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 …

Dig a little deeper

Tracey Quail Davidoff, MD, FCUCM I was scanning the tracking board during an urgent care shift the other day and, as usual, my brain was five steps ahead. I read the chief complaints and had already determined the questions I’d ask to guide the history based on the differential diagnoses I’d predicted. This is a regular occurrence in the UC and ED, whether we admit it or not. It’s part of how we move things …

Evaluation of Nonfatal Drowning in Urgent Care

Urgent message: Lingering warm weather and postpandemic euphoria continue to have patients eager to pursue outdoor activities, including swimming in pools, freshwater lakes, and oceans. Those who have suffered a drowning episode and whose symptoms have resolved may seek care or reassurance at the local urgent care center. Citation: Davidoff TQ. Evaluation of nonfatal drowning in urgent care. J Urgent Care Med. 2021;15(11):11-14. Case Presentation A 4-year-old Hispanic male without significant past medical history is …

Actinomyces neuii as a Cause of Vulvar Abscess

Urgent message: While abscesses are seen commonly in the urgent care setting, location and presenting complaints can offer essential clues as to the causative organism—and inform timely diagnosis and treatment decisions. Tracey Q. Davidoff, MD, FCUCM Introduction Abscesses are common in urgent care and emergency medicine and are easily treated with drainage, and in some cases antibiotics. The majority of cases are caused by Staphylococcus aureus and Streptococcal sp. Rarely, gram-negative bacilli can be found …

Dealing with an Epidemic of Information in the Midst of a Pandemic

We are in an unprecedented time in medicine as we face a pandemic of an emerging viral disease spreading rapidly across the world. Information regarding the COVID-19 pandemic is also expanding at lightning speed. This leads to an overabundance of information which can alter our decision-making abilities. This editorial will help the reader develop a plan to manage excessive information and misinformation. We’ve all about had it. Too many patients, too many worried well, not …

Bariatric Surgery Complications in the Urgent Care Center

Urgent message: Obesity continues to be a significant health problem in the United States, with more and more patients opting for a surgical solution to their own weight loss challenges. As this trend continues, urgent care providers can expect to see more patients with post bariatric surgery complaints, ranging from the typical and benign to pulmonary emboli, anastomotic leaks, and respiratory failure account. Tracey Quail Davidoff, MD, FCUCM Obesity has become one of the …

Atypical Chest Pain in a Fibromyalgia Patient Presenting to Urgent Care

Tracey Q. Davidoff, MD, FACP, FCUCM Urgent message: Underlying medical and psychiatric conditions can cloud judgment and lead to cognitive errors, which may result in potentially serious medical errors.1 Case Presentation A 31-year-old woman with a medical history significant for fibromyalgia, migraines, bipolar disorder, and anxiety presents with 2 hours of severe bilateral neck spasms, left shoulder and arm pain, and chest pain which began soon after taking a new prescription for olanzapine. She also …

Postoperative Complications in the Urgent Care Setting

Urgent message: Patients who have had recent surgical procedures may present to urgent care centers for reasons ranging from seeking reassurance to presentation of life-threatening complications. Tracey Quail Davidoff, MD Introduction Patients often experience complications—or, at least as often, fear they’re experiencing complications—after a surgical procedure. While the surgeon is often the best person for them to consult, this may not be possible for a variety of reasons. Outpatient surgical centers are opening almost at …

Tattoos and Piercings: What the Urgent Care Provider Needs to Know

Urgent message: Tattoos and piercings are becoming commonplace, but patients who experience complications with these forms of body art may present to urgent care centers, as access to dermatology and plastics specialists frequently requires a referral or extended wait periods. The urgent care provider should possess a working knowledge about how tattoos and piercings are performed, how to recognize the complications, and how to treat them appropriately. Tracey Quail Davidoff, MD TATTOOS Introduction The term …

The Red-Hot Joint

Urgent message: Septic arthritis can lead to significant morbidity if not treated in a timely manner. Bacteria within the synovial space can lead to rapid joint destruction and irreversible loss of function. When patients present to the urgent care center with a red, hot, swollen, painful joint, every attempt must be made to rule out this disease entity to prevent significant morbidity and mortality. Introduction Patients frequently present to urgent care with a red, swollen, …

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