Clinical Archives - Journal of Urgent Care Medicine

Negative RADT and Bacterial Growth on Throat Culture

Kristin Hrabowy, DO; Jenna Santiago-Wickey, DO; Brianna Promutico, DO; Godwin Dogbey, PhD; and Elizabeth Gignac, DO, FACOEP Urgent message: “Sore throat” is among the most common presenting complaints in the urgent care setting. Accurate diagnosis—including appropriate use of diagnostic tools—is essential to ensure timely, appropriate treatment, including appropriate utilization of antibiotic agents to minimize risk for antibiotic resistance. Citation: Hrabowy K, Santiago-Wickey J, Promutico B, Dogbey B, Gignac E. Negative RADT and bacterial growth on …

A 35-Year-Old with Ankle Pain and a History of Gunshot Wound

A 35-year-old male presents with progressive pain in his ankle. He reports a history of a gunshot to the foot without any aftercare. Review the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 20-Year-Old Female with Weakness, Vomiting, and a History of Alcohol Abuse

The patient is a 20-year-old female who presents complaining of 1 day of generalized weakness and vomiting. She has a history of alcohol abuse and denies chest pain, shortness of breath, lower extremity swelling, fevers, chills, or any infectious symptoms. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 33-Year-Old with New, Painful ‘Lumps’ on Her Legs

A 33-year-old female presents with painful “lumps” on her legs that developed over the past few days. She decided to seek care when some of them began to drain pus. She had no trauma and feels well. Her past medical history is significant for type 2 diabetes mellitus. On examination she is afebrile, with scattered tender nodules, some with purulent drainage, on the legs. View the image taken and consider what your diagnosis and next …

Human Trafficking in the Urgent Care Setting: Recognizing and Referring Vulnerable Patients

Urgent message: As it is common for human trafficking victims to present to urgent care, providers should be able to understand and identify common red flags in the patient presentation, history, and physical exam; treat immediate medical concerns; and know how to refer and safely provide resources for suspected cases. Preeti Panda, MD Citation: Panda P. Human trafficking in the urgent care setting: recognizing and referring vulnerable patients. J Urgent Care Med. 2023;17(6):13-22. Key words: …

An Itchy Back with New Moles: A Case Report of Occult Malignancy

Joshua Russell, MD, MSc, FCUCM, FACEP Key words: paraneoplastic syndrome, gastric cancer, seborrheic keratosis, case report ABSTRACT Introduction: Lesar-Trélat sign (LTS) is an infrequent paraneoplastic phenomenon associated with an array of malignancies. Given that the primary manifestation is a seemingly benign dermatologic issue, such patients may choose urgent care as their initial site of clinical evaluation. Clinical presentation: A 43-year-old man with no significant past medical history presented to UC with complaints of itching and …

Abstracts in Urgent Care – March 2023

Ivan Koay MBChB, MRCS, FRNZCUC, MD Are Urine Dipsticks Accurate in Diagnosing UTIs in Infants? Take-home point: Point-of-care (POC) urinalysis (ie, urine dipstick) is moderately sensitive and highly specific for diagnosing urinary tract infection in febrile infants. The optimum cut-point for excluding UTI is leucocytes (1+), and the optimum cut-point for confirming UTI is nitrites (trace). Citation: Waterfield T, Foster S, Platt R, et al. Diagnostic test accuracy of dipstick urinalysis for diagnosing urinary tract …

Key Signs and Symptoms of Severe Illness in Urgent Care: Cervical Necrotizing Fasciitis and Necrotizing Mediastinitis

Urgent message: Cervical necrotizing fasciitis and necrotizing mediastinitis may ultimately occur in patients presenting with symptoms of odontogenic infection. While severe illnesses rarely present in urgent care, it is important to establish a prompt diagnosis and implement rapid medical management for these patients, in order to improve survival. Vitoria Regina Nunes Maia, MS and Lindsey E. Fish, MD ABSTRACT Cervical necrotizing fasciitis (CNF) is a rapidly progressive infection that can be fatal. This condition can …

Conquering the Fear of Penicillin Allergy: The Boogeyman of Urgent Care

I had time to see one more patient as my shift was winding down. “Wound check. That should be a quick one,” I said to myself. Famous last words. I soon learned that the young woman with the dog bite on her hand was returning for her fourth visit in as many days for the same issue. She sat fidgeting on the exam table and was visibly irritated when I walked in the room. “It’s …

Retrospective Study on the Impact of Increased Value-Add Time on Patient Experience in Pediatric Urgent Care Centers

Urgent message: Increase in the proportion of value-add time during an encounter was associated with an increased rate of positive perceptions of timeliness and overall patient experience in pediatric urgent care centers. Aimy Patel, MD; Brian R. Lee, MPH, PhD; Amanda Montalbano, MD, MPH; and Amanda Nedved, MD Citation: Patel A, Lee BR, Montalbano A, Nedved A. Retrospective study on the impact of increased value-add time on patient experience in pediatric urgent care centers. J …

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