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Persistent meningeal signs despite previous treatment for cryptococcal meningitis -- a case report
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-07)Cryptococcal meningitis continues to be a life-threatening fungal infection in patients with HIV. Treatment involves a year of antifungal therapy, and persistent meningeal signs months after treatment initiation are uncommon. ... -
Intradermal moving tracks
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-07)A 64-year-old female presented in August of 2022 to the infectious disease clinic for pruritic lesion and seeing worms on her left foot. Her medical history includes hyperlipidemia, seborrheic keratosis, actinic keratosis ... -
Interventions that can improve the retention in care among patients with HIV: A review
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-07)Introduction: Despite the transformation in healthcare outcomes with the availability of effective antiretroviral therapy, retention in human immunodeficiency virus (HIV) care remains a challenge. Patients with poor retention ... -
In-hospital mortality rate and predictors of 30-day readmission in patients with iron deficiency anemia and diastolic heart failure: A cross-sectional study
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-07)Introduction: There is currently strong evidence of the adverse effects of anemia on the prognosis of heart failure with reduced ejection fraction. Unfortunately, the data on the effects of anemia on a large sample of ... -
Campylobacter fetus meningitis and bacteremia in a well-controlled HIV patient
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-07)We present a case of Campylobacter fetus meningitis and bacteremia in an HIV patient. He was initially admitted due to concern for meningitis. After brief observation, the patient was discharged--once infectious etiologies ... -
Acute chest syndrome: a narrative review to guide inpatient management
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-04)ACS is defined as a new infiltrate in a chest radiograph involving at least one broncho-pulmonary segment in an individual with one additional clinical finding. There are multiple causes of ACS which include infections, ... -
Nighttime resident supervision and education: results of a national survey of internal medicine residency program directors
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-04)Over the past several years, the Accreditation Council for Graduate Medical Education (ACGME) has issued new restrictions on resident duty hours while calling for increased supervision to ensure patient safety. To meet ... -
Partial anomalous pulmonary venous return mimics arterial positioning after central line placement for plasmapheresis
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-04)Case: A 61-year-old male who was status post right single lung transplant complicated by grade three primary graft dysfunction was admitted and mechanically ventilated for hypoxic respiratory failure. Donor specific antibody ... -
Do no harm: health systems' duty to promote clinician well-being
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-04)Burnout and mental health disorders plague the health care workforce. Since the pandemic began, there has been an uptick in symptoms of anxiety, depression, and suicidality among health care professionals. These threats ... -
A solitary red nodule on the wrist: bacillary angiomatosis in a patient with lymphoplasmacytic lymphoma
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-01)A 54-year-old male with well-controlled human immunodeficiency virus (HIV) presented with fevers and a red nodule on the wrist. Two weeks previous, he was scratched by his cat. His medical history included lymphoplasmacytic ... -
Anti-NMDA receptor encephalopathy secondary to an ovarian teratoma
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-01)The following case highlights the diagnosis and treatment course of a previously healthy female adult patient who was treated initially for presumptive psychosis and later found to have anti-NMDAR encephalitis -
Development of warfarin-induced, non-uremic calciphylaxis following recovery from COVID-19 infection with acute renal injury -- a report of a case.
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-01)Herein we report a case of an obese female presenting with calciphylaxis after a prolonged hospital course due to COVID-19, with multiple complications including now-recovered acute renal failure and deep venous thrombosis ... -
Promotion of academic hospitalists : room for improvement
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-10)Introduction: Academic hospitalist medicine has grown rapidly and often focuses on clinical rather than academic productivity. Hospitalist faculty may face challenges achieving academic promotion. Materials and Methods: ... -
Diagnosis and treatment of moccasin-type/hyperkeratotic tinea pedis
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-10)CASE: A man in his 70s was referred to infectious diseases for evaluation of a clinically unresponsive fungal infection. Eight months ago, the patient noticed bilateral erythematous papules and patches on both feet with ... -
Length of stay and its impact on hospitals, physicians and patients : an economic perspective
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-10)INTRODUCTION: Patient's inpatient Length of stay (LOS) is a frequently used metric in hospital medicine. Decreased in LOS has been correlated with lower risk of opportunistic infections and medication side effects [1]. In ... -
The importance of early reconigition : a case of DRESS Syndrome
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-10)This case examines the presentation, diagnosis, and treatment of an otherwise healthy 22-year-old female who presented to urgent care with abdominal pain and fever 27 days after her first exposure to trimethoprim/sulfamethoxazole ... -
“Who? What? Is that a test?” African Americans in non-metropolitan Midwest U.S. identify knowledge gaps and opportunities for PrEP for HIV prevention
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-07)A substantive gap exists in understanding the knowledge and perception of Pre-exposure prophylaxis (PrEP) among African Americans overall and especially those in non-urban areas. Thus, this analysis explores these issues ... -
Transcutaneous carbon dioxide monitoring could reduce physical contact with COVID-19 patients
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-07)Background: Transcutaneous carbon di-oxide (TcCO2) monitoring can be valuable to allow non-invasive monitoring of plasma carbon dioxide (PaCO2) levels in patients with acute respiratory failure including those with novel ... -
Review of Obesity Paradox
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-07)Introduction: Obesity is a risk factor for many health conditions and complications but may be regarded as a prognostic factor in other conditions. This has been described as the "obesity paradox." The debate whether this ... -
Malignant Mesothelioma Manifesting in an Elderly Female without Occupational Asbestos Exposure
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-07)Case Presentation: A 71-year-old Caucasian female with a history of SARS-CoV-2 pneumonia, chronic obstructive pulmonary disease (COPD) and 50 pack-years smoking presented with dyspnea, cough, fever, anorexia, and 12-pound ...