Internal Medicine Commons^™

Early Diagnosis Of Purulent Pericarditis Secondary To Methicillin-Sensitive Staphylococcus Aureus In An End-Stage Renal Disease Patient, Stephen Shey, Alejandro Espinosa-Tello, Amnah Andrabi

North Texas GME Research Forum 2023

Introduction Purulent pericarditis is a rare illness in the modern age of medicine due to the increased usage of antibiotics. Unfortunately, diagnosis of this disease is often delayed due to its nonspecific symptoms. Without treatment, the mortality is nearly one hundred percent due to major complications such as cardiac tamponade and constrictive pericarditis. As a result, most cases of purulent pericarditis are discovered post-mortem. This case report details an early diagnosis of purulent pericarditis secondary to methicillin-sensitive Staphylococcus aureus (MSSA) in an end-stage renal disease (ESRD) patient. Case Presentation A 66-year-old female with past medical history of ESRD initially presented …

Disseminated Miliary Tuberculosis And Intestinal Tuberculosis Mimicking Ibd, Danny Tran, Kunaal Patel, Areeba Asfaq, Brittany Lyons

South Atlantic Division GME Research Day 2023

No abstract provided.

Invasive Mold Infections Following Hurricane Harvey-Houston, Texas, Mitsuru Toda, Samantha Williams, Brendan R Jackson, Sebastian Wurster, Jose A Serpa, Masayuki Nigo, Carolyn Z Grimes, Robert L Atmar, Tom M Chiller, Luis Ostrosky-Zeichner, Dimitrios P Kontoyiannis

Faculty, Staff and Student Publications

BACKGROUND: Characterizing invasive mold infection (IMI) epidemiology in the context of large flooding events is important for public health planning and clinical decision making.

METHODS: We assessed IMI incidence (per 10 000 healthcare encounters) 1 year before and after Hurricane Harvey at 4 hospitals in Houston, Texas. Potential IMI cases were assigned as proven or probable cases using established definitions, and surveillance cases using a novel definition. We used rate ratios to describe IMI incidence and multivariable logistic regression to examine patient characteristics associated with IMI case status.

RESULTS: IMI incidence was significantly higher posthurricane (3.69 cases) than prehurricane (2.50 …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

A Case Of Embolic Stroke Due To Native Mitral Valve Pasteurella Multocida Infective Endocarditis, Alexia Foy-Crowder, Omar Kandah, Mohamed Faris

South Atlantic Division GME Research Day 2023

No abstract provided.

Mycotic Aortic Abdominal Aneurysm: A Rare Case, Jazmine Duran, Judy Jin, Skyler Westerfeld

Central & West Texas GME Research Day 2023

No abstract provided.

Surviving The Apprehensive Methicillin-Sensitive Staphylococcus Aureus (Mssa) Bacteremia: A Case Of Bacteremia With An Undetermined Source Of Infection Leading To Suspected Cardioembolic Ischemia And Biochemical Septic Shock, Greisy D. Curbelo Sesin, Eduardo Marino-Urbino, Christopher Fontela, Melanio J. Rodriguez, Jorge A. Diaz, Shivaan C. Oomrigar, Ramon Mendoza Bello, Yoandy Rodriguez Fuentes

East Florida Division GME Research Day 2023

Introduction: This research presents a complex case of a 70-year-old male with acute metabolic encephalopathy and biochemical septic shock, later attributed to cardioembolic ischemia, resulting from Methicillin-Sensitive Staphylococcus Aureus (MSSA) bacteremia with an elusive source of infection.

Case Description: The 70-year-old patient, with a medical history of hypertension and aortic valve stenosis status post-Coronary Artery Bypass Grafting and bioprosthetic valve replacement on dual anti-platelet therapy (clopidogrel and aspirin), was admitted following an unwitnessed fall and a day of vomiting and generalized weakness. Upon arrival, the patient exhibited altered mental status, hypotension, and acidosis. Initial diagnostic workup raised suspicion of biochemical …

Atraumatic Splenic Rupture: An Unaccustomed Complication Of H. Parainfluenzae Endocarditis, Daniel P. High, Jose M. Acosta-Rullan, Danay Herrera, Mauricio Danckers

East Florida Division GME Research Day 2023

No abstract available.

Veillonela Discitis: A Rare Presentation And Review Of Literature, Akankcha Alok, Vidya Sagar Kollu, Gautam Kalyatanda

North Florida Division GME Research Day 2023

No abstract provided.

Subacute Stroke Like Presentation Likely Due To Disseminated Histoplasmosis In An Immunocompromised Patient, Ashley R. Diaz, Priya Mohan, Utmitha Konda, Alfonso Manotas, Issac Ichoa

East Florida Division GME Research Day 2023

Histoplasmosis capsulatum is an opportunistic fungal infection that is largely asymptomatic and found to have nonspecific signs and symptoms. It predominates in Central and North America, and is one of the leading causes of hospitalization among the fungal family. However, in the right host, such as in this case, a patient with significant immunosuppression can develop serious manifestations as it disseminates outside of the pulmonary system. The challenging element of disseminated histoplasmosis is that despite proper treatment immunocompromised patients will frequently relapse with worsening presentation. There is limited literature on subacute stroke-like presentation in a patient with chronic infection of …

A Rare Case Of Right Atrial Appendage Mass In Patient With Recurrent Methicillin-Resistant Staphylococcus Aureus Bacteremia, Vivek Nadipalli, Ahmed Mahmood, Thomas Alexander

Gulf Coast Division GME Research Day 2023

No abstract provided.

O. Anthropi: An Unusual Cause Of Pneumonia And Bacteremia, Zefr Chao, Anaam Fayyaz, Suresh Antony

Central & West Texas GME Research Day 2023

No abstract provided.

Clostridium Septicum Bacteremia As The Presenting Sign Of Colon Cancer, Andrew Abraham, Sripal Padam

North Florida Division GME Research Day 2023

No abstract provided.

Acute Colonic Perforation With Septic Shock Secondary To Disseminated Histoplasmosis In A Autologous Bone Marrow Transplant Recipient, Harsimrandeep Bhatti, Srijisnu De, Enkhbileg Batbileg, Glen Friedman

Central & West Texas GME Research Day 2023

No abstract provided.

Hairy Cell Leukemia Presenting As Group B Streptococcus Cellulitis And Abscesses, Hannah Berrett, Mattias D'Anna, Ajay Iyer, Zachary Hancock, Meg Laures, Muzaffar Iqbal

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Fever Of Unknown Origin Secondary To Staphylococcus Epidermidis Infective Endocarditis In A Patient With Aicardi Syndrome, Kimberly Sanchez Lopez, Elvis Caraballo Antonio, Gabriel Barciela Perez, Melanio J. Rodriguez, Yeissen Godinez

East Florida Division GME Research Day 2023

INTRODUCTION Aicardi syndrome is a rare neurodevelopmental disorder predominantly affecting females and characterized by agenesis of the corpus callosum, infantile spasms, and distinctive chorioretinal lacunae. We present the case of a 24-year-old female with a known history of Aicardi syndrome who presented with fever of unknown origin, ultimately attributed to Staphylococcus Epidermidis infective endocarditis involving a native valve.

CASE DESCRIPTION A 24-year-old female with a history significant for Aicardi syndrome and epilepsy presented to the emergency department for fever during the past week; her primary care physician sent her for outpatient blood work a few days prior, including blood culture, …

Staph What?: An Uncommon Species Of Staphylococcus Endocarditis In An Atypical Case Of Diabetic Ketoacidosis, Gilberto Rivera-Gonzalez, Habiba Khan, Harsimrandeep Bhatti, Jazmine Duran, Caleb Nieves, Paul Mathew

Central & West Texas GME Research Day 2023

No abstract provided.

Chromobacterium Haemolyticum Infection From Hot Springs Near Yellowstone National Park, Kyle Patterson, Sean Shearen, Ken Chapman, Katie Suleta

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Empyema Necessitans Due To Actinomycetes Odontolyticus, Alexandra E. Thomson, Jean Toffrey, Jessica Thomas, Jana Byrd, Chad Martins

South Atlantic Division GME Research Day 2023

No abstract provided.

The Re-Emergence Of An Ancient Disease: A Case Presentation Of Spinal Tuberculosis, Danay Herrera, Nargisa Ergasheva, Paola Solari, Daniel Kaswan, Bryan Greendield

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Introduction: An ancient disease identified in Egyptian and Peruvian mummies, tuberculous spondylitis caused by Mycobacterium tuberculosis (MTB) is considered the most common form of extrapulmonary tuberculosis (TB) [1,5]. Despite the identification of the causative agent, the improvement in diagnostic tools, the production of the Bacillus Calmette-Guerin (BCG) vaccine, and the development of antimicrobial regimens since the disease was first described, it remains a major health burden today with significant morbidity and mortality among developing countries [5]. Spinal TB can lead to severe deformity and permanent neurological deficits, as such early recognition …

Cryptogenic Liver Abscess Caused By Actinomyces Meyeri, Thomas Walter, Simona Oprea, Greg Hicks

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

What? Is Epstein–Barr Virus Infection Linked To Multiple Sclerosis?, Asha Mahajan, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Do You Know The Pathophysiology Of Cytokine Storm During Covid-19?, Shameera Shaik Masthan, Deekshitha Turaka, Ahmed Abdelhaleem, Mounica Vorla, Steven B. Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

What About Anosmia From Covid-19 ?, Sharanya S E Santhi, Sara Elnour, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Treating Cytokine Storm In Patients With Covid-19, Ahmed Abdelhaleem, Deekshitha Turaka, Shameera Shaik Masthan, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Noninvasive Testing And Surrogate Markers In Invasive Fungal Diseases, George R Thompson, David R Boulware, Nathan C Bahr, Cornelius J Clancy, Thomas S Harrison, Carol A Kauffman, Thuy Le, Marisa H Miceli, Eleftherios Mylonakis, M Hong Nguyen, Luis Ostrosky-Zeichner, Thomas F Patterson, John R Perfect, Andrej Spec, Dimitrios P Kontoyiannis, Peter G Pappas

Faculty, Staff and Student Publications

Invasive fungal infections continue to increase as at-risk populations expand. The high associated morbidity and mortality with fungal diseases mandate the continued investigation of novel antifungal agents and diagnostic strategies that include surrogate biomarkers. Biologic markers of disease are useful prognostic indicators during clinical care, and their use in place of traditional survival end points may allow for more rapid conduct of clinical trials requiring fewer participants, decreased trial expense, and limited need for long-term follow-up. A number of fungal biomarkers have been developed and extensively evaluated in prospective clinical trials and small series. We examine the evidence for these …

Antimicrobial Stewardship Meets Transitions Of Care: Defining Length Of Therapy For Community-Acquired Pneumonia (Cap), Christopher Whitman, Sarah E. Moore, Matthew Song, Brian C. Bohn, Ashley M. Wilde

The University of Louisville Journal of Respiratory Infections

Introduction: Hospital-based antimicrobial stewardship efforts have traditionally focused on inpatient settings. Antibiotic prescribing at discharge is often an overlooked area of focus for antimicrobial stewardship programs. Discharge prescribing optimization is necessary to combat antibiotic overuse.

Methods: This was an observational, retrospective cohort study at a four–adult community hospital system. Four hundred adult patients admitted with community-acquired pneumonia and discharged with antibiotics were included. The primary outcome was overall (inpatient and discharge) antibiotic length of therapy. The secondary outcome was percentage of patients discharged on a fluoroquinolone who had not received one in the hospital. Descriptive statistics were utilized.

Results: The …

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: Correspondence, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Covid-19, Vaccination, And Heart Transplantation, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.