Tag Archives: diagnostic testing

Hidden Giant: Medium Vessel Vasculitis as a Cause for Unresolving Fever

The purpose of this article is to determine if conversion from eating wild game harvested with lead-based ammunition to nonlead-based ammunition results in lower blood lead levels. Supersonic injection of toxin-leeching frangible projectiles into food is intuitively bad. As much as 95% of the ~13.7 million hunters in the United States choose shrapnel-inducing lead bullets […]

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Cardiac Tamponade: An Unusual Presentation of Systemic Lupus Erythematosus

A 55-year-old Ghanaian man was admitted to our service with 4 days of acute, progressive dyspnea. He developed orthopnea the night prior to his admission. Review of systems revealed progressive asthenia, anorexia, and low-grade fever for the past few months, with an unintentional weight loss of approximately 40 lbs. No other symptoms were elicited. The […]

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Elongated Mitral Valve Vegetation

To the Editor: A 41-year-old woman presented with a 2-week history of neck and back pain and suddenly developed pulseless electrical activity cardiac arrest while in the emergency department, with return of spontaneous circulation after 2 rounds of advanced cardiac life support. Physical examination and labs were notable for fever, sinus tachycardia, leukocytosis, and lactic […]

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Unusual Case of Fever and Abdominal Pain

Pyogenic liver abscess is an uncommon type of intra-abdominal abscess and occurs in approximately 3.6 per 100,000 hospitalized individuals.1 The incidence of pyogenic liver abscess is increasing.1 Here we present a case of Streptococcus anginosus liver abscess, secondary to acute uncomplicated sigmoid diverticulitis and acute cholecystitis. Case Report A 63-year-old man presented to our tertiary medical center with a […]

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The Frequency of Unnecessary Testing in Hospitalized Patients

Testing is an important part of medicine across all specialties and settings. As a result, the volume of testing is enormous, with an estimated 4-5 billion tests performed in the United States each year.1 Unnecessary laboratory testing and diagnostic imaging is believed to be common. Studies looking at testing of patients have found 40%-60% of tests […]

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