Source: UpToDate

Thanks to Dr. Amy Wu for a great morning report on pulmonary cocci!

Learning Points:
-Primary infections due to Coccidioides sp. most frequently manifest as community-acquired pneumonia (CAP)
-Keep cocci in your differential for a patient presenting with CAP, especially if they are not clinically improving with empiric antibiotics
-There is a wide spectrum of clinical manifestations; from a subclinical, self-limited illness, to a subacute process known as Valley Fever with respiratory complaints, to disseminated (extrapulmonary) disease (most commonly spreading to bones, skin, and CNS).
-Serologies in the acute phase may be falsely negative
-Since uncomplicated primary infections are usually self-limited, the decision to treat with antifungals can be considered for patients on an individual basis.
-For more on this topic, here is a great article by the Journal of Clinical Microbiology

Thanks to Dr. Hsieh for an excellent morning report on Lung Abscesses

Learning Points:
— Risk factors for developing lung abscesses: peridontal disease, dysphagia, diminished gag or cough reflex, ETOH abuse and seizure disorder
— Common anaerobes: Peptostreptococcus species, Bacteroides species, Fusobacterium species and microaerophilic streptococci
— Common aerobes: Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae (rarely), Klebsiella pneumoniae, Haemophilus influenzae, Actinomyces species, Nocardia species, and Gram-negative bacilli.

Check out this great Medscape article by our own Dr. Jason Bahk and Dr. Nader Kamangar

Thank you Dr. Sue Zhang for a great morning report on a patient with Cushing’s disease!

Learning points:
-Consider screening for hypercortisolism in a patient with hypokalemia, metabolic alkalosis, and hypertension
-Etiologies for Cushing’s Syndrome include 1) Cushing’s Disease (pituitary) 2) Ectopic ACTH-secreting tumor 3)Primary adrenal neoplasm
-In a patient with both hypokalemia and hyperglycemia, make sure to aggressively replete potassium before administering insulin.
—Cushing’s syndrome review article: A thorough review of the epidemiology, workup, etiology, and management of Cushing’s syndrome

Thanks to Caleb Hsieh for an excellent morning report!

Learning Points:
-Common causes of rhabdomyolysis include muscle trauma or crush injury, extreme exertion, drugs and toxins.
-The mainstay of treatment of AKI due to rhabdomyolysis is aggressive fluid resuscitation and correction of electrolyte abnormalities.
–Rhabdo Review Article: An excellent review of epidemiology, pathophysiology, and treatment of rhabdo.