Journal of Urgent Care Medicine

Postpartum Presentations: When Risk Arises After Delivery – Vaginal Bleeding and Discharge

Urgent Message: Postpartum vaginal bleeding and discharge have a broad range of etiologies ranging from benign and self-limited to life-threatening. As postpartum patients may present to urgent care centers with concerns for bleeding or discharge, it is important for clinicians to have an understanding of the unique differential diagnosis for causes of hemorrhage in this population. Alexa Bailey, BS; Lauren Kostandaras, BS; Hannah Poorman, BS; Michael Weinstock, MD; Catherine Neal, DO. Citation: Bailey A, Kostandaras …

Urgent Care Evaluation and Management of Suspected Lisfranc Injuries

Urgent Message: Rapid identification of Lisfranc injuries in urgent care is critical, as delays in diagnosis can lead to chronic disability. Most patients with Lisfranc fractures or dislocations should be referred directly to the emergency department. Cross-sectional imaging (ie, computed tomography) and orthopedic consultation are time-sensitive, and urgent operative repair is often indicated. Alexandra Eby, BS; Nicole Meschbach, MD Questions for the Urgent Care Clinician at the Bedside Abstract A Lisfranc injury is a tarsometatarsal …

51-Year-Old With Hemoptysis

A 51-year-old man presents to urgent care complaining of night sweats and a productive cough with visible blood for the past 2 weeks. He says he’s been feeling rather tired lately. A chest x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

Insidious Unilateral Axillary Swelling in a Patient with Untreated HIV: A Case Report

Urgent Message: Lymphadenopathy in patients living with HIV is most commonly related to HIV infection, but it may also be related to many forms of systemic infection or malignancy. Definitive diagnosis is most often achieved by fine-needle aspiration. Hana Kusumoto, MD, MPH; Lindsey E. Fish, MD Citation: Kusumoto H, Fish LE. Insidious Unilateral Axillary Swelling in a Patient with Untreated HIV: A Case Report. J Urgent Care Med. 2025; 19(8):31-35 Key words: Diffuse Large B …

17-Year-Old With Syncope

A 17-year-old male presents to urgent care with syncope. He has a family history of sudden cardiac death. He is well appearing and with normal vital signs. An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Brief Report: A Pilot Quality and Feasibility Project Focusing on Clinician Use of an Order Set for Acute Asthma Care in Pediatric Urgent Care Centers

Urgent Message: There are limited data on implementation and use of clinical decision support tools for the evidence-based management of asthma in pediatric urgent care settings. In this pilot project, providing reports and feedback to clinicians on their use of order sets increased utilization of order sets but not adherence to best practice guidelines for asthma care. Richmond Darko, MD, MPH; Andrea Aguilera, MD; Gabriela Lins, DO; Maria Ramon-Coton, MD Citation: Darko R, Aguilera A, …

55-Year-Old With Hand Rash

A 55-year-old woman presents to urgent care with complaints of arthralgia and a pustular rash on her hands. She has a past medical history of Crohn disease and has taken infliximab as treatment for the past year. The patient has no recent history of travel or infections and no history of any skin conditions. On dermatological examination, multiple pustules, some becoming confluent to form “lakes of pus,” were seen on the palms and fingers. Bacterial …

Abstracts in Urgent Care – May 2025

Which Topical Agent is the Best Choice for Epistaxis? Take Home Point: This study found that oxymetazoline was most effective in achieving hemostasis in cases of epistaxis when compared to tranexamic acid (TXA) and an epinephrine-lidocaine combination (ELC) solution. Citation: Celik T, Altun M, Kudu E, et. al. Comparison of the efficacy of oxymetazoline, tranexamic acid, and epinephrine-lidocaine combination in the treatment of epistaxis. Am J Emerg Med. 2025 Feb 23:91:104-109. doi: 10.1016/j.ajem.2025.02.036 Relevance: Controlling …

Recurrent Neuropsychiatric Symptoms in a Patient With Repeated Exposure to Metronidazole: A Case Report

Urgent Message: Metronidazole, even during short courses of therapy, can result in disabling neuropsychiatric symptoms. It is important for clinicians to be knowledgeable about these relatively uncommon but serious adverse medication reactions. Faren Clum, MD; Joshua Russell, MD, MSc, ELS, FCUCM, FACEP Citation: Clum F, Russell J. Recurrent Neuropsychiatric Symptoms in a Patient With Repeated Exposure to Metronidazole: A Case Report. J Urgent Care Med. 2025; 19(7):37-41 Abstract Introduction: Metronidazole is a commonly prescribed antibiotic. …

Urgent Care Evaluation and Management of Spontaneous Pneumothorax

Urgent Message: Spontaneous pneumothorax (PTX) occurs unpredictably. Many patients with spontaneous pneumothorax may initially present to urgent care, so it is important for clinicians to include it in the differential diagnosis of patients presenting with acute chest pain and/or dyspnea. Rarely, a spontaneous pneumothorax can progress to a tension pneumothorax if the diagnosis is delayed. Vrunda Patel, BS; Kevin Radecki, MD Citation: Patel V, Radecki, K. Urgent Care Evaluation and Management of Spontaneous Pneumothorax. J …

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