Practice Management
A 62-year-old female presents to urgent care with acute dyspnea that worsened significantly 2 hours prior to arrival. She has noted progressive shortness of breath over the past week but now feels severely winded. She denies chest pain, cough, fever, leg swelling, or history of deep vein thrombosis. On evaluation, the patient is tachycardic and tachypneic with a heart rate of 110 beats per minute and an oxygen saturation of 91% on room air. She …
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Urgent Message: Necrotizing fasciitis may present without visible soft tissue abnormalities. Therefore, clinical signs and symptoms—including localized pain and tachycardia—are findings that should warrant further clinical investigation. Abstract Introduction: Necrotizing fasciitis (NF) is a severe, rapidly progressing soft tissue infection. Early NF may present to urgent care without visible soft tissue abnormalities. As such, clinical signs and symptoms, including localized pain with tachycardia, should warrant further clinical investigation. Case Presentation: A 43-year-old male presented to …
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An 86-year-old male presents to urgent care with intermittent palpitations for the past several days. He says he has a history of Wolff-Parkinson-White syndrome.An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 59-year-old male with a past medical history of hypertension presents with dyspnea and pleuritic chest pain in urgent care, and an ECG is obtained. View the ECG captured below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 52-year-old male presents to urgent care complaining of palpitations. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Francesca Cocchiarale, DO; Alexa Bailey, MS-3; Michael Weinstock, MD Urgent Message: Pulmonary embolism can be frequently missed as a diagnosis because it can present with a variety of signs and symptoms. Understanding clinical decision rules and myriad presentations can help urgent care providers determine when patients benefit from immediate referral to an emergency department. Citation: Cocchiarale F, Bailey A, Weinstock M. An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism …
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