ACUTE RENAL FAILURE.

Case Presentation: A 43-year-old male with history of hypertension and alcohol abuse presented with a 3-day history of URI like symptoms including high grade fevers, cough productive of yellowish sputum, generalized abdominal pain, nausea and [...]

By | 2019-03-11T14:38:56+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on LEGIONELLA PNEUMONIA COMPLICATED BY RHABDOMYOLYSIS AND ACUTE RENAL FAILURE.

Abstract Number: 886

STRESS IS THE ENEMY: A CASE OF ANTI-NMDA RECEPTOR ENCEPHALITIS TRIGGERED BY EMOTIONAL STRESS

Case Presentation: We present a previously healthy 22-year-old female presenting with disorganized behaviors, restlessness and sub-acute decline in mental status. There was no other relevant medical, personal or familial history. However, she had stressors three [...]

By | 2019-03-11T14:38:51+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on STRESS IS THE ENEMY: A CASE OF ANTI-NMDA RECEPTOR ENCEPHALITIS TRIGGERED BY EMOTIONAL STRESS

Abstract Number: 884

SPONTAENOUS IDIOPATHIC PULMONARY VEIN THROMBOSIS SUCCESSFULLY TREATED WITH ORAL ANTICOAGULATION: A CASE REPORT AND REVIEW OF THE LITERATURE

Case Presentation: 68-year-old obese woman with history of recurrent urinary tract infections (UTI) presented with weakness and abdominal pain after failed outpatient treatment for UTI with Nitrofurantoin. During hospitalization, she was noted to be dyspneic [...]

By | 2019-03-11T14:38:47+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SPONTAENOUS IDIOPATHIC PULMONARY VEIN THROMBOSIS SUCCESSFULLY TREATED WITH ORAL ANTICOAGULATION: A CASE REPORT AND REVIEW OF THE LITERATURE

Abstract Number: 883

A GOOD DRUG GOES ROGUE

Case Presentation: A 28-year-old man with ulcerative colitis treated with adalimumab presented with headache, fever and sinus symptoms that progressed over two weeks to neck stiffness, “clouded” thinking, and intermittent left arm and facial numbness. [...]

By | 2019-03-11T14:38:45+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A GOOD DRUG GOES ROGUE

Abstract Number: 882

A CASE OF ACQUIRED FACTOR VIII INHIBITOR CAUSING SPONTANEOUS NON-TRAUMATIC HEMATOMAS

Case Presentation: 82-year-old man on chronic Warfarin presented for evaluation of spontaneous right lower extremity swelling with bruising. Workup showed hemoglobin of 9.5 g/dL, platelet of 286 K/µL, PT 47.4 seconds, INR 5.0, and PTT [...]

By | 2019-03-11T14:38:44+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF ACQUIRED FACTOR VIII INHIBITOR CAUSING SPONTANEOUS NON-TRAUMATIC HEMATOMAS

Abstract Number: 881

‘ACHY BREAKY HEART’: A CASE REPORT OF AUTOIMMUNE MYOCARDITIS AND CONSTRICTIVE PERICARDITIS DUE TO SYSTEMIC SCLEROSIS

Case Presentation: 59 year old woman with a history of recently diagnosed rheumatoid arthritis (RA) not on therapy presents with substernal non radiating chest pain and right upper quadrant pain worsening with inspiration and dyspnea [...]

By | 2019-03-11T14:38:42+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ‘ACHY BREAKY HEART’: A CASE REPORT OF AUTOIMMUNE MYOCARDITIS AND CONSTRICTIVE PERICARDITIS DUE TO SYSTEMIC SCLEROSIS

Abstract Number: 880

POINT OF CARE ULTRASOUND DEFUSES A TICKING TIME BOMB: EARLY BEDSIDE EVALUATION OF INFECTIVE ENDOCARDITIS

Case Presentation: A 30 year-old female presented postpartum day 1 following a normal vaginal delivery from an outside hospital after chest CT angiography (CTA) identified a 2.5 cm pericardial effusion. Review of systems was positive [...]

By | 2019-03-11T14:38:40+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on POINT OF CARE ULTRASOUND DEFUSES A TICKING TIME BOMB: EARLY BEDSIDE EVALUATION OF INFECTIVE ENDOCARDITIS

Abstract Number: 879

INFERIOR MESENTERIC VEIN THROMBOSIS SECONDARY TO ACUTE SIGMOID DIVERTICULITIS: A RARE COMPLICATION.

Case Presentation: A 50-year-old male presented to the emergency room with worsening left lower quadrant abdominal pain of two days duration associated with subjective fever and diarrhea. Three weeks prior to his presentation, he was [...]

By | 2019-03-11T14:38:38+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on INFERIOR MESENTERIC VEIN THROMBOSIS SECONDARY TO ACUTE SIGMOID DIVERTICULITIS: A RARE COMPLICATION.

Abstract Number: 876

MESENTERIC PANNICULITIS: A UNIQUE CASE OF ABDOMINAL PAIN

Case Presentation: A 56 year-old woman with past medical history of gastritis and past surgical history of appendectomy and C-section presented with a six-month history of intermittent abdominal discomfort, non-bloody diarrhea, nausea and bloating that [...]

By | 2019-03-11T14:38:33+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MESENTERIC PANNICULITIS: A UNIQUE CASE OF ABDOMINAL PAIN

Abstract Number: 874

SUPERFICIAL PUNCTATE KERATITIS AS HERALDER OF GRANULOMATOSIS WITH POLYANGITIS

Case Presentation: 51yoM with no significant medical history presents to ED for evaluation of progressive bilaterally injected, painful conjunctiva of 1 months duration, nonproductive cough and pleuritic chest pain of 1 week’s duration. He was [...]

By | 2019-03-11T14:38:30+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SUPERFICIAL PUNCTATE KERATITIS AS HERALDER OF GRANULOMATOSIS WITH POLYANGITIS

Abstract Number: 873

LEMMEL SYNDROME : A CASE OF ASYMPTOMATIC PERIAMPULLARY DUODENAL DIVERTICULUM

Case Presentation: A 75-year-old male with a history of HTN, CVA, and smoking, presented for follow up evaluation of his abdominal aortic aneurism. CT angiography with run-off was performed and revealed a choledochal cyst, common [...]

By | 2019-03-11T14:38:28+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on LEMMEL SYNDROME : A CASE OF ASYMPTOMATIC PERIAMPULLARY DUODENAL DIVERTICULUM

Abstract Number: 872

FOOT DROP AND MUSCLE DESTRUCTION: A RARE CASE OF HYPOTHYROIDISM MYOPATHY IN A YOUNG MALE.

Case Presentation: 26 year old male with no history of substance use, only history of hypothyroidism status post radioactive Iodine treatment three years ago for Graves’ disease presented with three days of lower limbs pain, [...]

By | 2019-03-11T14:38:26+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on FOOT DROP AND MUSCLE DESTRUCTION: A RARE CASE OF HYPOTHYROIDISM MYOPATHY IN A YOUNG MALE.

Abstract Number: 871

FLASH PULMONARY EDEMA WITH LEFT VENTRICLE NON-COMPACTION CARDIOMYOPATHY

Case Presentation: A 87 year old female with history of Left ventricular non-compaction(LVNC), HFrEF with EF25-30%, CAD, hypertension, hyperlipidemia presented with acute dyspnea. She denied chest pain, palpitation, lightheadedness. Exam revealed tachycardia, tachypnea and hypoxia, [...]

By | 2019-03-11T14:38:25+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on FLASH PULMONARY EDEMA WITH LEFT VENTRICLE NON-COMPACTION CARDIOMYOPATHY

Abstract Number: 870

WHEN CPR COMES WITH A COST: A RARE CASE OF ATRIO-ESOPHAGEAL FISTULA

Case Presentation: We present a case of a 42-year-old male with a past medical history of atrial fibrilation (AF) on anti-coagulation (AC) who underwent left atrial radio-frequency ablation (RFA) and pulmonary vein isolation (PVI) and [...]

By | 2019-03-11T14:38:23+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WHEN CPR COMES WITH A COST: A RARE CASE OF ATRIO-ESOPHAGEAL FISTULA

Abstract Number: 869

A RARE CASE OF RIGHT SIDED AORTIC ARCH AND KOMMERELL DIVERTICULA

Case Presentation: 56-year-old male patient with PMHx of HTN, HLD, pulmonary embolism and cigarette smoking presented to the emergency department with recurrent chest pain. He described his chest pain as substernal, non-radiating, He was evaluated [...]

By | 2019-03-11T14:38:21+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF RIGHT SIDED AORTIC ARCH AND KOMMERELL DIVERTICULA

Abstract Number: 868

TEMSIROLIMUS INDUCED REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME (RPLS)

Case Presentation: Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by a combination of clinical symptoms and radiographic findings. Clinical signs range from headaches and visual disturbances, to more classic seizures.1 Radiologic findings usually include vasogenic [...]

By | 2019-03-11T14:38:19+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TEMSIROLIMUS INDUCED REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME (RPLS)

Abstract Number: 867

WITH MYSTERIES , LOOK AT THE MEDICATIONS LIST: CHOREA AS A RARE SIDE EFFECT OF CYPROHEPTADINE

Case Presentation: A 62-year-old man with a past medical history of chronic obstructive pulmonary disease (COPD) and intravenous drug abuse presented to the emergency department (ED) with progressive worsening of jerky movements in his right [...]

By | 2019-03-11T14:38:17+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WITH MYSTERIES , LOOK AT THE MEDICATIONS LIST: CHOREA AS A RARE SIDE EFFECT OF CYPROHEPTADINE

Abstract Number: 865

DON’T GET COCCI WHEN INTERPRETING CEREBROSPINAL FLUID STUDIES: A REVIEW OF DIAGNOSING FUNGAL MENINGITIS

Case Presentation: A 65-year-old man presents with five days of altered mental status, ataxia, and headaches. Four months prior, he traveled to Arizona. Soon after, he sought care for sinus pain, cough, weight loss, and [...]

By | 2019-03-11T14:38:13+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DON’T GET COCCI WHEN INTERPRETING CEREBROSPINAL FLUID STUDIES: A REVIEW OF DIAGNOSING FUNGAL MENINGITIS

Abstract Number: 863

A RARE COMPLICATION OF DAPTOMYCIN TREATMENT FOR DISSEMINATED MSSA INFECTION

Case Presentation: We present the case of a 70-year-old man who developed MSSA bacteremia after removal of a spinal stimulator. The bacteremia cleared with cefazolin treatment, but he developed an MSSA psoas abscess. He underwent [...]

By | 2019-03-11T14:38:10+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE COMPLICATION OF DAPTOMYCIN TREATMENT FOR DISSEMINATED MSSA INFECTION

Abstract Number: 862

A CASE OF ACUTE PROGRESSIVE WEAKNESS IN A HEROIN USER

Case Presentation: 42 year old male with history of active substance abuse and multiple psychiatric diagnosis who presented with acute onset of progressive weakness and multiple cranial nerve palsies (extra ocular, facial and bulbar involvement) [...]

By | 2019-03-11T14:38:08+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF ACUTE PROGRESSIVE WEAKNESS IN A HEROIN USER

Abstract Number: 861

FUROSEMIDE – A CULPRIT IN EOSINOPHIL MEDIATED ORGAN DAMAGE AND DRUG-INDUCED LIVER INJURY

Case Presentation: A 74-year-old male with a history of coronary artery disease and atrial fibrillation presented with shortness of breath, orthopnea and leg edema of 2 weeks duration. He denied any chest pain, palpitations, or [...]

By | 2019-03-11T14:38:06+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on FUROSEMIDE – A CULPRIT IN EOSINOPHIL MEDIATED ORGAN DAMAGE AND DRUG-INDUCED LIVER INJURY

Abstract Number: 860

WEAK AND WOBBLY: A CASE OF ACUTE DISSEMINATED ENCEPHALOMYELITIS IN A YOUNG WOMAN WITH ENTEROVIRUS/ RHINOVIRUS

Case Presentation: An eighteen-year-old woman presents with progressively worsening weakness in her legs as well as numbness throughout her body. She also endorsed rhinorrhea, nasal congestion, abdominal discomfort, nausea, vomiting and decreased urine output. Her [...]

By | 2019-03-11T14:38:04+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WEAK AND WOBBLY: A CASE OF ACUTE DISSEMINATED ENCEPHALOMYELITIS IN A YOUNG WOMAN WITH ENTEROVIRUS/ RHINOVIRUS

Abstract Number: 859

SKIN-MELTING SUPPLEMENTS: A CASE OF SJS/TEN IN A YOUNG WOMAN

Case Presentation: A thirty-three year-old woman presented with four days of rash progressing to facial swelling with painful oral ulcers and difficulty swallowing as well as vaginal pain with painful urination. She also endorsed headaches, [...]

By | 2019-03-11T14:38:03+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SKIN-MELTING SUPPLEMENTS: A CASE OF SJS/TEN IN A YOUNG WOMAN

Abstract Number: 858

DERMAL DILEMMAS: WHEN TWO RARE CAUSES OF BREAST ULCERATIONS COLLIDE, DIFFUSE DERMAL ANGIOMATOSIS AND CALCIPHYLAXIS

Case Presentation: A 51year-old female presented with one week of worsening pain and malodorous drainage from a chronic breast wound. Her PMH included HTN induced ESRD on HD. Her wound started 6 months ago as [...]

By | 2019-03-11T14:38:01+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DERMAL DILEMMAS: WHEN TWO RARE CAUSES OF BREAST ULCERATIONS COLLIDE, DIFFUSE DERMAL ANGIOMATOSIS AND CALCIPHYLAXIS

Abstract Number: 857

A WOMAN WITH SPLINTER HEMORRHAGES AND ERYTHEMA NODOSUM; A RARE PRESENTATION OF HUMAN PARVOVIRUS B19 INFECTION

Case Presentation: A 57 year-old Japanese female with no significant past medical history presented with fever, productive cough and swelling of right ankle for seven days. She lived with her grandchild and her son. Her [...]

By | 2019-03-11T14:37:59+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A WOMAN WITH SPLINTER HEMORRHAGES AND ERYTHEMA NODOSUM; A RARE PRESENTATION OF HUMAN PARVOVIRUS B19 INFECTION

Abstract Number: 856

A SERIOUS ADVERSE EVENT OF RED BLOOD CELL TRANSFUSION: A CASE OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES)

Case Presentation: A 46-year-old woman with iron deficiency anemia presented with headache, right hand weakness, and “difficulty texting and folding clothes,” two weeks after being hospitalized for symptomatic anemia with shortness of breath and hemoglobin [...]

By | 2019-03-11T14:37:58+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A SERIOUS ADVERSE EVENT OF RED BLOOD CELL TRANSFUSION: A CASE OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES)

Abstract Number: 855

CELIAC DISEASE MANIFESTING AS SEVERE MALABSORPTION

Case Presentation: A 20-year-old man with type 1 diabetes, hypothyroidism, and hypomagnesemia presented for evaluation of hypocalcemia. Patient reported progressive lack of motivation and depression. He developed lower extremity swelling and abdominal distention over the [...]

By | 2019-03-11T14:37:56+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CELIAC DISEASE MANIFESTING AS SEVERE MALABSORPTION

Abstract Number: 854

SODIUM ‘SWING AND A MISS’: A CASE OF SODIUM SHIFTS AND MASKED ENDOCRINOPATHIES

Case Presentation: A 33-year-old woman with metastatic breast cancer and recent subtotal resection of a suprasellar brain metastasis presented with subacute fatigue and confusion a month after her surgery. She was oriented only to self, [...]

By | 2019-03-11T14:37:55+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SODIUM ‘SWING AND A MISS’: A CASE OF SODIUM SHIFTS AND MASKED ENDOCRINOPATHIES

Abstract Number: 853

DOPAMINE SECRETING PHEOCHROMOCYTOMA OF THE ADRENAL GLAND WITH NEGATIVE METANEPHRINES: A CASE REPORT

Case Presentation: 42 year old male presented to the hospital with non-exertional left-sided chest pain that was radiating to his left jaw. His past medical history was significant for gastro-esophageal reflux disease and generalized anxiety [...]

By | 2019-03-11T14:37:53+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DOPAMINE SECRETING PHEOCHROMOCYTOMA OF THE ADRENAL GLAND WITH NEGATIVE METANEPHRINES: A CASE REPORT

Abstract Number: 852

AN UNUSUAL CASE OF AUTOIMMUNE PANCREATITIS ASSOCIATED WITH ULCERATIVE COLITIS: REASSESSING OUR APPROACH

Case Presentation: 33 yo Caucasian female with a PMH of Graves’ thyrotoxicosis and recurrent acute pancreatitis was admitted for suspected pancreatitis. She presented with acute onset epigastric pain radiating to back. She denied any associated [...]

By | 2019-03-11T14:37:51+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN UNUSUAL CASE OF AUTOIMMUNE PANCREATITIS ASSOCIATED WITH ULCERATIVE COLITIS: REASSESSING OUR APPROACH

Abstract Number: 851

RECURRENT PANCREATICOLITHIASIS IN A YOUNG PATIENT WITH IDIOPATHIC CHRONIC CALCIFIC PANCREATITITS

Case Presentation: This is a 35-year old Indian female, living in the United States for the past several years, presented with chronic mid-epigastric and left upper quadrant pain radiating to the back, nausea, and bilious [...]

By | 2019-03-11T14:37:49+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on RECURRENT PANCREATICOLITHIASIS IN A YOUNG PATIENT WITH IDIOPATHIC CHRONIC CALCIFIC PANCREATITITS

Abstract Number: 850

RECOGNIZING THE UNUSUAL STEMI IN A 40 YEARS OLD PREGNANT:STEMI IN PREGNANCY IS A DIFFERENT ENTITY

Case Presentation: We present the case of a 40-year-old previously healthy female, G5 P2, approximately 26 weeks pregnant. The patient presented with midsternal chest pain radiating to the neck and shoulder. Antacids and rehydration had [...]

By | 2019-03-11T14:37:47+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on RECOGNIZING THE UNUSUAL STEMI IN A 40 YEARS OLD PREGNANT:STEMI IN PREGNANCY IS A DIFFERENT ENTITY

Abstract Number: 849

POST PARTY SYNDROME: OLD SYMPTOMS SHOULD ALWAYS BE REVISITED

Case Presentation: A 57-year-old African-American male, with past medical history of nonischemic cardiomyopathy, moderate aortic insufficiency, HTN, and cocaine abuse presented to the emergency room with complaints of shortness of breath (SOB), and chest pain [...]

By | 2019-03-11T14:37:46+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on POST PARTY SYNDROME: OLD SYMPTOMS SHOULD ALWAYS BE REVISITED

Abstract Number: 847

A RARE DISEASE WITH DRASTIC PRESENTATION: EOSINOPHILIC GASTROENTERITIS PRESENTING AS GASTRIC OUTLET OBSTRUCTION

Case Presentation: A 48 year old female with no significant past medical history presented with acute onset of dysphagia, early satiety, nausea /vomiting and epigastric pain. Epigastric pain and non-bloody non-bilious emesis occurred after each [...]

By | 2019-03-11T14:37:42+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE DISEASE WITH DRASTIC PRESENTATION: EOSINOPHILIC GASTROENTERITIS PRESENTING AS GASTRIC OUTLET OBSTRUCTION

Abstract Number: 846

BURKHOLDERIA INFECTIONS IN DIABETIC PATIENTS EMERGING AS A CHALLENGE FOR PHYSICIANS

Case Presentation: A 52-year-old diabetic male came with chief complains of fever since last 15 days and swelling of left knee joint since last 3 days. Patient was put on amoxicillin-clavulinic acid along with regular [...]

By | 2019-03-11T14:37:41+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on BURKHOLDERIA INFECTIONS IN DIABETIC PATIENTS EMERGING AS A CHALLENGE FOR PHYSICIANS

Abstract Number: 845

NOT SIMPLY TYPHOID

Case Presentation: A 20 year old female with two prior typhoid episodes, presented to the hospital with a three week history of epigastric pain. The patient returned from a one month trip to Bangladesh four [...]

By | 2019-03-11T14:37:39+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NOT SIMPLY TYPHOID

Abstract Number: 843

THERE’S A FUNGUS AMONG US

Case Presentation: A 29 year-old woman presented with three weeks of headache on a background of headaches for the last five months associated with nausea, vomiting, and photophobia. She now developed blurry vision, diplopia, and [...]

By | 2019-03-11T14:37:36+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THERE’S A FUNGUS AMONG US

Abstract Number: 841

MANY FACES OF MAY THURNER SYNDROME: CHANGING YOUR PERSPECTIVE

Case Presentation: 73-year-old male with past medical history of seizure disorder, non insulin dependent diabetes mellitus, hyperlipidemia presents for evaluation of pain and swelling of right lower extremity, found to have deep venous thrombosis involving [...]

By | 2019-03-11T14:37:32+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MANY FACES OF MAY THURNER SYNDROME: CHANGING YOUR PERSPECTIVE

Abstract Number: 840

“B AWARE”: A CASE OF FULMINANT HEPATIC FAILURE SECONDARY TO ACUTE HEPATITIS B INFECTION

Case Presentation: A 25-year-old man presented with two days of malaise, anorexia, nausea, subjective fever and yellowing of his eyes. He denied travel out of the country, IV drug use, and drank alcohol sparingly. Vitals [...]

By | 2019-03-11T14:37:30+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on “B AWARE”: A CASE OF FULMINANT HEPATIC FAILURE SECONDARY TO ACUTE HEPATITIS B INFECTION

Abstract Number: 838

MAKING SENSE OF A [CU]LPRIT

Case Presentation: A 20 year old woman with history of depression on SSRI presented with jaundice, generalized fatigue, and malaise for four days. She had associated progressive nausea, nonbloody, nonbilious emesis and intermittent diarrhea. Her [...]

By | 2019-03-11T14:37:27+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MAKING SENSE OF A [CU]LPRIT

Abstract Number: 837

LEIOMYOSARCOMA: A LESSON IN THE IMPORTANCE OF A THOROUGH MENORRHAGIA WORKUP

Case Presentation: A 52-year-old female with a history of uterine leiomyomas presents with abdominal pain and vaginal bleeding for six months, acutely worsened over the past two weeks. Two months prior to the current admission, [...]

By | 2019-03-11T14:37:26+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on LEIOMYOSARCOMA: A LESSON IN THE IMPORTANCE OF A THOROUGH MENORRHAGIA WORKUP

Abstract Number: 835

BREAKING BLOOD: HEMOLYSIS AND HYPOXEMIA

Case Presentation: A 21-year-old man presented with two weeks of progressive dyspnea. He denied chest pain, lower extremity edema, orthopnea, melena, hematochezia, hemoptysis, cough, or fever. He had a previous presentation with similar symptoms of [...]

By | 2019-03-11T14:37:22+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on BREAKING BLOOD: HEMOLYSIS AND HYPOXEMIA

Abstract Number: 834

NOT YOUR AVERAGE RASH: A CASE OF METASTATIC CROHN DISEASE

Case Presentation: A 36 year old female, with known ileocolonic Crohn disease, status post total colectomy with end ileostomy, maintained on Infliximab and Azathioprine, presented with one day history of subjective fevers and fixed, non-progressive, [...]

By | 2019-03-11T14:37:20+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NOT YOUR AVERAGE RASH: A CASE OF METASTATIC CROHN DISEASE

Abstract Number: 832

A RARE CASE OF ACUTE LIVER FAILURE DUE TO BLUNT CARDIAC INJURY FROM MOTOR VEHICLE ACCIDENT

Case Presentation: A 53 years old woman presented to the outside hospital with altered mental status. She was found to have acute liver failure on lab investigations and was transferred to our institution for further [...]

By | 2019-03-11T14:37:17+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF ACUTE LIVER FAILURE DUE TO BLUNT CARDIAC INJURY FROM MOTOR VEHICLE ACCIDENT

Abstract Number: 831

LAMOTRIGINE-INDUCED HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

Case Presentation: A 45-year-old woman presented to the Emergency Room with complaints of influenza-like symptoms and neck stiffness for a duration of about one week. Initial laboratory data was significant for acute anemia, thrombocytopenia, transaminitis [...]

By | 2019-03-11T14:37:15+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on LAMOTRIGINE-INDUCED HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

Abstract Number: 830

A UNIQUE PRESENTATION OF DISSEMINATED COCCIDIOIDOMYCOSIS

Case Presentation: A 66-year-old gentleman presented to the ER with complaints of worsening right lower extremity pain and weakness for two weeks. Vital signs were notable for fever, tachycardia, and hypotension. Initial laboratory data was [...]

By | 2019-03-11T14:37:13+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A UNIQUE PRESENTATION OF DISSEMINATED COCCIDIOIDOMYCOSIS

Abstract Number: 829

IT’S NOT GOUT, BUT STEROIDS STILL WORK! A CASE OF ACUTE ARTHRITIS IN THE HOSPITAL

Case Presentation: A 77 year old man with adenocarcinoma of the lung s/p chemotherapy and radiation presented to the Orthopedics service with hip pain & a left femoral lytic lesion.Soon after his IR-guided femur biopsy, [...]

By | 2019-03-11T14:37:12+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on IT’S NOT GOUT, BUT STEROIDS STILL WORK! A CASE OF ACUTE ARTHRITIS IN THE HOSPITAL

Abstract Number: 826

BIOPSY PROVEN AL AMYLOIDOSIS AFTER SEVERE GASTROINTESTINAL BLEEDING

Case Presentation: A 39-year-old Bulgarian man, recently diagnosed with non ischemic cardiomyopathy was transferred to our hospital due to upper gastrointestinal bleeding. The patient reports seven months of intermittent hematemesis that worsened after two significant [...]

By | 2019-03-11T14:37:06+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on BIOPSY PROVEN AL AMYLOIDOSIS AFTER SEVERE GASTROINTESTINAL BLEEDING

Abstract Number: 825

A RARE CASE OF LATE ONSET SYSTEMIC LUPUS ERYTHEMATOSUS PRESENTING WITH LARYNGITIS AND NEPHRITIS

Case Presentation: Introduction:Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that most commonly affects younger women. Late onset SLE is relatively rare and represents a specific subgroup. Laryngeal involvement in SLE is uncommon and [...]

By | 2019-03-11T14:37:05+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF LATE ONSET SYSTEMIC LUPUS ERYTHEMATOSUS PRESENTING WITH LARYNGITIS AND NEPHRITIS

Abstract Number: 824

‘THOSE WORMS DID NOT WANT TO BE EXTRACTED’: A CASE OF ASCARIS LUMBRICOIDES BILIARY OBSTRUCTION AND CHOLANGITIS

Case Presentation: A 24 year old, Chuukese-speaking woman visiting the United States from Micronesia, with no known past medical history, presented with complaint of 24 hours of acute epigastric pain. Patient was on no medications. [...]

By | 2019-03-11T14:37:03+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ‘THOSE WORMS DID NOT WANT TO BE EXTRACTED’: A CASE OF ASCARIS LUMBRICOIDES BILIARY OBSTRUCTION AND CHOLANGITIS

Abstract Number: 823

A DRUG INTERACTION THAT SPIRALED OUT OF CONTROL: THE TOXIC COMBINATION OF METHOTREXATE AND TRIMETHOPRIM-SULFAMETHOXAZOLE

Case Presentation: A 69-year-old lady with a history of Psoriatic Arthritis on Methotrexate (MTX) and CKD stage III was admitted to the hospital with mucositis and leukopenia. Sixteen days prior to the admission she was [...]

By | 2019-03-11T14:37:01+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A DRUG INTERACTION THAT SPIRALED OUT OF CONTROL: THE TOXIC COMBINATION OF METHOTREXATE AND TRIMETHOPRIM-SULFAMETHOXAZOLE

Abstract Number: 820

WHEN YOUR EYES DECEIVE YOU: BROADENING THE DIFFERENTIAL FOR ALTERED MENTAL STATUS

Case Presentation: A 91 year-old female with history of atrial fibrillation on coumadin, hypertension, prior stroke, myeloproliferative disease, polycythemia vera and recently diagnosed macular degeneration presented with complaints of visual hallucinations for two weeks. She [...]

By | 2019-03-11T14:36:56+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WHEN YOUR EYES DECEIVE YOU: BROADENING THE DIFFERENTIAL FOR ALTERED MENTAL STATUS

Abstract Number: 819

AN UNUSUAL CASE OF VITAMIN B12 DEFICIENCY PRESENTING AS JAUNDICE

Case Presentation: A 29 year old Hispanic male with no significant past medical history presented to the Emergency Department with new onset jaundice. He also endorsed a constellation of symptoms for several months including weight [...]

By | 2019-03-11T14:36:54+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN UNUSUAL CASE OF VITAMIN B12 DEFICIENCY PRESENTING AS JAUNDICE

Abstract Number: 818

TREATING CATATONIA IN THE PSYCHOTIC PATIENT: THE BANE AND BOON OF BENZODIAZEPINES

Case Presentation: A twenty-two-year-old male with unknown history was brought in with altered mental status (AMS). On exam he was lying in bed, clutching a taco sauce packet mid-air as if perpetually about to pour; [...]

By | 2019-03-11T14:36:52+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TREATING CATATONIA IN THE PSYCHOTIC PATIENT: THE BANE AND BOON OF BENZODIAZEPINES

Abstract Number: 817

AN UNUSUAL INVASIVE INFECTION DUE TO HAEMOPHILUS INFLUENZAE SEROTYPE E

Case Presentation: A 19-year-old man with a history of Chlamydia infection presented with lower extremity swelling, rash, arthralgia and fever for 6 days. He initially noticed pain and swelling localized to the left anterior shin [...]

By | 2019-03-11T14:36:50+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN UNUSUAL INVASIVE INFECTION DUE TO HAEMOPHILUS INFLUENZAE SEROTYPE E

Abstract Number: 816

IDIOPATHIC CENTRAL DIABETES INSIPIDUS REVEALED BY AN INCIDENTAL, IATROGENIC WATER DEPRIVATION TEST

Case Presentation: A 46-year-old, previously healthy woman of Korean descent initially developed heartburn associated with thirst and frequent urination. Two months later, she presented to the Emergency Department with epigastric pain and persistent thirst. She [...]

By | 2019-03-11T14:36:48+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on IDIOPATHIC CENTRAL DIABETES INSIPIDUS REVEALED BY AN INCIDENTAL, IATROGENIC WATER DEPRIVATION TEST

Abstract Number: 815

A CASE OF WIDE COMPLEX TACHYCARDIA IN WOLFF-PARKINSON-WHITE SYNDROME

Case Presentation: A 40 year-old man presented to the hospital with a six-hour history of worsening palpitations accompanied by diaphoresis and non-radiating, retrosternal chest pain. He had been diagnosed with pre-excitation on ECG three years [...]

By | 2019-03-11T14:36:46+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF WIDE COMPLEX TACHYCARDIA IN WOLFF-PARKINSON-WHITE SYNDROME

Abstract Number: 814

WHEN YOU FORGET TO SAY GESUNDHEIT

Case Presentation: A 63 year-old man with diabetes mellitus, hypertension, and GERD presented from an outside hospital with bilateral upper extremity paralysis, paresthesias, and neck pain which started minutes after sneezing. Vital signs were stable [...]

By | 2019-03-11T14:36:44+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WHEN YOU FORGET TO SAY GESUNDHEIT

Abstract Number: 813

A PERPLEXING CASE OF PANCREATITIS WITH EUGLYCEMIC DIABETIC KETOACIDOSIS

Case Presentation: A 46-year-old male with a history of type II diabetes mellitus on metformin presented with five days of severe, post-prandial epigastric pain with inability to tolerate meals. Labs on admission were notable for [...]

By | 2019-03-11T14:36:43+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A PERPLEXING CASE OF PANCREATITIS WITH EUGLYCEMIC DIABETIC KETOACIDOSIS

Abstract Number: 812

A CASE OF CELIAC DISEASE PRESENTING AS CELIAC CRISIS: RARE AND LIFE THREATENING PRESENTATION

Case Presentation: A 20 year old male with past medical history of Type 1 Diabetes and Hypothyroidism presented to our hospital with severe hypocalcemia. His calcium was 5.8 mg/dl (normal range 8.6-10.3 mg/dl). His ionized [...]

By | 2019-03-11T14:36:41+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF CELIAC DISEASE PRESENTING AS CELIAC CRISIS: RARE AND LIFE THREATENING PRESENTATION

Abstract Number: 811

DUBIOUS ALLERGY DOCUMENTATION AND DELAYED SEPSIS MANAGEMENT: CLINICAL IMPACT OF ‘PENICILLIN ALLERGY’

Case Presentation: A 75 year-old male with past medical history of aplastic anemia requiring immunosuppression and pRBC and platelet transfusions presented to the infusion center with hypotension. He was found unresponsive with BP of 59/36 [...]

By | 2019-03-11T14:36:39+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on DUBIOUS ALLERGY DOCUMENTATION AND DELAYED SEPSIS MANAGEMENT: CLINICAL IMPACT OF ‘PENICILLIN ALLERGY’

Abstract Number: 810

TOO MUCH OF A GOOD THING? VITAMIN C INDUCED OXALATE NEPHROPATHY

Case Presentation: A 54-year-old man with metastatic melanoma presented to the hospital in acute renal failure. Nine months prior, he was diagnosed with metastatic melanoma and offered immunotherapy. He declined in favor of naturopathic treatment, [...]

By | 2019-03-11T14:36:37+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TOO MUCH OF A GOOD THING? VITAMIN C INDUCED OXALATE NEPHROPATHY

Abstract Number: 809

INCOGNITO INVADER: SPONTANEOUS GRAM-NEGATIVE MENINGITIS IN AN IMMUNOCOMPETENT COMMUNITY-DWELLING ADULT

Case Presentation: An 84-year-old man from China with a history of remote gastric cancer with prior subtotal gastrectomy, chronic hepatitis B virus infection on antivirals (without cirrhosis, normal liver function tests) was brought to the [...]

By | 2019-03-11T14:36:36+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on INCOGNITO INVADER: SPONTANEOUS GRAM-NEGATIVE MENINGITIS IN AN IMMUNOCOMPETENT COMMUNITY-DWELLING ADULT

Abstract Number: 805

PULMONARY CEMENT EMBOLISM, A RARE EXCEPTION TO D-DIMER BASED DIAGNOSTIC PATHWAY FOR PULMONARY EMBOLISM.

Case Presentation: We present a case of a 62 year old woman with past medical history of HTN, CAD, bipolar disorder, osteoporosis and vertebral compression fractures, who presented to the ER 8 days after T6-T10 [...]

By | 2019-03-11T14:36:29+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PULMONARY CEMENT EMBOLISM, A RARE EXCEPTION TO D-DIMER BASED DIAGNOSTIC PATHWAY FOR PULMONARY EMBOLISM.

Abstract Number: 804

HYPERVISCOSITY SYNDROME DUE TO WALDENSTRÖM’S MACROGLOBULINEMIA: AN UNUSUAL CAUSE OF ANEMIA

Case Presentation: A 61-year-old African American female with a history of diabetes mellitus presented with right lower quadrant abdominal pain and melena for 1 week. Her stool was guaiac-positive. CBC with differential and CMP revealed [...]

By | 2019-03-11T14:36:27+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HYPERVISCOSITY SYNDROME DUE TO WALDENSTRÖM’S MACROGLOBULINEMIA: AN UNUSUAL CAUSE OF ANEMIA

Abstract Number: 803

A CASE OF RAPIDLY PROGRESSIVE HIV ENCEPHALITIS MIMICKING PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA

Case Presentation: A 51-year-old African female with 7-year untreated HIV infection presented with sudden-onset acute psychosis. She was agitated and reported auditory hallucinations upon arrival. On exam, she was hemodynamically stable but appeared drowsy, intermittently [...]

By | 2019-03-11T14:36:26+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF RAPIDLY PROGRESSIVE HIV ENCEPHALITIS MIMICKING PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA

Abstract Number: 802

CREUTZFELDT JAKOB DISEASE IN A FORMER HEALTHCARE WORKER: A POTENTIALLY OVERLOOKED RISK FACTOR

Case Presentation: A 60 year old female was admitted for rapid cognitive and functional decline over 6 weeks. Three months prior, she ceased working as an OR nurse due to depression and emotional outbursts and [...]

By | 2019-03-11T14:36:24+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CREUTZFELDT JAKOB DISEASE IN A FORMER HEALTHCARE WORKER: A POTENTIALLY OVERLOOKED RISK FACTOR

Abstract Number: 799

A CASE OF AEROCOCCUS URINAE BACTEREMIA CAUSING ENDOCARDITIS AND OSTEOMYELITIS

Case Presentation: A 69-year-old man with a past medical history of symptomatic sick sinus syndrome with a permanent pacemaker (PPM), as well as benign prostatic hyperplasia (BPH), initially presented to the hospital with substernal chest [...]

By | 2019-03-11T14:36:18+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF AEROCOCCUS URINAE BACTEREMIA CAUSING ENDOCARDITIS AND OSTEOMYELITIS

Abstract Number: 798

TO BE OR NOT TO BE (MALIGNANT)

Case Presentation: A 66-year-old man with atopic dermatitis (managed with topical triamcinolone) presented with three weeks of a diffuse pruritic eczematous rash, anorexia, and a 15-lb weight loss. Vital signs were normal, but he was [...]

By | 2019-03-11T14:36:17+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on TO BE OR NOT TO BE (MALIGNANT)

Abstract Number: 797

THE PARADOX OF PREVENTION: SIMULTANEOUS TOXICITIES OF A COMMON ANTIBIOTIC

Case Presentation: A 66-year-old woman presented as a hospital transfer for further evaluation of 1 week of abdominal pain and jaundice and several months of a worsening dry cough and dyspnea. These were respectively attributed [...]

By | 2019-03-11T14:36:15+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THE PARADOX OF PREVENTION: SIMULTANEOUS TOXICITIES OF A COMMON ANTIBIOTIC

Abstract Number: 794

A CASE OF ISOLATED SEVERE AORTIC REGURGITATION: A DIAGNOSTIC DILEMMA

Case Presentation: A 39-years-old male with a history of hypertension presented with a one-month history of worsening shortness of breath associated with orthopnea, paroxysmal nocturnal dyspnea, and leg swelling. He denied fevers or chills, but [...]

By | 2019-03-11T14:36:10+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF ISOLATED SEVERE AORTIC REGURGITATION: A DIAGNOSTIC DILEMMA

Abstract Number: 793

REPLACING HEROIN USE WITH BUPRENORPHINE AND A NEW HEART VALVE

Case Presentation: A 34-year-old man with history of injection (IV) heroin misuse, anxiety, and homelessness presents with dyspnea and pleuritic chest pain. He was recently hospitalized with Methicillin-Sensitive Staph Aureus (MSSA) tricuspid valve (TV) endocarditis [...]

By | 2019-03-11T14:36:08+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on REPLACING HEROIN USE WITH BUPRENORPHINE AND A NEW HEART VALVE

Abstract Number: 792

AN UNCOMMON PRESENTATION OF POTT’S PUFFY TUMOR: LATENT NOCARDIA OSTEOMYELITIS FROM PREVIOUS TRAUMA

Case Presentation: The patient is a 51 year old female with a past medical history of asthma, who presented with worsening, constant, right-sided frontal headaches for 1 month. Her headaches were associated with periorbital swelling [...]

By | 2019-03-11T14:36:07+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on AN UNCOMMON PRESENTATION OF POTT’S PUFFY TUMOR: LATENT NOCARDIA OSTEOMYELITIS FROM PREVIOUS TRAUMA

Abstract Number: 789

A CASE OF PULMONIC STENOSIS AFTER REPAIR OF ANOMALOUS ORIGIN OF LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY

Case Presentation: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly usually presenting in infants with high mortality. This is a one of the rare cases of [...]

By | 2019-03-11T14:35:59+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF PULMONIC STENOSIS AFTER REPAIR OF ANOMALOUS ORIGIN OF LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY

Abstract Number: 787

SEVERE CYANOCOBALAMIN DEFICIENCY DUE TO PERNICIOUS ANEMIA PRESENTING WITH PANCYTOPENIA AND MASQUERADING AS LEUKEMIA: A CASE REPORT

Case Presentation: The clinical manifestations of Pernicious Anemia are a result of cyanocobalamin deficiency and often slowly progressive and difficult to establish. In this case report we present a patient who presented with severe pancytopenia [...]

By | 2019-03-11T14:35:56+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on SEVERE CYANOCOBALAMIN DEFICIENCY DUE TO PERNICIOUS ANEMIA PRESENTING WITH PANCYTOPENIA AND MASQUERADING AS LEUKEMIA: A CASE REPORT

Abstract Number: 786

ASSOCIATION BETWEEN GRAVES DISEASE AND MYASTHENIA GRAVIS: TWO CASE REPORTS

Case Presentation: Case 1:A 55 year-old woman with a history of myasthenia gravis presented to with symptoms of double vision. She was also complaining of palpitations, weight loss, sweating, and insomnia. She was diagnosed with [...]

By | 2019-03-11T14:35:55+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ASSOCIATION BETWEEN GRAVES DISEASE AND MYASTHENIA GRAVIS: TWO CASE REPORTS

Abstract Number: 785

“NOT ENTIRELY HARMLESS AFTER ALL” A CASE OF THIAZIDE INDUCED IMMUNE MEDIATED LIVER FAILURE

Case Presentation: 63-year-old male with history of hypertension (HTN) on Lisinopril, with recent addition of hydrochlorothiazide (HCTZ) for uncontrolled HTN a week prior to presentation. He presented with dark color urine, nausea, constipation reported to [...]

By | 2019-03-11T14:35:53+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on “NOT ENTIRELY HARMLESS AFTER ALL” A CASE OF THIAZIDE INDUCED IMMUNE MEDIATED LIVER FAILURE

Abstract Number: 784

ENTEROPATHY ASSOCIATED T-CELL LYMPHOMA OF SMALL INTESTINE DIAGNOSED BY DOUBLE-BALLOON-ENDOSCOPY.

Case Presentation: A 54-year-old Japanese man presented to his primary care physician with a 3-month history of epigastric pain, fever, and unintentional weight loss. Upper endoscopy showed only a gastric polyp. Abdominal computed tomography showed [...]

By | 2019-03-11T14:35:51+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ENTEROPATHY ASSOCIATED T-CELL LYMPHOMA OF SMALL INTESTINE DIAGNOSED BY DOUBLE-BALLOON-ENDOSCOPY.

Abstract Number: 783

MONO-PHOMA?

Case Presentation: A 29-year-old male presented to our hospital with four weeks of worsening fatigue, shortness of breath and a 15lb weight loss due to anorexia. He was short of breath walking up a single [...]

By | 2019-03-11T14:35:50+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on MONO-PHOMA?

Abstract Number: 780

HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS WITH UNEXPECTED POTENTIAL TRIGGERS IN AN ADULT

Case Presentation: A 54-year old Caucasian man, with no significant past medical history presented to the Emergency Department with complaints of fever to 38.9°C, chills, night sweats and mild diffuse headaches which had progressed over [...]

By | 2019-03-11T14:35:44+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS WITH UNEXPECTED POTENTIAL TRIGGERS IN AN ADULT

Abstract Number: 779

PERICARDIAL TAMPONADE DUE TO PURULENT BACTERIAL PERICARDITIS WITH THORACIC EMPYEMA AND MSSA BACTEREMIA

Case Presentation: A 68 year old caucasian female presented to the emergency department with 1 week of fever, chest pain, and dyspnea. On exam, she appeared cachectic and toxic . Her temperature was 101F, heart [...]

By | 2019-03-11T14:35:42+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on PERICARDIAL TAMPONADE DUE TO PURULENT BACTERIAL PERICARDITIS WITH THORACIC EMPYEMA AND MSSA BACTEREMIA

Abstract Number: 778

A RARE PRESENTATION OF CLOMIPHENE-INDUCED HYPERTRIGLYCERIDEMIA CAUSING ACUTE PANCREATITIS

Case Presentation: A 38-year-old Asian American male presented with severe non-radiating upper abdominal pain for the previous 18 hours. The pain was exacerbated with deep breathing and movement. He had no significant past medical, surgical, [...]

By | 2019-03-11T14:35:41+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE PRESENTATION OF CLOMIPHENE-INDUCED HYPERTRIGLYCERIDEMIA CAUSING ACUTE PANCREATITIS

Abstract Number: 777

GRAVE’S RAVE

Case Presentation: A 21-year-old previously healthy female with no known medical history was brought in by ambulance from a rave party with concerns for being pale, tremulous and diaphoretic. She reportedly had consumed three shots [...]

By | 2019-03-11T14:35:39+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on GRAVE’S RAVE

Abstract Number: 774

THE RING OF FIRE

Case Presentation: A 36-year-old female was referred for an infectious disease consultation for severe lower back pain, 40 lbs weight lost over 6 months and abnormal MRI imaging consistent with discitis. She was in excellent [...]

By | 2019-03-11T14:35:34+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THE RING OF FIRE

Abstract Number: 773

HAPPY ENDING: A CASE OF CATATONIA AND MUTISM IN PATIENT WITH RENAL FAILURE

Case Presentation: A 44-year-old female with CKD5, ESRD, HIV on ARV (abacavir, dolutegravir, lamivudine) was admitted for sepsis and diagnosed with an iliac vein hematoma. She underwent three different operations, and on the third day [...]

By | 2019-03-11T14:35:33+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on HAPPY ENDING: A CASE OF CATATONIA AND MUTISM IN PATIENT WITH RENAL FAILURE

Abstract Number: 771

FALLING THROUGH THE CRACKS: A CASE OF SUBCLAVIAN STEAL SYNDROME

Case Presentation: A 63-year-old man with history of recurrent syncope and atrial fibrillation (AF) on warfarin presented to our hospital with headache. Within the last year, he had suffered several falls due to syncope, which [...]

By | 2019-03-11T14:35:29+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on FALLING THROUGH THE CRACKS: A CASE OF SUBCLAVIAN STEAL SYNDROME

Abstract Number: 770

A ‘LANE’ LESS TRAVELED: HEMOPTYSIS IN A PATIENT WITH SEVERE IRON DEFICIENCY ANEMIA

Case Presentation: A 36 year old man with a history of iron deficiency anemia (IDA) of unclear etiology was admitted with a three-week history of progressively worsening fatigue, weakness and lightheadedness. Further questioning revealed a [...]

By | 2019-03-11T14:35:28+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A ‘LANE’ LESS TRAVELED: HEMOPTYSIS IN A PATIENT WITH SEVERE IRON DEFICIENCY ANEMIA

Abstract Number: 769

NOT YOUR AVERAGE SINUSITIS

Case Presentation: A 22-year-old man with a history of sinusitis requiring surgery, presented with 3 weeks of right sided facial swelling and pain. He denied any facial trauma or drug use. He had used tap [...]

By | 2019-03-11T14:35:26+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on NOT YOUR AVERAGE SINUSITIS

Abstract Number: 768

BOURBON VIRUS- A NOVEL VIRUS

Case Presentation: A 68 year-old male transferred from an outside hospital to this tertiary care academic medical center. He presented at the outside hospital with syncope, nausea, diarrhea, rash, profound weakness and fever. Because he [...]

By | 2019-03-11T14:35:24+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on BOURBON VIRUS- A NOVEL VIRUS

Abstract Number: 767

A RAPIDLY PROGRESSIVE DISSEMINATED KAPOSI SARCOMA FROM IMMUNE RECONSTITUTION INFLAMMATION SYNDROME: A CONUNDRUM FOR CLINICIANS

Case Presentation: A 30 year-old MSM with a newly diagnosed HIV presented with shortness of breath and cough. He stated that he became sick 5 weeks ago at which point he made an appointment to [...]

By | 2019-03-11T14:35:23+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RAPIDLY PROGRESSIVE DISSEMINATED KAPOSI SARCOMA FROM IMMUNE RECONSTITUTION INFLAMMATION SYNDROME: A CONUNDRUM FOR CLINICIANS

Abstract Number: 765

GLENN PHYSIOLOGY AND HEMODYNAMICS: A REVIEW OF HEMODYNAMIC AND VENTILATOR MANAGEMENT IN AN ADULT PATIENT WITH PULMONARY ATRESIA WITH INTACT VENTRICULAR SEPTUM STATUS POST BIDIRECTIONAL GLENN ANASTOMOSIS

Case Presentation: We present a 20 year old gentleman in acute hypoxic and hypercapnic respiratory failure and cariogenic shock secondary to hemodynamically unstable hemoptysis requiring mechanical ventilation and vasopressor support with norepinephrine and vasopressin. He [...]

By | 2019-03-11T14:35:19+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on GLENN PHYSIOLOGY AND HEMODYNAMICS: A REVIEW OF HEMODYNAMIC AND VENTILATOR MANAGEMENT IN AN ADULT PATIENT WITH PULMONARY ATRESIA WITH INTACT VENTRICULAR SEPTUM STATUS POST BIDIRECTIONAL GLENN ANASTOMOSIS

Abstract Number: 764

LATE ONSET IGA NEPHROPATHY IN AN ELDERLY PATIENT ASSOCIATED WITH SQUAMOUS CELL CARCINOMA OF THE SKIN

Case Presentation: The patient is a 76-year-old male with a PMHx of DM2, HTN and HLD who presented with a complaint of bloody urine in addition to fevers and chills for a day. He denied [...]

By | 2019-03-11T14:35:17+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on LATE ONSET IGA NEPHROPATHY IN AN ELDERLY PATIENT ASSOCIATED WITH SQUAMOUS CELL CARCINOMA OF THE SKIN

Abstract Number: 762

BETWEEN THE ROCK AND THE HARD PLACE- HYPONATREMIA MASKING NEUROLEPTIC MALIGNANT SYNDROME (NMS)

Case Presentation: Our patient is a 63-year-old Caucasian male with a past medical history of schizophrenia on risperidone, psychogenic polydipsia and chronic hyponatremia. He presented to the emergency department after being discovered unresponsive in a [...]

By | 2019-03-11T14:35:14+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on BETWEEN THE ROCK AND THE HARD PLACE- HYPONATREMIA MASKING NEUROLEPTIC MALIGNANT SYNDROME (NMS)

Abstract Number: 760

VALUE OF A PHYSICAL EXAMINATION: LESSONS LEARNT FROM A CASE REPORT

Case Presentation: Microangiopathic hemolytic anemia (MAHA) refers to mechanical hemolytic anemia characterized by schistocytes on peripheral smear (PS). It is seen in various conditions such as thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), disseminated [...]

By | 2019-03-11T14:35:11+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on VALUE OF A PHYSICAL EXAMINATION: LESSONS LEARNT FROM A CASE REPORT

Abstract Number: 759

A RARE CASE OF PNEUMATOSIS INTESTINALIS DUE TO TACROLIMUS IN BONE MARROW TRANSPLANT PATIENT

Case Presentation: 50 year old male with past medical history of multiple myeloma status post bone marrow transplant, on tacrilomus presented with 2 day history of worsening abdominal pain, bloating and right-sided flank pain. Physical [...]

By | 2019-03-11T14:35:09+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF PNEUMATOSIS INTESTINALIS DUE TO TACROLIMUS IN BONE MARROW TRANSPLANT PATIENT

Abstract Number: 758

A NEW GENERATION OF CYBER RECREATIONAL DRUGS: A CASE REPORT ON PHENIBUT AND KRATOM INDUCED KIDNEY FAILURE AND PSYCHOSIS

Case Presentation: A 42 year old gentleman with past medical history of anxiety and depression presented with acute psychosis, hypertensive urgency, tachycardia and worsening agitation ultimately needing sedation and intubation. He was found to be [...]

By | 2019-03-11T14:35:06+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A NEW GENERATION OF CYBER RECREATIONAL DRUGS: A CASE REPORT ON PHENIBUT AND KRATOM INDUCED KIDNEY FAILURE AND PSYCHOSIS

Abstract Number: 757

A COMPLEX COMPLEMENT OF SYMPTOMS: C3 GLOMERULONEPHRITIS WITH THROMBOTIC MICROANGIOPATHY

Case Presentation: An 18-year-old female with past medical history of benign primary hypergammaglobulinemic purpura of Waldenstrom presented with an acute kidney injury, nausea, and vomiting. On admission vital signs were significant for blood pressure elevated [...]

By | 2019-03-11T14:35:05+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A COMPLEX COMPLEMENT OF SYMPTOMS: C3 GLOMERULONEPHRITIS WITH THROMBOTIC MICROANGIOPATHY

Abstract Number: 756

APPENDICITIS & ULCERATIVE COLITIS: CONSERVATIVE MANAGEMENT OR APPENDECTOMY?

Case Presentation: A 41-year-old male with past medical history of ulcerative colitis (UC) currently on vedolizumab infusions every 8 weeks presented to the hospital with right lower quadrant abdominal pain. The patient endorsed nausea, vomiting, [...]

By | 2019-03-11T14:35:03+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on APPENDICITIS & ULCERATIVE COLITIS: CONSERVATIVE MANAGEMENT OR APPENDECTOMY?

Abstract Number: 755

VANCOMYCIN-INDUCED DRESS SYNDROME: AN UNCOMMON REACTION TO A COMMON DRUG

Case Presentation: We report a case of vancomycin-induced DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome in a 48-year-old female presenting 6 days after discontinuation of IV vancomycin for the treatment of MRSA bacteremia [...]

By | 2019-03-11T14:35:01+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on VANCOMYCIN-INDUCED DRESS SYNDROME: AN UNCOMMON REACTION TO A COMMON DRUG

Abstract Number: 754

A CASE OF PRIMARY PERITONITIS FOLLOWING A COLONOSCOPY: CAUSE OR COINCIDENCE?

Case Presentation: A 20-year-old male with a family history of Hepatoblastoma in his brother, presented with a two-week history of intermittent left lower quadrant abdominal pain. He was afebrile and initial work-up showed a normal [...]

By | 2019-03-11T14:35:00+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF PRIMARY PERITONITIS FOLLOWING A COLONOSCOPY: CAUSE OR COINCIDENCE?

Abstract Number: 751

RECTUS SHEATH HEMATOMA INDUCED BY A FORCEFUL COUGH

Case Presentation: 62-year-old male presenting to the hospital for left sided abdominal pain. His past medical history is significant for chronic obstructive pulmonary disease (COPD) requiring six liters of oxygen via nasal cannula daily, hypertension [...]

By | 2019-03-11T14:34:55+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on RECTUS SHEATH HEMATOMA INDUCED BY A FORCEFUL COUGH

Abstract Number: 750

RANKLING THE BONES WITH A RANKL INHIBITOR

Case Presentation: A 70-year-old Caucasian female with Breast cancer with extensive bone metastases ,HFrEF, atrial fibrillation presented with fatigue associated with diarrhea and melena. The symptoms had progressed over the last few weeks. Of note, [...]

By | 2019-03-11T14:34:52+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on RANKLING THE BONES WITH A RANKL INHIBITOR

Abstract Number: 749

A RARE CASE OF ACUTE HEPATITIS A IN A PATIENT WITH PREVIOUSLY DOCUMENTED IMMUNITY

Case Presentation: A 44-year-old male with a history of i cirrhosis of liver secondary to chronic hepatitis C,and Illicit drug use presented from a jail to a regional medical center with abdominal discomfort and jaundice [...]

By | 2019-03-11T14:34:51+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RARE CASE OF ACUTE HEPATITIS A IN A PATIENT WITH PREVIOUSLY DOCUMENTED IMMUNITY

Abstract Number: 748

A UNIQUE PRESENTATION OF AN EMERGING INVASIVE INFECTIOUS DISEASE: BRUGADA IN THE SETTING OF KLEBSIELLA LIVER ABSCESS (KLA) SYNDROME

Case Presentation: A 55 year-old Korean male with a past medical history of hypertension and hyperlipidemia presented to the Emergency Department after feeling short of breath with chest pain, palpitations, mottled skin and blue lips. [...]

By | 2019-03-11T14:34:49+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A UNIQUE PRESENTATION OF AN EMERGING INVASIVE INFECTIOUS DISEASE: BRUGADA IN THE SETTING OF KLEBSIELLA LIVER ABSCESS (KLA) SYNDROME

Abstract Number: 747

CARDIAC RESYNCHRONIZATION THERAPY BY HIS BUNDLE PACING IN A PATIENT WITH CONGESTIVE HEART FAILURE AND LEFT BUNDLE BRANCH BLOCK: AN INSIGHT FOR THE INTERNIST

Case Presentation: A 65 year old male with ischemic cardiomyopathy, EF of 25% and NYHA III symptoms despite optimal medical therapy, severe mitral regurgitation (MR) and left bundle branch block (LBBB) with QRS>150ms (figure 1) [...]

By | 2019-03-11T14:34:47+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CARDIAC RESYNCHRONIZATION THERAPY BY HIS BUNDLE PACING IN A PATIENT WITH CONGESTIVE HEART FAILURE AND LEFT BUNDLE BRANCH BLOCK: AN INSIGHT FOR THE INTERNIST

Abstract Number: 746

A CASE OF E. COLI TRICUSPID VALVE ENDOCARDITIS

Case Presentation: A 64-year-old male with gastric carcinoma and no prior cardiac history presented to the emergency room with altered mental status. On arrival, the patient was tachypneic, hypoxic, hypothermic, tachycardic and hypotensive. Initial investigations [...]

By | 2019-03-11T14:34:45+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF E. COLI TRICUSPID VALVE ENDOCARDITIS

Abstract Number: 745

THE ERA OF IMMUNOTHERAPY IN CANCER: 2 CASE REPORTS OF IMMUNE RELATED ADVERSE EVENTS SECONDARY TO PEMBROLIZUMAB

Case Presentation: Case1: A 72- year old male with a diagnosis of stage four non-small cell Lung carcinoma who was treated with Pembrolizumab, presented two weeks after his first dose with generalized body aches and [...]

By | 2019-03-11T14:34:44+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on THE ERA OF IMMUNOTHERAPY IN CANCER: 2 CASE REPORTS OF IMMUNE RELATED ADVERSE EVENTS SECONDARY TO PEMBROLIZUMAB

Abstract Number: 744

WILD AND WOBBLY WEST NILE VIRUS

Case Presentation: We report the case of a 63-year-old male with a history of alcoholism and congestive heart failure who was brought to the Emergency Department after being found unconscious. He was febrile at 102.5° [...]

By | 2019-03-11T14:34:42+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on WILD AND WOBBLY WEST NILE VIRUS

Abstract Number: 743

A CASE OF CONCURRENT C. DIFFICILE, CMV COLITIS AND CRYPTOSPORIDIUM ENTERITIS CO-INFECTION IN A PATIENT WITH HIV/AIDS AND NEUTROPENIC SEPSIS

Case Presentation: A 46-year-old female with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) on antiretroviral therapy, as well as stage IV diffuse large B-cell lymphoma with central nervous system involvement presented to clinic [...]

By | 2019-03-11T14:34:40+00:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF CONCURRENT C. DIFFICILE, CMV COLITIS AND CRYPTOSPORIDIUM ENTERITIS CO-INFECTION IN A PATIENT WITH HIV/AIDS AND NEUTROPENIC SEPSIS