Case Reports

Posted On February 1, 2018 By In Case Reports, Slider

Neck Rash on a 21-year-old Male

Urgent message: Acanthosis nigricans has a strong association with obesity and insulin resistance. Assessment involves a thorough physical exam to differentiate from other dermatosis, as well as full workup for insulin resistance. Early diagnosis in the urgent care setting, and treatment, will improve the appearance of acanthosis nigricans, but also the patient’s overall morbidity. Shailendra Saxena, MD, PhD and Bao Chau Nguyen, BS Introduction A 21-year-old Caucasian male presented for a circumferential hyperpigmented rash around the neck that began several months ago. History Past medical history was significant for morbidRead More
Urgent message: Treating preverbal children can be challenging under every-day circumstances for pediatricians who know the child and the family. Urgent care providers who may not have the benefit of that history must be especially vigilant for all available signs and symptoms to make diagnoses based on the full scope of the presentation. Michael Weinstock, MD Case Presentation (Please note: The Case Presentation is drawn directly from the treating physician’s notes, without editing or correction, to reflect the conditions at the time of presentation.) 5 month old male with multipleRead More
Urgent message: While Boerhaave syndrome is a rare finding, a relatively high number of cases may present in the urgent care setting. As such, awareness of and vigilance for related symptoms are essential to taking a proper history and, ultimately, early diagnosis of acute, subacute, or chronic Boerhaave syndrome.  John Shufeldt, MD, MBA, JD, FACEP, Amber Hawkins, and Carli Nichta, MS4   Introduction Boerhaave syndrome is a spontaneous esophageal rupture indicated in some cases by Mackler’s triad: subcutaneous emphysema, vomiting, and lower chest pain. Early diagnosis is critical for positiveRead More
Urgent message: Back pain is a common complaint in the urgent care setting. Common causes of musculoskeletal back pain include overuse and work-related injury. Other causes can include disc herniation, metastasis, osteoporosis, arthritis, spinal stenosis, and nephrolithiasis. Crystal N. Bharat MD, Ronald Dvorkin, MD, and Glenn G. Gray MD Case Presentation A 65-year-old female complained of 1 day of low back pain radiating to her left flank, which was aggravated with movement. Symptoms began while at work. Patient denied nausea, vomiting, diarrhea, fever, urinary frequency, urinary urgency, dysuria and hematuria,Read More
Urgent message: Acute aortic obstruction should be suspected in all patients with back pain and a history of peripheral vascular disease and atrial fibrillation, as over 50% of these cases are misdiagnosed, resulting in high mortality rates in affected patients.  Kristopher Palmer, DO and JM Alderson, DO Introduction Aortic occlusion is a rare but potentially fatal vascular phenomenon that must be considered in all patients with peripheral vascular disease (PVD) complaining of severe pain. Here, we present a case of acute infrarenal aortic occlusion in a 76-year-old female with severeRead More
Urgent message: Superior mesenteric artery syndrome should be included in the differential diagnosis in children with abdominal pain and weight loss with rapid increase in linear growth. Ralph Mohty, MS3, and Michael Esmay, MD Introduction Abdominal pain is one of the most common complaints in childhood. A minor self-limited condition such as constipation or viral gastroenteritis is usually the cause, but more serious conditions need further evaluation and management.1 Chronic abdominal pain is a term used to describe intermittent or constant abdominal pain (of functional or organic etiology) that hasRead More

Posted On July 3, 2017 By In Case Reports

An Unexpected Cause of Amenorrhea

Urgent message: The simplest explanation for a mundane symptom may not always reflect the correct diagnosis. Urgent care providers should consider all the possibilities in order to reach the correct conclusion as early as possible, or risk missing a more serious underlying diagnosis. Introduction Sometimes a simple complaint results in a common diagnosis, but other times a rare diagnosis will be discovered. The following case illustrates the importance of considering a wide differential and obtaining appropriate follow-up. Further morbidity was prevented by the vigilance and care of the urgent careRead More
Urgent message: Urgent care providers must maintain a high index of suspicion for life-threatening conditions when assessing patients whose self-reporting of symptoms can be vague and nonspecific. Introduction Elderly patients often present for medical evaluation with vague complaints, oftentimes requiring the provider to obtain additional history from family and caregivers. Urgent care providers must maintain a high index of suspicion for life-threatening conditions based on non-specific symptoms. This case demonstrates the importance of recognizing a rare but serious entity: chronic salicylate toxicity in an elderly patient with altered mental status.Read More