Practice Management
Urgent message: Spinal epidural abscesses are a rare condition that can be fatal if untreated. Populations most at risk include the elderly, diabetics, and IV drug users. The most common cause of an epidural abscess is the bacteria Staphylococcus aureus. Savannah Chavez, MD; Jordan Miller, DO; J. Chika Morah, MD INTRODUCTION Incidence of spinal epidural abscesses ranges from 0.2 to 2.8 cases per 10,000 per year, with a peak incidence occurring in patients between 60 …
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Urgent message: Respiratory complaints due to use of e-cigarettes or vaping may be difficult to distinguish from those associated with influenza and other common respiratory illnesses. It is essential for the urgent care provider to ask patients who present with any respiratory complaint about vaping history, and to have a sound understanding of next steps for patients suspected of having e-cigarette or vaping-associated lung injury (EVALI). Marco Propersi, DO and Anand Swaminathan, MD, MPH Citation: …
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The patients is a 25-year-old woman who presents with 1 month of smooth, red-brown plaques on her elbows and the tops of her feet which are pruritic. The lesions are round with a slightly darker ring on the outside, with no scaling or significant surface change to the skin. She has no systemic symptoms. View the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the …
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A 74-year-old female presents to urgent care complaining of two episodes of chest pain in the past 2 days. The pain is midsternal, squeezing, does not radiate, and began at rest. The patient denies associated nausea, vomiting, diaphoresis, cough, lower extremity swelling or pain. Personal medical history is remarkable for hypertension, asthma, and diabetes. View the ECG ordered and consider what your diagnosis and next steps would be. Resolution of the case is described …
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The patient is a 28-year-old male who presents with a complaint of diarrhea and a 1-week history of abdominal pain. He reports no food allergies, recent travel, or known exposure to sick contacts. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent message: The capability to identify patients with COVID-19 before they undergo a surgical procedure is essential to the safety of the patient, the surgical team, and postoperative staff. Given the fact that many patients with the virus never exhibit symptoms, proactive preoperative testing in the urgent care center may lower the risk of spread and help quantify the rate of asymptomatic infection. Sarah Greenwood, PA; Bronson Elizabeth Delasobera, MD; Amanda Joy, PA; Rita Malley, …
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Urgent message: As visits to urgent care after possible traumatic brain injury continue to rise, so does the importance of understanding which patients require a CT scan. Assessing the value of the Canadian Computed Tomography Head Rule in making that determination can raise the urgent care provider’s ability to make informed decisions in this regard, reducing the risk of unnecessary radiation exposure in patients who are determined to not need a CT. Jessicah Ray, DHSc, …
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The patient is a 24-year-old man who presents with excessive foot odor that he describes as “worse than anything I could have imagined.” He denies pain or burning, but reports that the soles of his feet itch occasionally. He also says his feet sweat heavily when he plays recreational ice hockey a few nights a week. Upon examination, several shallow rounded pits are found on the pressure-bearing areas of the soles. View the image …
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The patients is a 48-year-old female with a family history of breast cancer who complains of 2 months of fatigue, nausea, and generalized body aches, including chest pain. She reports 40 pounds of unintentional weight loss during this time. Review the ECG taken and consider what other tests you would order, as well as possible diagnoses. (Case presented by Tom Fadial, MD, McGovern Medical School Department of Emergency Medicine.)
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The patient is a 52-year-old male who presents with a chief complaint of 1 month of right shoulder pain. View the image taken and consider what your diagnosis and next steps would be.
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