Journal of Urgent Care Medicine

Reducing Morbidity and Mortality Due to MRSA in the Urgent Care Setting

Urgent message: Staphylococcus aureus is a common pathogen in the community—one that can lead to a range of infections, including abscess and sepsis. Invasive methicillin-resistant S aureus (MRSA) infections have decreased in the healthcare setting; however, at the same time, community-acquired infections have increased. Delayed treatment increases morbidity and mortality. Jordan Miller, DO and Ari Leib, MD AN ILLUSTRATIVE CASE A 40-year-old female presented to an urgent care center with the chief complaint of a …

An 18-Year-Old Male with Shortness of Breath and ‘Tightness’ in His Chest

The patient is an 18-year-old male who presents to urgent care complaining of 1-day history of intermittent shortness of breath, as well as a sore throat. He reports that he woke up with “chest tightness” and “discomfort.” He is unable to take a deep breath. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

An 8-Year-Old Girl with Persistent Sore Throat and Fever

The patient is an 8-year-old girl who is brought to your urgent care center by her father, who reports his daughter has had a sore throat and a fever for “a few days.” Most recently, a petechial rash has appeared, spreading from her head and neck down to her torso. She also started complaining of nausea. The father also observes that her tongue appears redder than usual. View the image and consider what your diagnosis …

Kaposi Sarcoma Presenting in the Urgent Care Setting as a Single Mass Lesion of the Foot

Urgent message: Kaposi sarcoma is considered an AIDS-defining illness with variable locations of presentation. Proper diagnosis of lesions can allow patients to seek out necessary care for potentially serious pathologies. Brad White, DO, Susannah Boulet, OMV-IV, William Billari, OMS-IV, and Jennifer Lee, OMS-IV Introduction Skin lesions and abscesses are common and often relatively benign findings that a physician may not deem serious enough for further investigation. However, as first-line providers, it is critical for urgent …

A 50-Year-Old Male with Several Chronic Conditions and Foot Pain at an Amputation Site

The patient is a 50-year-old man who presents with foot pain at the site of a right-foot amputation. He has a history of chronic renal disease, diabetes mellitus, and hypertension. View the ECG taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

A 2-Year-Old with Foot Pain After Jumping Off a Bed

The patient is a 2-year-old boy who presents with a painful, swollen foot after jumping off a bed. You observe that he limps when trying to walk. View the image taken and consider what your diagnosis and next steps would be.

A 51-Year-Old Woman with Multiple Dermatological Symptoms and Muscle Weakness

The patient is a 51-year-old woman who presented to urgent care complaining of a rash, pruritus, myalgias, and muscle weakness. The rash was an erythematous blanching patch spread across her chest in a V shape. She had also noticed that her fingernail folds were red and swollen. The patient can’t recall when she first noticed her symptoms, but reports that they’ve started affected her everyday life (such as having difficulty rising from a chair) within …

A 65-Year-Old Man with Epigastric Pain, Dyspnea, and a ‘Clammy’ Feeling

Figure 1. Case The patient is a 65-year-old man with symptoms of epigastric pain over the last 2 hours, with some dyspnea and a “clammy feeling.” He has a history of GERD and has used both an oral antacid and omeprazole within the past hours without relief. Upon exam, you find: General: Alert and oriented. Skin cool and moist Lungs: CTAB Cardiovascular: Regular rate and rhythm without f/r/g Abdomen: Soft and nontender without rigidity, …

A 57-Year-OId Man with Rib Pain with Deep Breathing

The patient is a 57-year-old man who reports to urgent care complaining of right-sided pain in his ribs when taking deep breaths. He reports that he worked out at his health club that morning before work, but denies any pain at the time or potential cause of injury related to that. Rather, he said the pain began suddenly a couple of hours later while he was at work. View the images taken and consider what …

Abstracts in Urgent Care-December

More Advice on Inquiring About—and Assessing—Vaping and EVALI Key points: Citation: Siegel DA, Jatlaoui TC, Koumans EH, et al. Update: Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury—United States, October 2019. MMWR Morb Mortal Wkly Rep. 2019;68:919–927. Key point: Physicians should inquire about e-cig or vaping use in a nonjudgemental but thorough manner. Ask about specific products, frequency, and associated drug use. …

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