Journal of Urgent Care Medicine

Intraoral Angioedema After Olanzapine Overdose: A Case Report

Urgent Message: Patients may present to an urgent care facility with intraoral angioedema, a life-threatening emergency that requires referral to an emergency department in any case with rapid progression or concerns for airway involvement. This case report describes angioedema from olanzapine, an antipsychotic prescription drug. Chantelle Petterson, BDS, Benjamin Fu, MD, BDSc (HONS), MPhil, FRACDS (OMS) Citation: Petterson C, Fu B. Intraoral Angioedema After Olanzapine Overdose: A Case Report. J Urgent Care Med. 2024; 18(9):34-36 …

Influence of Clinical Setting on Antibiotic Prescribing Practices for Acute Otitis Media in Children at an Urban Academic Medical Center

Urgent Message: This retrospective chart review study found that the odds of children receiving an antibiotic prescription for acute otitis media in urgent care and the emergency department were significantly higher compared to a primary care setting. Further research is needed to better understand factors contributing to higher antibiotic prescribing rates in acute care settings. Angelica M. Mangahas, BS; Heather M. Weinreich, MD, MPH; Johanna Wickemeyer, MD; Margaret Schmit MD; Rakhi Thambi, MD, MBA Citation: …

48-Year-Old With Foot Pain After Hiking

A 48-year-old man presents to urgent care complaining of pain in his right foot after hiking last weekend on a rough trail. He denies any trauma or specific injury. Review the images below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

42-Year-Old With Stinging Sensation

A 42-year-old woman presented to urgent care early in the morning saying that she felt a stinging sensation on her arm while she was cleaning her basement the previous day. She thinks it might be a bite but didn’t see anything. She had subsequent marked pain at the site and over the past few hours developed nausea and muscle aches. On physical examination, the patient had a temperature of 101.3°F (38.5°C). There were reddish-brown reticulate …

57-Year-Old With Progressive Dyspnea

A 57-year-old man presents to urgent care with progressive dyspnea for 1 month. The patient has a history of unmanaged hypertension. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Expanding the Differential of Thunderclap Headache Beyond Subarachnoid Hemorrhage: A Case Report

Urgent Message: Cerebral venous thrombosis is a serious cause of headache that can present in a variety of manners, including sudden-onset or “thunderclap” fashion. Caroline S. Mifsud, OMS-IV; Jordan L. Jones, OMS-IV; Michael B. Weinstock, MD Citation: Mifsud C, Jones J, Weinstock M. Expanding the Differential of Thunderclap Headache Beyond Subarachnoid Hemorrhage: A Case Report. J Urgent Care Med. 2024; 18(8):21-24 Key Words: dural sinus thrombosis, cerebral venous thrombosis, headache, thrombophilia, case report Abstract Introduction: …

A Review of Genital Mycoplasma and Ureaplasma Infections for the Urgent Care Clinician

Urgent Message: Mycoplasma species, most notably Mycoplasma genitalium are an increasingly recognized etiology of persistent urethral discomfort and non-gonococcal urethritis in males. These infections are commonly asymptomatic and can also have significant consequences in females. Antibiotic resistance is a common concern and treatment recommendations differ significantly from those for other sexually transmitted infections. Joseph Something, PA-C; Greg Smithers, PA-C; Ina Park, MD, MS Citation: Something J, Smithers G, Park I. A Review of Genital Mycoplasma …

Abstracts in Urgent Care – May 2024

Encouraging Shorter Course Antibiotic Prescribing Take Home Point: In this quality improvement project, both education with performance feedback in combination with clinical decision support (CDS) were effective in modifying clinician behavior surrounding antibiotic prescribing. Citation: Vernacchio L, Hatoun J, Patane L, et al. Improving Short Course Treatment of Pediatric Infections: A Randomized Quality Improvement Trial. Pediatrics.2024;153(2): e2023063691 Relevance: There is increasing evidence that shorter courses of antibiotics for the treatment of pediatric pneumonias (CAP) and …

Urgent Care Evaluation and Management of Boxer’s Fractures

Urgent Message: Boxer’s fractures are among the most common hand fractures and should be suspected in cases of closed fist injury. Additionally, a laceration that accompanies a boxer’s fracture may represent a fight bite, which should be treated to reduce the risk of infection. Jennifer Hicks, DO; Bradley Strauch, MD Citation: Hicks J, Strauch WB. Urgent Care Evaluation and Management of Boxer’s Fractures. J Urgent Care Med. 2024; 18(8):32-36 Editor’s Note: While the images presented …

NSAIDs in Urgent Care and Emergency Departments: A Narrative Review

Urgent Message: This narrative review of non-steroidal anti-inflammatory drugs (NSAIDs) characterizes the specific evidence-based indications, previous studies on dosing and route, and side effects of these medications. It supports NSAIDs as an important class of medications in the management of acute pain in urgent care and emergency settings. Campbell Belisle Haley, MD; Andy T. Hsueh, MD; Chih-Hsuan Chen, MD; Ariana M. Nelson, MD Citation: Belisle Haley C, Hsueh AT, Chen CH, Nelson A. NSAIDs in …