Journal of academic hospital medicine, volume 6, issue 4 (2014 October-December)

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https://hdl.handle.net/10355/63813

Table of Contents
Review Article

Care of the Hospitalized Patient with Cystic Fibrosis: A Summary of Current Practice Guidelines; Recommendations for the Hospitalist, Part 2 / Melissa M. Kouba

Ask a Specialist: Ask a Pathologist / Emily Coberly
Clinical Vignettes

HIV associated Lymphoma / Stephanie Peace, Hariharan Regunath, Deepa Prabhakar, and William Salzer

Case Reports

Thiamine Deficiency: A Case Presentation and Literature Review / Alyssa Easter, and Natraj Katta
An Interesting Case of Anemia / Syed H. Naqvi, Veronica L. Chastain, and Rubab Khalil
Hypermucoviscous Klebsiella Pneumoniae Liver Abscess in a Previously Healthy Burmese Male / Victoria Levasseur, and Natraj Katta
Denosumab-Induced Severe Hypocalcemia in a Patient with Crohn's Disease. / Michelle C. Spiegel, Tonya Tidwell, Rajasekhar, and Natraj Katta

Diagnostic Dilemma

Unusual presentation of Coxsackie B Rhabdomyolysis: Case Report and Literature Review / Sajal Patel, Rajasekhar Mulyala, and Natraj Katta

ID Corner

A Case Series On Fixed Drug Eruptions / Maxwell D. Newby, John Cascone, and Hariharan Regunath

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Now showing 1 - 5 of 9

Thiamine deficiency : A case presentation and literature review
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2014-10) Easter, Alyssa; Katta, Natraj
This case examines the complicated hospital course of a patient ultimately diagnosed with thiamine deficiency. The presentation, diagnostic work up, and treatment of a 53-year-old male with a history of schizoaffective disorder, pituitary adenoma status post trans-sphenoidal adenectomy, GERD, hyperlipidemia, and glaucoma are evaluated. He had lived at a care facility for over 10 years, and he was brought to an outside hospital after members of the staff found him in bed, unresponsive. They also had concerns about a one-day history of inability to sit or stand up straight and gait abnormalities. An extensive work up with chest x-ray, EKG, urinalysis, routine CBC and CMP, blood and urine cultures, head CT, MRI of the brain and spine, lumbar puncture, EEG, and various miscellaneous labs ensued. Urinalysis and urine cultures revealed evidence of Enterococcus urinary tract infection. EEG revealed evidence of encephalopathy. The patient was also hyponatremic with thiamine and pyridoxine deficiency. Thiamine deficiency was diagnosed after a dramatic improvement in gait and mentation after administration of thiamine.
Ask a pathologist
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2014-10) Coberly, Emily
Question: I ordered a type and screen on my patient, and the blood bank reported that her direct Coombs test was positive. Does that mean my patient has autoimmune hemolytic anemia?
A case series on fixed drug eruptions
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2014-10) Newby, Maxwell; Cascone, John; Regunath, Hariharan
A 60 year old male truck driver with a history of recurrent skin boils presented with painful lesions on the glans penis that started a few days prior. A week ago he was treated with co-trimoxazole for skin abscesses on the left leg. The penile lesions were noted as vesicular eruptions that eventually coalesced and there was absence of discharge, scrotal involvement, or lymphadenopathy. He reported a similar episode one year ago following a course of co-trimoxazole for skin abscesses.
Hypermucoviscous Klebsiella pneumoniae liver abscess in a previously healthy Burmese male
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2014-10) Levasseur, Victoria; Katta, Natraj
We report the case of a 38 year-old previously healthy Burmese man who presented with abdominal pain, headache, myalgia, and back pain. He was found to have leukocytosis, transaminitis, hyperbilirubinemia, and evidence of systemic inflammation. A hypodense hepatic mass was identified with a CT of the abdomen. The patient was ultimately diagnosed with hypermucoviscous K. pneumoniae CA-PLA. This case provides additional evidence for the emergence of hypermucoviscous K. pneumoniae CA-PLA outside of East Asia and supports the need for continued research to gain a better understanding of its pathogenesis predilection for individuals of Asian decent. This report also delineates the importance of acknowledging the dynamic state of infectious disease, the shifting racial demographics in the Western world, and the ever-present potential for antibiotic resistance. With this information clinicians will be more equipped to identify and treat a potentially fatal disease in individuals with symptoms of a seemingly self-limiting infection.
Care of the hospitalized patient with Cystic Fibrosis : A summary of current practice guidelines; recommendations for the hospitalist, part 2
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2014-10) Kouba, Melissa
The cystic fibrosis care team often acts as the gate keeper for hospital admissions given the specialized ability to recognize a pulmonary exacerbation. However, patients may present to the emergency department with symptoms requiring urgent attention, such as massive hemoptysis or pneumothorax. The following recommendations are summarized from guidelines provided by the Cystic Fibrosis Pulmonary Therapies Committee. The CF Foundation pulmonary therapies committee consists of a multi-disciplinary group including representative physicians, nurses, respiratory therapists, physical therapists, pharmacists, CF families and CF Foundation staff. High volume cystic fibrosis centers participated in a questionnaire, a literature search was performed, and an expert panel reviewed all of the data collected. This information was brought to the committee for review with eventual creation of these guidelines following group consensus.

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