Journal of Urgent Care Medicine

Abstracts in Urgent Care – April 2023

Ivan Koay MBChB, MRCS, FRNZCUC, MD Clinician Training to Optimize Antibiotic Choice and Duration for Uncomplicated Skin/Soft Tissue Infections Take-home point: Maintenance of certification (MOC) project participation was associated with improvement in evidence-based practice and was sustained after the intervention period. Citation: Wiltrakis S, Jaggi P, Lu L, et al. Optimizing antibiotic treatment of skin infections in pediatric emergency and urgent care centers. Pediatrics. 2022 Oct 1;150(4): e2021053197. Relevance: Antibiotic stewardship remains one of the …

Evaluating Abandonment of Urgent Care Prescriptions Sent to an Automated Drug Dispenser vs a Community Pharmacy: A Retrospective Cohort Study

Urgent message: Urgent care and emergency department visits focus on acute clinical conditions, with an emphasis on timely administration of medications. Patients discharged outside the typical service hours of a community pharmacy may not have access to a 24-hour pharmacy and have to return home without their prescription medication, creating additional barriers to prescription adherence for patients. Emilie M. Collongette, PharmD, BCMTMS; Sara Panella, PharmD, BCPS; Michael A. DeCoske, PharmD, BCPS; Ernesto Sanz Martinez, MD …

A Consolidation of Signs of Symptoms of Pediatric Pneumonia

Urgent message: While pneumonia in general continues to be a common diagnosis in children in the United States, relatively few studies have sought to determine the signs and symptoms that help to predict occult bacterial pneumonia. Awareness of associated signs and symptoms may assist the urgent care provider in proceeding more quickly to a correct diagnosis. Alyssa Whited, PA-C and Christina Gardner, PA-C CASE PRESENTATION A 5-year-old male with no significant past medical history presented …

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 …