A 63-year old woman with no significant past medical history presents with 3-months of short-term memory difficulty, trouble concentrating, and emotional lability. She also has been noted by family to have intermittent bilateral jerking of her arms upon being startled. CMP, CBC, TSH, CRP, ESR, and B12 were all negative. RPR, ANA HIV, paraneoplastic antibody panel, urine drug screen, and serum HSV PCR were negative. Lumbar puncture was performed and lab results are pending. Brain MRI is shown below:
What is the name of the above MRI finding and likely diagnosis? Scroll down for the answer.
We had a wonderful ID-themed Journal Club with Dr. Tim Brown presenting the 2017 NEJM paper entitled “A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses,” a multicenter, prospective trial comparing the I&D alone vs. I&D with either clindamycin or TMP-SMX.
Thank you to our faculty discussants at each site: Dr. Cutrell at the VA, Dr. Frankie Lee at CUH, and Dr. Ank Nijhawan at Parkland!
Neil Keshvani and Kimberly Berger published in BMJ Quality & Safety last week. Their piece, titled, ”Roadmap for improving the accuracy of respiratory rate measurements” details their quality improvement project, where they shadowed nurses and patient care advocates to elucidate barriers to accurate respiratory rate measurement. They found that PCAs don’t have time-keeping devices, which makes counting very difficult. They created a modified workflow process to improve accuracy and efficiency with a goal of retraining all PCAs and nurses to use this workflow.
Well done Neil and Kim, and a big thanks for faculty mentors Dr. Oanh Nguyen and Dr. Anil Makam.