An 11-Year-Old Girl with Back Pain and Chronic Poor Appetite

An 11-Year-Old Girl with Back Pain and Chronic Poor Appetite

Urgent message: Patients with recurrent symptoms should have an expanded history—including a genitourinary history in premenarchal girls. Lavanya Boddu, MD, MBA PRESENTATION The patient is an 11-year-old female brought by her mother to urgent care, with a chief complaint of back pain. The patient was pushed down at school about 2 weeks ago playing ball, landed on her buttocks, and is complaining of back pain radiating to BL hips. She is still able to walk …

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A 44-Year-Old Man with Cough of Several Weeks’ Duration

A 44-Year-Old Man with Cough of Several Weeks’ Duration

Urgent message: Lung cancer—the leading causes of cancer-related deaths in the United States—may first present with relatively benign symptoms and findings, such as those seen in urgent care. A pulmonary nodule may be the first manifestation of lung cancer in tobacco users. Early diagnosis and intervention, as well as ensuring a patient has appropriate and timely access to follow-up, is a critical measure in decreasing mortality.   Introduction Lung cancer is the second most common …

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Infection Masquerading as a Fall in the Elderly

Infection Masquerading as a Fall in the Elderly

Urgent message: Falls in the elderly may be mechanical or due to an underlying etiology, making the urgent care evaluation tricky. The provider will need to evaluate the sequelae of the fall as well as searching for the hidden cause.   Introduction Medical complaints from the elderly population will pose more of a challenge when the chief complaint is fall. The source can range from a neurologic etiology, a cardiac abnormality, or a metabolic or …

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Shortness of Breath in a Postprocedural Pneumothorax

Shortness of Breath in a Postprocedural Pneumothorax

Urgent message: Patient histories can be helpful in guiding the examination and raising red flags for possible diagnosis. However, it is essential to resist the urge to accept a patient’s self-diagnosis at face value.   Katlin F. Mattson, M3 and Shailendra Saxena, MD   Case Presentation A 65-year-old female with a history of metastatic endometrial cancer, COPD, and asthma presented with increasing shortness of breath. Four days prior, the patient had undergone a chest wall …

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Cat Scratch Disease Presenting as Parinaud’s Oculoglandular Syndrome

Cat Scratch Disease Presenting as Parinaud’s Oculoglandular Syndrome

Urgent message: Cat scratch disease caused by the bacteria Bartonella henselae typically presents as isolated lymphadenopathy in the region draining the inoculation site (cat scratch or saliva), as well as systemic symptoms such as a fever and malaise. In otherwise healthy people, oculoglandular symptoms are occasionally seen as a complicated presentation. CSD should be included in the differential diagnosis of these symptoms. Joseph V.M. Kelly, MD, MBA, Nicholas Baltera OMS I, and Ronald Dvorkin, MD, …

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A Pregnant Mother Presenting to Urgent Care with Chickenpox

A Pregnant Mother Presenting to Urgent Care with Chickenpox

Urgent message: Failure to correctly diagnose and provide immediate treatment for varicella zoster virus (VZV) infection in pregnant patients can lead to life-threatening complications for the mother, and serious congenital malformations to the fetus. Samrana Arefeen, MD and Khalid Aziz, MD Introduction There are several types of skin lesions and rashes that are common during pregnancy. Some are benign and confer no risk to the expectant mother or the fetus. However, some are symptoms of …

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Post Sports Injury Burn Due to Inappropriate Use of Cryotherapy

Post Sports Injury Burn Due to Inappropriate Use of Cryotherapy

Urgent message: PRICE (protection, rest, ice, compression and elevation) treatment is often advised to patients as part of sports soft tissue injuries; however, incorrect use of cryotherapy may lead to complications. Amitesh Kumar, MD Introduction Cryotherapy involves application of ice on acute soft tissue injuries in the form of ice cubes, ice packs, ice towels, ice massage, frozen gel packs, ethyl chloride, and other chemical devices. The goal is temperature reduction of 10-15⁰ C1 to …

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A 32-Year-Old Male with Unsteady Gait

A 32-Year-Old Male with Unsteady Gait

Urgent message: Early diagnosis and management of multiple sclerosis are crucial for long-term prognosis. Urgent care providers must be vigilant with proper history taking and thorough physical examination when looking for signs and symptoms of early MS. Waqas Memon, MD, Zonaira Shabbir, OMS IV, and Muhammad Akhtar, MD, FACP Introduction In the early course of multiple sclerosis (MS), the initial symptoms are nonspecific and intermittent, which makes the diagnosis challenging.1 Focusing on common symptoms and …

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Rhabdomyolysis in a Previously Healthy 33-Year-Old Man

Rhabdomyolysis in a Previously Healthy 33-Year-Old Man

Urgent message: Life-threatening degrees of rhabdomyolysis can be seen in young, healthy patients with stable presentation and nearly normal examination findings.   John Shufeldt, MD, JD, MBA, FACEP and Zana Alattar, MS3   Introduction This case demonstrates the importance of considering and ruling out rhabdomyolysis in patients with myalgia. We describe a case illustrating the management and work-up of myalgia in a young, healthy individual to identify the underlying cause. As with many illnesses, the …

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Leg Pain in a 34-Year-Old Man

Leg Pain in a 34-Year-Old Man

Urgent message: The ability to differentiate deep vein thrombosis from other diagnoses such as cellulitis is important in choosing the correct treatment option. Jeff Heimiller, MD  Case Presentation A 34-year-old male presented with a 1-week of right calf pain that was exacerbated by palpation and walking. He was unable to see his primary care physician that day, so he went to urgent care for evaluation. The patient also reported a sensation of shortness of breath …

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