Rhabdomyolysis in the Urgent Care: An Unexpected Case of Myalgias

Urgent message: Rhabdomyolysis has a wide range of presentations, from asymptomatic to life-threatening. The most dramatic presentation can result in acute renal failure, electrolyte imbalances, and/or disseminated intravascular coagulation (DIC).  Jordan Miller, DO, Ari Leib, MD, and Andre Bonnet, DO EPIDEMIOLOGY Approximately 26,000 cases of rhabdomyolysis are reported in America yearly, with 10% to 50% progressing to acute renal failure.1,2 Mortality rates range from 7% to 80% and are higher in patients who develop multiorgan failure.3 While the most common cause is direct muscle trauma, a wide range of processes …
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Bariatric Surgery Complications in the Urgent Care Center

Urgent message: Obesity continues to be a significant health problem in the United States, with more and more patients opting for a surgical solution to their own weight loss challenges. As this trend continues, urgent care providers can expect to see more patients with post bariatric surgery complaints, ranging from the typical and benign to pulmonary emboli, anastomotic leaks, and respiratory failure account. Tracey Quail Davidoff, MD, FCUCM Obesity has become one of the foremost public health concerns in our time. It may result in poor self-esteem, depression, discrimination, as …
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Urgent Identification and Management of Postsplenectomy Sepsis

Urgent message: Asplenic individuals have a rate of severe infections 2-3 times higher than the general population. Postsplenectomy sepsis should be considered in patients with impaired splenic function who present with a fever. Megan L. Lawson, PA-C and Christina Gardner, DHSc, MBA, PA-C CASE PRESENTATION A 45-year-old male presented to the urgent care with 18 days of sinus pain and congestion unresponsive to two courses of antibiotics, cefdinir and levofloxacin. Past surgical history revealed a splenectomy 20 years ago after a motor vehicle accident. Physical exam showed a temperature of …
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Evaluation and Diagnosis of Trigger Finger with Current Management Strategies

Urgent message: Appropriate treatment of “trigger finger” in the urgent care setting starts with differentiating that diagnoses from other disorders of the hand. This is relatively straightforward if one finger is involved, but can become more complex with multiple digits. Shailendra K. Saxena, MD, PhD and Alexander M. Stock, BS INTRODUCTION Trigger finger, also known as stenosing flexor tenosynovitis, is a common hand disorder that affects approximately 2.6% of the general population during their lifetime.1 For diabetics, the risk of developing trigger finger approaches 4% to 10%, with more complicated …
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Reducing Morbidity and Mortality Due to MRSA in the Urgent Care Setting

Urgent message: Staphylococcus aureus is a common pathogen in the community—one that can lead to a range of infections, including abscess and sepsis. Invasive methicillin-resistant S aureus (MRSA) infections have decreased in the healthcare setting; however, at the same time, community-acquired infections have increased. Delayed treatment increases morbidity and mortality. Jordan Miller, DO and Ari Leib, MD AN ILLUSTRATIVE CASE A 40-year-old female presented to an urgent care center with the chief complaint of a spider bite on her right foot. She states that she woke up to her foot …
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