Left Eye Pain in an Overall Healthy 19-Year-old Female

Left Eye Pain in an Overall Healthy 19-Year-old Female

Urgent message: Eye pain is a common presentation to the urgent care clinic. A provider needs to be able to recognize concerning components of history and physical which require further emergent evaluation. Lindsey E. Fish, MD CASE PRESENTATION History A 19-year-old female with past medical history significant only for scoliosis presents to an urgent care clinic complaining of left eye pain for the last 3 days. She reports that the pain feels like it is …

Read More
A 69-Year-Old Female with Hypertension, Dyslipidemia, and a Constellation of Otolaryngologic Symptoms

A 69-Year-Old Female with Hypertension, Dyslipidemia, and a Constellation of Otolaryngologic Symptoms

Urgent message: Epiglottitis is classically viewed as a pediatric disease, but has become increasingly common in the adult population. While symptoms may present as an isolated sore throat, they can quickly progress to complete airway compromise with need for emergency cricothyroidotomy. Due to the high risk for morbidity and mortality, urgent care providers must maintain a high index of suspicion to avoid misdiagnosing a potentially catastrophic disease. Zachary DePriest, MS, PA-C INTRODUCTION Adult epiglottitis (AE) …

Read More
A New-Onset, Suspicious Skin Lesion

A New-Onset, Suspicious Skin Lesion

Urgent message: Patients and providers alike may be inclined to eliminate possible diagnoses based on first impressions. It is essential that the urgent care clinician maintain a wide differential when evaluating patients for new-onset complaints that do not have an obvious cause. Failure to do so may cause delayed diagnoses (and, consequently, delayed treatment). Haley Harrington, Ross L. Pearlman, MD and Robert T. Brodell, MD INTRODUCTION Ticks are small—so small that patients often do not …

Read More
Cannabis-Associated Myocardial Infarction in a Young Woman Without Other Cardiac Risk Factors

Cannabis-Associated Myocardial Infarction in a Young Woman Without Other Cardiac Risk Factors

Urgent message: A growing body of evidence suggests increased cardiovascular risk with frequent cannabis use. With cannabis availability and legalization increasing, the urgent care provider must understand how it affects the risk for acute medical issues among frequent users. Bella Nagappan, MD and Susanne Demeester, MD INTRODUCTION Cannabis, or marijuana, is legal for recreational use in 11 states and medical use in 33 states.1 With this increasing availability and legalization, the urgent care clinician must …

Read More
Foraged Mushroom Toxicity Presenting to Urgent Care with Acute Kidney Injury

Foraged Mushroom Toxicity Presenting to Urgent Care with Acute Kidney Injury

Urgent message: Though it occurs relatively rarely, mushroom toxicity can result in irreversible organ damage and, in certain cases, death if not recognized quickly. Diagnosis can be difficult due to the facts that toxicity may present at different intervals from time of ingestion, depending on the species of mushroom,  and initial symptoms are nonspecific and similar to those of benign gastrointestinal illnesses. Timely consultation with a poison control center may be life-saving. Michele L. Stowe, …

Read More
A Pregnant Woman with Upper Right Quadrant Pain

A Pregnant Woman with Upper Right Quadrant Pain

Urgent message: The presentation of a pregnant woman to urgent care is often associated with consternation for both the patient and the provider. When a pregnant patient presents to urgent care with right upper quadrant pain, initial bedside ultrasound screening for gall bladder disease can facilitate initial interventions as well as expedite follow up care. CASE PRESENTATION  History A 25-year-old nulliparous female 24 weeks pregnant presented to urgent care 4 hours after onset of nausea, …

Read More
Management of Lisfranc Dislocation in the Urgent Care Center

Management of Lisfranc Dislocation in the Urgent Care Center

Urgent message: Lisfranc dislocations are relatively rare, but should be on the urgent care provider’s radar in patients who refuse to bear weight and who have significant midfoot pain and swelling after an acute trauma causing hyperplantarflexion of the foot. Introduction The tarsometatarsal (TMT), or Lisfranc, joint complex is the attachment between the forefoot and midfoot. This joint is the keystone to normal foot function and is thus critical for normal gait.1 Jacques L. Lisfranc …

Read More
Guttate Psoriasis: An Uncommon Cause of a Rash

Guttate Psoriasis: An Uncommon Cause of a Rash

Urgent message: While skin-related complaints are not uncommon in the urgent care setting, with psoriasis being a relatively common source, evaluation and diagnosis of a rash can be challenging. This is especially true in the case of a rare variant like guttate psoriasis.  Chasity L. Falls, MS, PA-C INTRODUCTION Psoriasis is a common condition. However, the guttate variant is rarer, commonly affecting children and young adults less than 40 years of age and accounting for …

Read More
When Is Tachycardia in a Patient with URI Symptoms a Sign of Something More Serious?

When Is Tachycardia in a Patient with URI Symptoms a Sign of Something More Serious?

Urgent message: Brugada syndrome is a genetic disorder associated with increased incidence of ventricular tachyarrhythmias and sudden cardiac death. There have been cases associated with fever, viral infections, and pneumonias—all conditions urgent care clinicians treat in abundance. This case report demonstrates how urgent care providers can diagnose a potentially lethal disorder when patients are being seen for febrile illnesses. Kathleen B. Raschka, MD Case Presentation A 55-year-old male with a history of hypertension, hyperlipidemia, and …

Read More
A Blistering Rash in an Otherwise Healthy 9-Year-Old Boy

A Blistering Rash in an Otherwise Healthy 9-Year-Old Boy

Urgent message: Impetigo is one of the most common skin infections in children, and can have a variable presentation. As such, it is essential that the urgent care provider be able to recognize this common skin infection, and to know the treatment options. Aimy T. Patel, MD, FAAP, Allison Burris, MD FAAP, and Nirav Shastri, MD, FAAP, FAMIA, ABMS-CI CASE PRESENTATION History A 9-year-old otherwise healthy boy presents with a 1-week history of an itchy …

Read More