Journal of Urgent Care Medicine

Diabetic Ketoacidosis Due to Intra-articular Steroids: A Case Report

Tracey Quail Davidoff, MD, FCUCM Urgent Message: Corticosteroid use is common, and patients receiving corticosteroids of any type are at risk for hyperglycemia and possible ketoacidosis. Citation: Quail Davidoff T. Diabetic Ketoacidosis Due to Intra-articular Steroids: A Case Report. J Urgent Care Med. 2023;18(2):39-40 Key Words: polyuria, polydipsia, glucosuria, ketoacidosis, corticosteroids, intra-articular corticosteroids. Abstract A 63-year-old male presents to urgent care with a self-diagnosis of urinary tract infection (UTI). The patient had been experiencing urinary …

What Happens If We Do Nothing?

Joshua Russell, MD, MSc, FCUCM, FACEP In its most modern form, medicine revolves around action. We are trained as clinicians to assess, diagnose, and intervene, but it’s the intervention part that patients expect most. This is especially true in urgent care (UC), where patients usually present in anticipation of some swift action for whatever is bothering them. I recently saw a healthy, middle-aged man in our clinic who was complaining of some mild chest pain. …

46-Year-Old Male With Severe, Worsening Chest Pain

A 46-year-old man with a history of hypertension presented in an urgent care center saying he’s had chest pain for 2 days. He also said the pain has been worsening each day, and today it is severe. He denies nausea, vomiting, or shortness of breath. On exam, he appears uncomfortable but has normal vital signs. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is …

8-Year-Old With Facial Lesions

An 8-year-old-boy presented to urgent care with his father for evaluation of 3 weeks of painless facial lesions. The patient had a history of atopic dermatitis and denies systemic symptoms. On examination, he appeared well. A cluster of umbilicated papules were seen over his right cheek. View the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

4-Year-Old With Right-Sided Pelvic Pain

On a Friday afternoon, a worried mother brings her 4-year-old daughter to the urgent care. She says the girl is complaining that her “side hurts.” The mother can’t recall any recent falls or injuries. Review the image of the anterior to posterior (AP) pelvis taken upon presentation and consider possible diagnoses and next steps you would recommend to the family.

Differentiating Acute Conjunctivitis Presentations in Children

Urgent message: Make the distinction between viral and bacterial conjunctivitis to ensure children receive appropriate treatment and to avoid the negative consequences of antibiotic overuse. Julian P. Ponsetto MD, Momoko K. Ponsetto MD Download the article PDF Here Citation: Ponsetto JP, Ponsetto MK. Differentiating acute conjunctivitis presentations in children. J Urgent Care Med. 2023;17(11):15-20. Infectious conjunctivitis or “pink eye” is common in the pediatric population, accounting for 2.7% of diagnoses in pediatric urgent care.1 However, …

Headache and Paranoid Delusions: A Case Report of Missed Neurocysticercosis

Urgent Message: Headaches are common, but when patients present with concurrent psychiatric symptoms, seizures, and signs of increased intracranial pressure, clinical teams might consider asking about recent travel to assess for possible neurocysticercosis. Naail Tariq, Cavan Scheetz, Michael Weinstock, MD Download the article PDF Here Citation: Tariq N, Scheetz C, Weinstock M. Headache and Paranoid Delusions: A Case Report of Missed Neurocysticercosis. J Urgent Care Med. 2023;17(X);31-34. Abstract Introduction Headache is a common urgent care …

When a Bleeding Hemorrhoid Is a Sign of Something More Sinister

Urgent Message: An expanded list of differential diagnoses can help clinicians identify when isolated bleeding is related to a more serious condition, as was the situation with this case of acute lymphoblastic leukemia. Download the article PDF Here Naushair Hussain, MD, Ahmad Ali, MD, Michael B. Weinstock, MD Citation: Hussain N, Ahmad A, Weinstock M. When a Bleeding Hemorrhoid Is a Sign of Something More Sinister. J of Urgent Care Med. 2023;17(X); 35-37 Key words: …

Abstracts in Urgent Care – October 2023

Which Sample is More Accurate for STIs: Vaginal or Urine? Take Home Point: Vaginal swabs are the optimal sample type for women being evaluated for chlamydia, gonorrhea, and/or trichomoniasis. Citation: Aaron K, Griner S, Footman A, et. al. Vaginal Swab vs Urine for Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis: A Meta-Analysis Ann Fam Med. 2023 Mar-Apr;21(2):172-179. doi: 10.1370/afm.2942 Relevance: Many sexually transmitted infections (STI) are asymptomatic in women and can have serious …

Cold Air For Croup Isn’t an Old Wives’ Tale

Results from a randomized controlled trial presented in Pediatrics indicates that exposing children with laryngotracheobronchitis/acute viral laryngotracheitis to cold, outdoor air (<10°C or <50°F) can be beneficial in reducing symptoms when used as an adjunct to oral dexamethasone. Children in the trial were aged 3 months to 10 years and were seen in a tertiary pediatric emergency department, where they received a single dose of 0.6 mg/kg oral dexamethasone. The group of patients who were …