fever Archives - Journal of Urgent Care Medicine

When a Fever is Not a URI: If It’s Not in the Differential, It Won’t Be in the Diagnosis

Urgent message: Fever in patients presenting to UC is often attributable to viral infections, urinary tract infections, otitis media, cellulitis, or pneumonia. When the source is not apparent after the initial evaluation, however, it is important to expand the differential in order to avoid missing less common, serious diagnoses. Samidha Dutta, DO; Caleb Marsh, OMS-IV, UP-KYCOM; Michael Weinstock, MD CASE PRESENTATION A 74-year-old man with a history of Parkinson’s disease and diabetes presented with 2 …

Abstracts in Urgent Care November 2022

Fever: To Treat or Not to Treat? Distinguishing Viral from Bacterial Conjunctivitis Scapular Fractures and Blunt Chest Trauma in Children Sterile vs Nonsterile Gloves for Laceration Repair Bronchiolitis Care: An Update Antibiotic Stewardship and Children Post Paxlovid Rebound Ivan Koay MBChB, FRNZCUC, MD What Are the Consequences of Treating Adult Fever? Take-home point: Fever therapy in adults does not seem to affect the risk of death and serious adverse events. Citation: Holgersson J, Ceric A, …

A 13-Year-Old Girl with Fever, Chills, Dry Cough, and Myalgia

A mother brings her 13-year-old daughter to your urgent care center with a complaint of fever, chills, dry cough, and myalgia for 3 days. On exam, the patient is febrile (101°F). In addition, there is conjunctival injection and blanching erythematous patches on the face and neck. The mother mentions that the family returned from a trip to Brazil 10 days prior. While traveling they ate local food, drank local (unfiltered) water, sustained a few mosquito …

A 73-Year-Old Man with a 2-Week History of Palpitations

Case The patient is a 73-year-old male smoker who complains that he has had intermittent palpitations for the past 2 weeks. He denies chest pain, diaphoresis, fever, or dizziness. He uses home oxygen, 2 L/min, but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented x 3 Lungs: Scattered minimal wheezing, which is symmetric Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, …

Ten-Day Dry Cough in a 36-Year-Old Man

Case A 36-year-old man presents to an urgent care center with a dry cough that he has had for the preceding 10 days. He has mild dyspnea. He has no rhinorrhea, fever, chest pain, blood in the urine or stool, or lower-extremity pain or swelling. He has no history of previous illnesses. He smokes cigarettes, occasionally drinks alcohol, and has a remote history of intravenous drug use. View the image taken (Figure 1) and consider …

Productive Cough and Chills in an Adult

A 37-year-old woman without a significant past medical history presents after 3 days of a cough that produces yellow sputum with some streaks of blood. She has not checked her temperature but says she has “felt warm” and has some chills. She does have associated shortness of breath, but she reports that she has not had chest pain, leg pain or swelling, sweating, or headache. She has a history of hypertension, and she takes an …

Eighteen-Year-Old with Cough and Yellow Sputum

An 18-year-old young woman without a significant past medical history presents after 4 days of a cough productive of yellow sputum. Her mother states that her daughter has felt warm to the touch, but she has not checked her temperature with a thermometer. View the radiograph obtained (Figure 1) and consider what your diagnosis would be.

Fever Phobia: Urgent Fears in Urgent Care

Urgent message: Fear of fever leads many parents to seek urgent care. Addressing their fears should be part of the care of febrile children. DEENA R. ZIMMERMAN, MD, MPH, IBCLC; NAHUM KOVALSKI, MD; BARUCH HAIN, BA; and JOSHUA LIPSITZ, PHD In several studies, researchers have found that a large percentage of parents have fever phobia, or inaccurate beliefs about the harmfulness of an elevated body temperature. Those studies were conducted in primary-care settings, so we …

27-year-old man with a cough and fever

This x-ray was taken on a 27-year-old man with a cough and fever. View the image taken (Figure 1) and consider what your diagnosis would be

3-year-old boy with a cough and fever

This x-ray was taken on a 3-year-old boy with a cough and fever. View the image taken (Figure 1) and consider what your diagnosis would be.

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