Clinical Feature Articles

Urgent message: Familiarity with the schedule for immunization against pertussis, as well as expertise in diagnosing and prescribing treatment, should be within the urgent care provider’s capabilities—as should the ability to distinguish which patients require transfer to a higher-acuity setting.   Ellen Laves, MD Microbiology and Immunity Pertussis is a toxin-mediated disease caused by the gram-negative coccobacillus Bordetella pertussis. Toxins produced by B pertussis impair ciliary clearance of pulmonary secretions through the paralysis of normally beating cilia.1 Childhood immunity to pertussis is conferred through the administration of the acellular pertussis …
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Urgent message: Urgent care centers may offer opportunities to provide preexposure prophylaxis (PrEP) services for HIV due to large numbers of patients seeking testing and treatment for sexually transmitted infection. In the same sense, the urgent care center may also serve as an important ally in providing referrals for patients not currently linked to primary care services. Yeow Chye Ng, PhD, FNP-BC, NP-C, CPC, AAHIVE, Jack J. Mayeux, MSN, APRN, NP-C, and Thuy Lynch, PhD, RN. Introduction Preexposure prophylaxis (PrEP) services for HIV are not currently offered in a majority …
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Urgent message: Patients who have had recent surgical procedures may present to urgent care centers for reasons ranging from seeking reassurance to presentation of life-threatening complications. Tracey Quail Davidoff, MD Introduction Patients often experience complications—or, at least as often, fear they’re experiencing complications—after a surgical procedure. While the surgeon is often the best person for them to consult, this may not be possible for a variety of reasons. Outpatient surgical centers are opening almost at the same rate as urgent care centers,1 but may not be well prepared to handle …
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 Urgent message: Urgent care providers often see acute public health emergencies due to easy patient accessibility. It is important to identify communicable disease rapidly to control any risk of a community outbreak. This article will focus on mumps, measles and varicella (chickenpox). Carmen N. Burrell, DO, Melinda J. Sharon, MPH, and Megan Kessell, BA In recent years, outbreaks of uncommon infectious diseases have occurred in schools and communities, due to increasing travel exposures, decreasing vaccination compliance, and varying effectiveness of vaccination response. In 2016, over 6,000 cases of mumps were …
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Urgent message: As patients start to feel the effects of the 2018–2019 influenza season, urgent care centers can expect to see visits by patients with related symptoms increase. Providers must be prepared to identify and treat patients most at risk for complications and poor outcomes—armed with old standbys and a newly approved antiviral agent. Samantha Arnold, DO Introduction Last month, JUCM explored prevention, diagnosis, and testing for influenza. In this issue, we focus on management of patients who have been diagnosed with influenza, with attention to duration of infectivity, complications …
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