Foraged Mushroom Toxicity Presenting to Urgent Care with Acute Kidney Injury

Urgent message: Though it occurs relatively rarely, mushroom toxicity can result in irreversible organ damage and, in certain cases, death if not recognized quickly. Diagnosis can be difficult due to the facts that toxicity may present at different intervals from time of ingestion, depending on the species of mushroom,  and initial symptoms are nonspecific and similar to those of benign gastrointestinal illnesses. Timely consultation with a poison control center may be life-saving. Michele L. Stowe, …
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A Pregnant Woman with Upper Right Quadrant Pain

Urgent message: The presentation of a pregnant woman to urgent care is often associated with consternation for both the patient and the provider. When a pregnant patient presents to urgent care with right upper quadrant pain, initial bedside ultrasound screening for gall bladder disease can facilitate initial interventions as well as expedite follow up care. CASE PRESENTATION  History A 25-year-old nulliparous female 24 weeks pregnant presented to urgent care 4 hours after onset of nausea, …
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Management of Lisfranc Dislocation in the Urgent Care Center

Urgent message: Lisfranc dislocations are relatively rare, but should be on the urgent care provider’s radar in patients who refuse to bear weight and who have significant midfoot pain and swelling after an acute trauma causing hyperplantarflexion of the foot. Introduction The tarsometatarsal (TMT), or Lisfranc, joint complex is the attachment between the forefoot and midfoot. This joint is the keystone to normal foot function and is thus critical for normal gait.1 Jacques L. Lisfranc …
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Guttate Psoriasis: An Uncommon Cause of a Rash

Urgent message: While skin-related complaints are not uncommon in the urgent care setting, with psoriasis being a relatively common source, evaluation and diagnosis of a rash can be challenging. This is especially true in the case of a rare variant like guttate psoriasis.  Chasity L. Falls, MS, PA-C INTRODUCTION Psoriasis is a common condition. However, the guttate variant is rarer, commonly affecting children and young adults less than 40 years of age and accounting for …
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When Is Tachycardia in a Patient with URI Symptoms a Sign of Something More Serious?

Urgent message: Brugada syndrome is a genetic disorder associated with increased incidence of ventricular tachyarrhythmias and sudden cardiac death. There have been cases associated with fever, viral infections, and pneumonias—all conditions urgent care clinicians treat in abundance. This case report demonstrates how urgent care providers can diagnose a potentially lethal disorder when patients are being seen for febrile illnesses. Kathleen B. Raschka, MD Case Presentation A 55-year-old male with a history of hypertension, hyperlipidemia, and …
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