Lyme Carditis
Today’s Resident Report featured a fascinating case of Lyme carditis. Cardiac Implications of Lyme Disease – International Journal of Cardiology Volume 129, Issue 1, 16 September 2008, Pages 15-21 2006 IDSA Guidelines for Treatment of Lyme Disease – Clinical Infectious Diseases 2006; 43:1089–134 Did you know that there is a huge controversy in treatment of chronic […]
Esophageal Squamous Cell Carcinoma
Today’s Resident Report featured a patient with a new diagnosis of esophageal squamous cell carcinoma. The patient is a 61 y.o. Kenyan man with no prior medical history presenting with progressive symptoms of dysphagia, oodynophagia and new GERD-like symptoms. Clinical Pearl: New onset of GERD in the elderly should be worked up with upper endoscopy. […]
Psychiatric Emergencies
We had a great case-based discussion with our psychiatry consultants on psychiatric emergencies for noon conference. Here are some helpful articles that they referenced: Movement Disorder Emergencies (Part I) – Arch Neurol.2011; 68: 567-572. Pharmacological Interventions for Bipolar Mania – Bipolar Disorders, 9: 551–560 Pharmacological Management of Agitation in Emergency Settings – Emerg Med J. 2003 July; […]
Legionella Pneumonia
The Heme/Onc team made a great diagnosis of Legionella pneumonia in a neutropenic patient undergoing chemotherapy for nasopharyngeal squamous cell carcinoma. Please remember to consider Legionella when you are working up your patients for causes of nosocomial pneumonia. It’s not as rare as you think. An article from CID (Clinical Infectious Disease) discussing the changing […]
Syphilis
A patient on HAC wards came in with subjective complaints of cognitive decline. Records from the patient’s PCP showed she had a positive FTA-Abs which was untreated. After a comprehensive physical exam and LP, it was determined that this patient had latent syphilis. Points discussed: Epidemiology of syphilis – South End in Boston has a […]
Bronchiectasis
64 y.o. M with medical history significant for pulmonary T.B. (treated in the 1980s) presenting with hemoptysis, but without other symptoms consistent with reactivation T.B. Discussed other causes of hemoptysis, particularly bronchiectasis, which was prominent in the patient’s imaging. See the links below: Bronchiectasis Powerpoint from today Bronchiectasis Review – Chest. 2008 Oct;134(4):815-23. Asbestosis Review […]
Necrotizing Fasciitis
58 y.o. M who presented to outside hospital with cellulitic-appearing rash on LLE with significant pain and blistering. Transferred to BMC for further evaluation for concern about necrotizing fasciitis. Following evaluation by Surgery service and ID service, it was thought that this patient was unlikely to have necrotizing fasciitis. Please see links below for more […]
Erythrasma
This was today’s image of the day. I will spare you from looking at that photo again. Erythrasma is an infection caused by Corynebacterium minutissimum that often can be mistaken for Candida or other fungal infections because of it’s location in skin folds. Here is a great link from Consultant (a primary care journal) which […]
Autoimmune Hepatitis
41 y.o. man presenting with new onset of jaundice. His labs, including high bilirubin were consistent with alcoholic hepatitis. However the patient vehemently denied being a heavy drinker. Serum ANA and anti-smooth muscle antibody both came back positive and the diagnosis of autoimmune hepatitis was entertained. Here are some links for your perusal: Review of […]
Eosinophilia
Today’s resident report focused on the workup of peripheral eosinophilia and pulmonary infiltrates. The patient is a 41 yo F from Haiti presenting with repeated asthma exacerbations and 38% Eos on differential. Broad categories for the differential diagnosis are: Infectious (parasitic, fungal) Hematologic (hyper-eosinophil syndrome) Autoimmune (Churg-Strauss syndrome, eosinophilic pneumonia) Allergic Reaction/Hypersensitivity Reaction Here are […]