A Perplexing Case Highlighting the Diagnostic Conundrum of Miliary Tuberculosis Mimicking Sarcoidosis and Progressing Into Hemophagocytic Lymphohistiocytosis.

Establishing the diagnosis of miliary tuberculosis (TB) can be challenging due to the heterogeneous clinical presentations and low sensitivity of diagnostic tests. Miliary TB shares overlapping clinical, radiological, and histopathological features with other chronic granulomatous diseases, such as sarcoidosis, often posing a significant diagnostic challenge for clinicians. A 36-year-old male from Haiti presented with a four-month history of recurrent fever, dry cough, night sweats, and weight loss.

Streptococcus thoraltensis Bacteremia: A Case of Pneumonia in a Postpartum Patient.

, Genus , is a rare species of streptococci that has been very rarely reported to cause infection in humans. It is isolated from the sows and is found in the intestinal tract of pigs. We describe here a case of bacteremia in a postpartum patient with pneumonia.

Safety of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients with Thrombocytopenia.

Background: Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) is an effective treatment of acute ischemic stroke (AIS). The safety of intravenous rtPA in patients with thrombocytopenia is unclear. This study sought to evaluate the impact of thrombocytopenia on in-hospital outcomes in patients with AIS who received intravenous thrombolysis.

Impact of Atrial Fibrillation on In-Hospital Outcomes in Patients With Diabetic Ketoacidosis.

Background: Diabetic ketoacidosis entails a huge health burden among patients with diabetes. Atrial fibrillation (AF) is the most common type of heart arrhythmia. This study aimed to evaluate the impact of AF on clinical outcomes in patients with diabetic ketoacidosis.

Clostridium tertium Bacteremia in a Non-neutropenic Patient with Liver Cirrhosis.

Clostridium tertium bacteremia is a rare condition that predominantly occurs in neutropenic patients. Clostridium tertium bacteremia, although extremely rare in non-neutropenic patients, represents the second-most common cause of bacteremia among Clostridium species. Infection with this bacteria can present variably and is usually managed with broad-spectrum antibiotics.

Drug-induced Thrombotic Microangiopathy Caused by Gemcitabine.

Hemolytic uremic syndrome (HUS) is the triad of nonimmune (Coombs negative) hemolytic anemia, low platelet count, and renal impairment. HUS has been associated with a variety of gastrointestinal malignancies and chemotherapeutic agents. We present a patient with pancreatic cancer treated with gemcitabine for palliation who developed gemcitabine-induced HUS (GiHUS) which responded to some extent to blood and platelet transfusions.

Safety and efficacy of ledipasvir/sofosbuvir on hepatitis C eradication in hepatitis C virus/human immunodeficiency virus co-infected patients.

Aim: To evaluate the safety and efficacy of ledipasvir/sofosbuvir on hepatitis C eradication in patients with hepatitis C virus (HCV)/human immunodeficiency virus (HIV) co-infection in an urban HIV clinic.

Methods: A retrospective cohort study of 40 subjects co-infected with HIV-1 and HCV treated with the fixed-dose combination of ledipasvir and sofosbuvir for 12 wk from 2014 to 2016. All patients included were receiving antiretroviral therapy (ART) with HIV RNA values of 100 copies/mL or fewer regardless of baseline HCV RNA level.

Brugada Syndrome in a Patient with Vascular Ehlers-Danlos Syndrome: Sudden Death Risk Amplified.

The vast majority of sudden cardiac arrests occur in patients with structural heart disease and in approximately 10% of the cases, it can occur in those with structurally normal hearts. Brugada syndrome is an autosomal dominant sodium channelopathy that has been implicated in sudden deaths. Given their low prevalence, our knowledge about Brugada syndrome is still evolving.

Monocular diplopia-associated migraine-like headache induced by nicotine withdrawal.

We describe an extremely rare case of migraine-associated monocular diplopia developed in a 23-year-old man after sudden cessation of smoking. The physical examination and brain MRI scan were unremarkable. The symptoms resolved after starting nicotine patch.

Comparison of hospital outcomes and resource use in acute COPD exacerbation patients managed by teaching versus nonteaching services in a community hospital.

Rationale, Aims, And Objectives: The impact of teaching versus nonteaching services on outcomes and resource use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is unknown. The aim of the study is to evaluate the impact of an internal medicine teaching service compared to a nonteaching service on outcomes and resource use in patients admitted with AECOPD in a community teaching hospital.

Methods: A retrospective cohort study of patients admitted for a primary diagnosis of chronic obstructive pulmonary disease exacerbation to Florida Hospital Orlando, a large community teaching hospital, between January 1, 2011, and December 31, 2014.

I smell a rat: a case report and literature review of paradoxical thrombosis and hemorrhage in a patient with brodifacoum toxicity.

Brodifacoum poisoning occurs as a result of ingestion of rodenticide compounds. It acts as a superwarfarin, inhibiting vitamin K epoxide reductase, in an irreversible fashion much like warfarin but with a much longer half-life. A 48-year-old female patient reported 4 days of mild dyspnea, dry cough, bilateral popliteal fossae pain and diffuse upper abdominal pain.

Should a Cardiologist be the Principal Attending Physician or the Consultant to a Hospitalist or General Internist for Cardiovascular Disease Admissions?

Cardiologists may be the principal attending physician or the consultant to general internists or hospitalists in hospitalized patients with cardiovascular diseases. To find out which role may be best for quality and efficiency, a retrospective cohort study of 15, 113 patients in 11 cardiovascular diagnosis groups was carried out. Hospital cost, length of stay, mortality, and 30-day readmissions were compared among attending physicians who were hospitalists, general internists, or cardiologists.

Prevalence of MRSA colonization in peripartum mothers and their newborn infants.

Methicillin-resistant Staphylococcus aureus (MRSA) cultures were obtained from 288 mother-infant pairs. A questionnaire given to mothers and medical record review assessed risk factors for colonization. Only 2.

Small cell carcinoma of the ovary with hypercalcemia causes severe pancreatitis and altered mental status.

Background: Small cell carcinoma of the ovary is a rare, highly malignant tumor that often exhibits a paraneoplastic hypercalcemia.

Case: A 27-year-old female presented with pancreatitis and altered mental status with hypercalcemia. Further investigation revealed a left ovarian mass and a small cell carcinoma of the ovary, hypercalcemic type was found.