Digital Commons Network^™

Evaluating Sglt2-Inhibitor Prescribing In Hospitalized Congestive Heart Failure Patients At A Community Teaching Hospital, Duc Khiem Ngo, Tejaswini Swamy, Carlos Alejos Aguero, Sobia Hassan Memon, Laura E. Garcia, Carlos Ramos

Research Colloquium

Background: Heart failure (HF) remains a major contributor to morbidity, mortality, and healthcare costs worldwide, particularly in underserved populations. Effective, evidence-based management is crucial to halting disease progression, reducing hospital readmissions, and enhancing quality of life. SGLT2 inhibitors have demonstrated significant clinical benefit in heart failure with both reduced and preserved ejection fraction, regardless of diabetes status. Despite strong guideline support, real-world prescription rates remain suboptimal. This quality improvement (QI) project aimed to evaluate current prescribing patterns of SGLT2 inhibitors in hospitalized CHF patients at Valley Baptist Medical Center (VBMC), identify documentation gaps and barriers, and assess internal medicine residents’ …

Segmenting The Flour Beetle: Rnai Probes Into Embryonic Gene Function In Tribolium Castaneum, Sydney Do, J. Garcia, Ezzat El-Sherif

Research Colloquium

Background: RNA interference (RNAi) silences specific gene expression through the introduction of double-stranded RNA (dsRNA). In Tribolium castaneum, RNAi enables precise manipulation of gene activity, allowing researchers to study developmental processes and genetic interactions across all life stages. dsRNA is processed by ribonucleases into small interfering RNAs (siRNAs) or microRNAs (miRNAs), which are recruited by the RNA-induced silencing complex (RISC), which targets and degrades specific mRNA molecules, allowing the observation of loss-of-function phenotypes.

T. castaneum offers advantages as a model for RNAi studies, including a fully annotated genome, a strong RNAi response, ease of application, and gene expression dynamics …

Thyrotoxic Periodic Paralysis In A Non-Asian Male: A Case Report, Stephen M. Garcia, Ruben Martinez Meza, Aun A. Bangash, Blake C. Martin, Jose Campo Maldonado

Research Colloquium

Background: Thyrotoxic periodic paralysis (TPP) is a rare and potentially life-threatening complication of hyperthyroidism, typically affecting adult males of Asian descent. Excess thyroid hormone increases Na+/K+-ATPase activity in skeletal muscle, resulting in a sudden and profound intracellular shift of potassium that leads to acute muscle weakness. Although uncommon in other populations, early recognition of TPP in atypical demographics is crucial to prevent serious complications such as cardiac arrhythmias. Simple, albeit careful, management for these patients includes IV or oral potassium supplementation with nonselective beta-blockers, which rapidly improves patients' clinical status and resolves hypokalemia. Definitive therapy/prevention of TTP is maintaining a …

Granulomatosis With Polyangiitis Masquerading As Refractory Community-Acquired Pneumonia In An Immunocompetent Adult: A Diagnostic Imperative, Stephen M. Garcia, Blake C. Martin, Aun A. Bangash, Gesler Madhere, Mathew Peynado, Jose Campo Maldonado

Research Colloquium

Introduction: Community-acquired pneumonia (CAP) is a prevalent and often treatable cause of respiratory failure. However, in cases where patients fail to demonstrate clinical improvement, clinicians must reevaluate the initial diagnosis. A key diagnostic pitfall is the failure to identify noninfectious mimics such as granulomatosis with polyangiitis (GPA), which presents with diffuse alveolar hemorrhage (DAH), which also manifests in other etiologies such as microscopic polyangiitis, systemic lupus erythematosus, or anti-glomerular basement membrane disease. Prompt recognition and initiation of immunosuppressive therapy is critical for improving clinical outcomes and ultimately decreasing mortality or long-term pulmonary sequelae.

Case Presentation: A previously healthy 35-year-old male …

Interlink Between Genomics By Gtex Portal And Gut Microbiome In Autism Spectrum Disorder, Sriya Gullapalli, Nina Mourao, Tori Sayers, Lois Baldado, Megan W. Szobody, Arjun Bellamkonda, Blake C. Martin, Kory D. Punch, Kevin Garcia Valdez, Anesu Karen Murambadoro, Miguel Quintanilla, Bethany Woolman, Kelsey Baker, Bharathi S. Gadad

Research Colloquium

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by repetitive behaviors, social deficits, and highly restrictive sensory patterns which results from aberrant early-life central nervous system functioning. While ASD has been traditionally associated with molecular genetic alterations, emerging evidence underscores the role of environmental elements. In fact, pathologic genetic variations of key regulator genes coupled with environmental factors, such as: advanced maternal age, poor maternal health during pregnancy, gestational diabetes mellitus, and altered gut microbiome and/or secondary environmental challenges to the offspring in early childhood have all been attributed to increased risk of developing ASD. In efforts to …

Improving Outcomes In Pediatric Congenital Heart Disease: The Integration Of Wearable Technology And Ai-Driven Analysis, Sophia Moon, Melissa Cruz, Pad Renga

Research Colloquium

Background: Wearable devices such as biosensors and smartwatches have demonstrated clinical utility in arrhythmia detection in adult populations, but their integration into pediatric congenital heart disease (CHD) care remains limited. Despite advances in CHD management, challenges persist in the timely identification of arrhythmias in children. The use of wearables in pediatrics is constrained by research gaps, adherence issues, and complex data interpretation. Traditional tools like Holter monitors and event recorders face limitations in detecting intermittent arrhythmias and ensuring compliance. These devices cannot leverage artificial intelligence (AI) and machine learning (ML) to enhance ECG interpretation. This study analysis evaluates the potential …

Stitching Confidence: A Brief Suturing Workshop For High School Students In A Medically Underserved Region, Smaran Marupudi, Jared Hensley, Blake Martin, Maci D. Oestreich, Jennifer V. Escamilla, Amin Ibrahim, Chloe C. Harris, David Sta. Maria, Kaitlyn D. Ybanez, Jacqueline Moreno, Roberto J. Fraga, Shiza Khan, Natasha N. Quailes, Aun Bangash, Michelle Nwaeri, Maria Villegas

Research Colloquium

Introduction: Foundational clinical skills like suturing are typically introduced during medical school, leaving many pre-health students—especially in underserved regions—without early exposure. This is particularly relevant in the Rio Grande Valley (RGV), a medically and dermatologically underserved area of South Texas. Research suggests that early confidence with hands-on skills may influence future interest in procedural and surgical careers. We developed and evaluated a low-resource suturing module for high school students as part of a dermatology outreach event aimed at building early procedural skills and career pipeline interest.

Methods: Tenth-grade students from a public health professions high school in the …

Protecting Those Who Protect Us: A Pilot Skin Cancer Screening And Education Initiative For Firefighters, Smaran Marupudi, Natasha N. Quailes, Miguel Lopez, Maria Villegas Md

Research Colloquium

Background: Firefighters are at elevated risk for skin cancer due to chronic exposure to carcinogens such as soot and combustion byproducts. However, targeted skin cancer prevention efforts in this population are rare. This study evaluated the feasibility and early impact of a firefighter-focused skin cancer screening and educational intervention.

Methods: Firefighters from the Harlingen Fire Department (N = 23 pre-survey; N = 21 post-survey) participated in a free skin cancer screening and educational event. Participants completed pre- and post-surveys assessing skin cancer knowledge (8-item multiple-choice quiz), self-reported confidence in skin self-examinations, perceived risk factors, and support for routine screening. …

Prescribing Happiness: Evaluation Of A Pilot Wellness Speaker Event For Medical Students, Smaran Marupudi, Jared Hensley, Sriya Gullapalli, David Sta. Maria, Nikhilesh Anand

Research Colloquium

Background: Medical students often face high levels of psychological stress due to intense academic workloads and numerous extracurricular activities, thereby leading to a reduction in overall well-being. In response, medical schools are adopting wellness-focused educational changes, though few have been rigorously evaluated. This pilot study assessed the feasibility, acceptability, and short-term effects of a single-session speaker event on medical student stress and happiness.

Methods: This study used an anonymous, pre-post design with independent samples to assess changes in perceived stress and happiness before and after a single-session wellness speaker event. First- and second-year medical students completed validated pre- and post-surveys, …

Diet And Dermatology: A Pilot Study Of Skin Health Education Among Adolescents, Smaran Marupudi, Jared Hensley, Kaitlyn Ybanez, Chloe C. Harris, Michelle Nwaeri, Natasha Quailes, Roberto J. Fraga, Jacqueline Moreno, Blake Martin, Aun Bangash, Maci D. Oestreich, Jennifer V. Escamilla, Amin Ibrahim, David Sta. Maria, Shiza Khan, Maria Villegas

Research Colloquium

Background: While the role of nutrition in overall health is widely acknowledged, its impact on skin health is often overlooked in adolescent education. Integrating diet-focused messaging into dermatology outreach may promote a more holistic understanding of skin wellness. This study evaluated the feasibility and early outcomes of a brief educational station on diet and skin health delivered as part of a broader dermatology event for high school students in a predominantly Hispanic community.

Methods: Students from a public health professions high school rotated through a “Diet & Skin Health” station within the Sun Smart Leaders workshop, a multi-station dermatology education …

Brightening Awareness: A Brief School-Based Intervention Improves Sun Safety And Skin Cancer Knowledge, Smaran Marupudi, Jared Hensley, Natasha N. Quailes, Roberto J. Fraga, Jacqueline Moreno, Blake Martin, Michelle Nwaeri, Aun Bangash, Kaitlyn Ybanez, Maci D. Oestreich, Jennifer V. Escamilla, Amin Ibrahim, Chloe C. Harris, David Sta. Maria, Shiza Khan, Maria Villegas

Research Colloquium

Background: Skin cancer is a preventable disease that remains underrecognized among adolescents and Hispanic populations. Misconceptions about personal risk and ineffective sun protection habits persist, contributing to delayed diagnosis and poor outcomes, particularly in underserved communities. This project evaluated the impact of a brief, station-based educational intervention delivered during a dermatology-focused workshop for high school students. The goal was to improve sun safety behaviors, knowledge of skin cancer risk in Hispanic populations, and overall confidence in personal sun protection.

Methods: High school participants rotated through a "Skin Cancer and Sun Safety" station as part of a larger dermatology outreach event. …

Not Every Focal Deficit Is A Stroke: A Case Of Valacyclovir Neurotoxicity In End-Stage Renal Disease, Sikandar Zia, Nida Asif, Elimar Gonzalez, Conrad Chouinard, Cesar Gutierrez

Research Colloquium

Background: Valacyclovir is a widely used antiviral agent for herpesvirus infections. It is a prodrug of acyclovir, which is primarily excreted by the kidneys. In patients with normal renal function, it is well tolerated. However, in individuals with chronic kidney disease (CKD) or end-stage renal disease (ESRD), impaired clearance can lead to the accumulation of the drug and its metabolites, increasing the risk of neurotoxicity. Clinical manifestations include confusion, hallucinations, ataxia, and seizures—often mimicking stroke or viral encephalitis. This case highlights the importance of considering medication toxicity in patients with renal impairment presenting with neurological symptoms.

Presentation: A 57-year-old man …

Does Per Oral Endoscopic Myotomy (Poem) Restore Esophageal Peristalsis In Patients With Achalasia?, Siddarth Vyas, Marc A. Ward, Brittany Buckmaster, Bola Aladegbami, Christine Wang, Gerald Ogola, Steven G. Leeds

Research Colloquium

Introduction: Peroral endoscopic myotomy (POEM) is a treatment for achalasia that effectively reduces lower esophageal sphincter (LES) pressure. However, the literature lacks clarity on POEM's ability to restore esophageal peristalsis. We aimed to determine whether POEM improves esophageal peristalsis in achalasia patients across different achalasia subtypes and related motility disorders.

Methods: A retrospective review of a prospectively maintained, Institutional Review Board-approved, database was conducted for achalasia patients who underwent POEM between January 2015 and December 2023. Inclusion criteria required pre and/or post POEM High-Resolution Manometry (HRM) data. Paired T-tests were used to compare changes in HRM measurements from baseline to …

Color Segmented Fluorescence (“Red Cap”) Sentinel Lymph Node Biopsy In Patients With Melanoma: Can It Increase Sensitivity In Sentinel Lymph Node Detection?, Siddarth Vyas, Ala Obaid, Catherine H. Davis, John T. Preskitt

Research Colloquium

Background: Sentinel lymph node biopsy (SLNB) is crucial for staging melanoma and determining metastasis. Indocyanine Green (ICG) has emerged as a promising near-infrared fluorescence (NIF) mapping technique. Recent advancements in NIF imaging systems, specifically with color-segmented fluorescence (termed “Red Capping”), may enhance the detection of positive sentinel lymph nodes. This study aims to compare node positivity rates between ICG alone and ICG combined with Red Capping in melanoma patients undergoing SLNB.

Methods: A retrospective review of a prospectively maintained, Institutional Review Board-approved database was performed for melanoma patients who underwent SLNB between July 2018 and September 2024. All patients received …

High Phosphorus Diets And Bone Health: A Hidden Risk​, Sean Corcoran, Daniela Ramos, Mohammed Razzaque

Research Colloquium

Background: As fast food, high in phosphorus content, becomes a staple in the American diet, the population increases its dietary phosphorus intake above the recommended amount. According to the NIH guidelines, adults over 19 years and older are 700mg per day (NIH, 2021, Wickham). For context, a meal consisting of a big cheeseburger, medium fries, and a can of soda contains around 600mg of phosphorus (Arquette, 2014). Although phosphorus is essential for bone health as it is part of the structural component of bones, consuming excess amounts of phosphorus has been linked to vascular calcification, cardiovascular disease, kidney disease, and …

Enhancing Care Through Culturally Sensitive Interventions For Hispanic/Bilingual Patients Along The Texas-Mexico Border, Samantha N. Solis, Joanna Garza

Research Colloquium

In 2022, Hispanics became the largest racial and ethnic minority in the United States, with a population of 63.7 million, comprising 19.1% of the total population. Despite this significant presence, Hispanic communities continue to face substantial barriers to healthcare, including limited access to services, language challenges, financial constraints, and the stigma surrounding mental health care.

Long Non-Coding Rna Uca1 Regulates Mpc1 Expression To Promote The Warburg Effect And Colorectal Cancer Progression, Salique Hassan Shaham, Ricardo Pequeno Bracho, Manish K. Tripathi

Research Colloquium

Background: Colorectal cancer (CRC) is the third most commonly diagnosed malignancy worldwide and the second leading cause of cancer-related deaths in the United States. In 2025, an estimated 154,270 new cases of colon cancer are expected to be diagnosed. CRC is projected to cause approximately 52,900 deaths in the U.S. in 2025, slightly increased from the 52,550 deaths estimated the previous year. Metastatic colorectal cancer (mCRC) continues to have a poor prognosis, with a survival rate of less than 15%. Urothelial cancer-associated 1 (UCA1), a long noncoding RNA (lncRNA), is known to be dysregulated in CRC and contributes to tumor …

Geriatric Brittle Type 1 Diabetes Mellitus: Case Study And Management Strategies, Saba Irfan, Amanda Cantu

Research Colloquium

“Brittle diabetes” describes a form of diabetes marked by severe, unpredictable fluctuations in blood glucose, often leading to frequent episodes of hypoglycemia and hyperglycemia. Though not formally recognized by major diabetes organizations, the term is clinically useful, especially for vulnerable populations such as older adults with Type 1 Diabetes Mellitus (T1DM). Age-related factors—cognitive impairment, mobility limitations, dexterity issues, sensory decline, inconsistent eating habits, and frailty—make glycemic control particularly challenging and require a personalized, multidisciplinary management approach.

We report the case of a 66-year-old Hispanic female with long-standing T1DM, seizure disorder, and osteoporosis. Despite adherence to a prescribed insulin regimen, her …

Back To The Basics: A Case Of The Mundane And Overlooked Cause Of Heart Failure Exacerbation, Roberto J. Fraga, Elizabeth Mills-Reyes, Nestor Malaga

Research Colloquium

Background: Heart failure is one of the most common reasons for hospital admissions among older adults. While healthcare providers often concentrate on medication adherence and complex triggers like ischemia or arrhythmia, this case emphasizes that dietary nonadherence—particularly excessive sodium and fluid intake—can be a significant yet overlooked factor contributing to decompensation.

Case Presentation: An 83-year-old Hispanic woman presented to the emergency department with shortness of breath, cough, and chest pain. Her symptoms and history were highly concerning. A non-ST elevation myocardial infarction (NSTEMI) just two months prior was attributed to vasospasm, likely triggered by her nicotine use. Her coronary angiogram …

Ischemic Stroke In A Patient With Atrial Fibrillation Despite Therapeutic Anticoagulation With Rivaroxaban: A Clinical Reminder, Ridwan Ademola Lawal, Angelica Lan Pham

Research Colloquium

Background: Atrial fibrillation is a well-established risk factor for cardioembolic stroke, with anticoagulation significantly reducing this risk. However, breakthrough ischemic strokes can still occur in anti-coagulated patients, with an estimated annual incidence of 1-2% despite appropriate direct oral anticoagulant (DOAC) therapy. These rare but consequential events challenge clinicians to maintain high diagnostic vigilance, especially in patients presenting with atypical or subtle neurological symptoms. Here, we present a case of an embolus in a patient on long-term rivaroxaban therapy, underscoring a vital clinical teaching point: therapeutic anticoagulation does not eliminate stroke risk, and homonymous hemianopsia may be the only presenting feature. …

"Cruel Memories," Song Lyrics, Undated, Bill Gessner

Bill Gessner Song Lyrics and Poems

Song lyrics for "Cruel Memories" by Bill Gessner. Seven pages total, including one double-sided page. The typewritten pages include multiple versions of the lyrics, with some pages including handwritten marks and notes; some notes and suggested revisions appear on yellow post-it notes affixed to the sheets of paper. The song is at least partly concerned with changes and restrictions to diet.

Implementing A Specific And Standardized Grading Scale For Therapeutic Injection Site Reactions To Improve Adverse Event Reporting, Priya Kale, Kavita Sarin

Research Colloquium

Up to 15.5% of patients taking biologic medication experience injection site reactions (ISRs) leading to morbidity, early discontinuation, and reduced treatment compliance. As biologic medications are increasingly used to treat chronic inflammatory conditions, including psoriasis and atopic dermatitis, there needs to be an improved understanding of ISRs. However, current methods of grading ISRs are nonspecific and unstandardized leading to a lack of understanding of medication-specific ISRs and ambiguity in perceptions of treatment tolerability. Here we aim to develop a standardized ISR grading scale for use in clinical trials. A scoping review was performed to evaluate current ISR grading scales and …

The Sodium Chronicles: Unraveling The Enigma Of Hypothyroidism-Induced Hyponatremia, Raquel Z. Lara, Tejaswini Swamy, Jennifer Rojas Huen, Ricardo Serna

Research Colloquium

Background: Hyponatremia is an electrolyte disturbance with various etiologies, but hypothyroidism is rarely the primary cause. Literature suggests that hypothyroidism-related hyponatremia occurs primarily in severe cases, with some studies suggesting that hypothyroidism should not be considered a sole contributor if TSH levels are below 50 mIU/L. Patients with hyponatremia have a high risk of prolonged hospital stays and readmission, underscoring the clinical importance of identifying uncommon causes such as severe hypothyroidism. This case highlights this rare association, contributing to the existing limited literature.

Case Presentation: A 74-year-old woman with Type 2 Diabetes, complicated nephrotic syndrome and nephropathy, congestive heart failure, …

Comparison Of Cytology And Histology Diagnosis Methods In Metastatic Anaplastic Thyroid Cancer, Phyllis Yang, John Nicholas Cauba, Shizue Mito

Research Colloquium

Background: Anaplastic thyroid cancer (ATC) is a rare and extremely aggressive form of thyroid cancer that presents as a rapidly enlarging neck mass with compressive symptoms. Its malignancy and mortality rates approach nearly 90% and is a feared transformation of papillary thyroid cancer (PTC). A contributor to its increased mortality is its predilection for metastasis, which by nature, is less documented in medical literature. The study of ATC’s diagnostic algorithm, which classically utilizes cytological and histological confirmation, is crucial in enhancing early recognition and atypical presentations.

Methods: This systematic review catalogs the diagnosis, clinical properties, and metastasis sites of anaplastic …

Alleviating Social And Psychological Ill-Being Research & Evaluation (Aspire) Study: Implementing An Act-Based Pathway For Patients In Primary Care, Monica C. Perez, Deepu George, Maria Hernandez, J. Garza, S. Solis

Research Colloquium

The Alleviating Social and Psychological Ill-being Research and Evaluation (ASPIRE) Study addresses a critical care gap for patients in the Rio Grande Valley by increasing access to behavioral health services within primary care. Psychosocial distress - including anxiety, depression, and lack of social support - negatively affects health outcomes and contributes to health disparities. The ASPIRE Study evaluates the impact of an Acceptance and Commitment Therapy (ACT)-based Psychological Flexibility (PF) Pathway on emotional well-being, systemic inflammation, and care engagement among patients in primary care settings.

Differences In Emergency Department Imaging Modalities For Femur Fractures Based On Insurance And Demographics, Patrick De La Torre Schutz, Bryce M. Bellon, Daniel Salinas, Kelsey Baker, Hamaad Gohar

Research Colloquium

Insurance status and race have been significant predictors of delayed care and reduced imaging utilization in emergency settings, particularly among minority and Medicaid-insured populations (Moser, Shan). The reasoning for the disparities in treatment for these underserved populations is still not well understood. To further analyze these claims, this study examined whether demographic factors such as ethnicity, sex, age, insurance type, and fracture classification were associated with differences in imaging modality among patients with femur fractures. Data from the Texas Department of State Health Services Trauma Registry (2018–2022) was analyzed using logistic regression to determine the odds ratios of receiving CT, …

Tc-Ptp Enhances Cordycepin-Induced Apoptosis In Human Pancreatic Cancer Cells, Olivia Samaie, Rodrigo Vidales, Lindsey Shim, Murali M. Yallapu, Subhash C. Chauhan, Mushfiq Hassan Shaikh, Dae Joon Kim

Research Colloquium

Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy marked by early metastasis, dense desmoplastic stroma, and profound resistance to conventional therapies. Despite the development of combination regimens such as gemcitabine and FOLFIRINOX, outcomes remain dismal, with median survival under one year for metastatic cases. This underscores the urgent need for novel therapeutic approaches that target multiple pathways simultaneously. T-cell protein tyrosine phosphatase (TC-PTP) is one of nonreceptor PTPs that negatively regulates oncogenic signaling pathways, particularly STAT3 and AKT, both of which are constitutively active in many solid tumors. Cordycepin, a nucleoside analogue derived from Cordyceps militaris, has …

Vitamin D3 Improves Non-Surgical Periodontal Treatment Outcomes, With Reduced Benefit In Type 2 Diabetes: Evidence From Two Randomized Controlled Trials (Rct), Noah Al-Hassan, John Nicholas Cauba, Taha Al-Hassan, Krishi Korrapati, Seratna Guadarrama-Beltran, Maria Quinones, Juan Carlos Lopez-Alvarenga

Research Colloquium

Background: Non‐surgical periodontal therapy reduces bacterial biofilm and inflammation in chronic periodontitis but often leaves residual pockets. Vitamin D₃ has immunomodulatory and anti‐inflammatory effects that may improve healing when added. Randomized evidence in patients with type 2 diabetes mellitus (T2DM) is scarce.

Methods: We meta‐analyzed two RCTs from 2023–2024. Lei et al. randomized 60 non‐diabetic adults to high‐dose (100 000 IU/month), low‐dose (25 000 IU/month), or no vitamin D₃ with standard therapy. Ramaprabha et al. enrolled 92 males (46 with T2DM, 46 without) randomized to 60 000 IU/week vitamin D₃ or therapy alone. Outcomes were changes in probing pocket depth …

Mthfr’S Role In Neuropsychiatric Disorders: Insights Into Precision Psychiatric Treatment, Anjana Ganesh, Nina Mourão, Elena Dike, Bharathi Gadad

Research Colloquium

Background: More than one in five U.S. adults live with a mental illness (1). Symptoms can range from mild to severe, with neuropsychiatric patients experiencing major difficulty in their daily activities. In 2021, an estimated 14.5 million adults in the United States had at least one major depressive episode with severe impairment in the past year (2). Treatment options currently include therapeutic and pharmacologic interventions based on large group data, but medications often take months to years to tailor to each patient. Genetic analysis provides an opportunity for personalized medicine for this vulnerable patient population through insight into the basis …

Murine Typhus Masquerading As A Urinary Tract Infection: A Case From Endemic South Texas, Nida Asif, Yareli Durazo, Corey Haines, Cesar Gutierrez

Research Colloquium

Background: Murine Typhus is a rare flea borne illness caused by Rickettsia typhi, with approximately 100-200 cases reported annually in the United States, primarily in Southern Texas, California and Hawaii, transmitted by fleas from rodents or other animals. It often presents with nonspecific symptoms, making diagnosis challenging. Given its vague clinical presentation and regional endemicity, murine typhus is frequently underrecognized delaying appropriate treatment.

Case presentation:A 77-year-old lady with a known history of HFrEF of 25-30% was presented to the ED due to mild left lower quadrant abdominal pain associated with two episodes of loose bowel movements and decreased appetite …