Practice Management
Urgent message: No definitive treatment is available for this condition but diagnosis is important to reassure patients and avoid unnecessary care. SHAILENDRA K. SAXENA, MD, PHD, MIKAYLA SPANGLER, PHARMD, BCPS, and ARCHANA MIKKILINENI, MD Rashes are a common reason for patients to present to the urgent care clinic. Many require treatment but some do not. Schamberg’s disease is one such rash. Case Presentation A 42-year-old male presented to our clinic with a chief complaint of …
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Urgent message: With the popularity of piercing of the ear cartilage, urgent care providers need to be on the alert for perichondritis and to treat it promptly. SHAILENDRA K. SAXENA, MD, PHD, and MIKAYLA SPANGLER, PHARM D, BCPS Case Presentation A 26-year-old female presented with complaints of a swollen right pinna for 2 weeks. The swelling progressively worsened over time. In addition, she also complained of severe pain of the right pinna, with an intensity …
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Urgent message: Most cases of paraphimosis can be managed in the urgent care setting and prompt treatment is necessary to avoid complications. MOHAMED A. FAYED, MD Overview An uncircumcised male’s penis consists of the penile shaft and glans penis covered by foreskin. At birth, the foreskin and glans penis are fused, which is called physiologic phimosis. Approximately half of uncircumcised males have fully retractable foreskins by age 10 years; by age 17, the foreskins of …
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Urgent message: Prompt recognition of dissecting cellulitis is important to help patients receive appropriate treatment and avoid long-term conse – quences such as alopecia. MOHAMED A FAYED, MD Introduction Dissecting cellulitis of the scalp is a chronic skin condition for which patients often present to urgent care providers. Prompt recognition of such cases could have significant potential benefit to patients in ensuring successful treatment and preventing complications. Case Presentation A 39-year-old African-American male presented with …
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Urgent message: For patients with flu-like symptoms, a careful history and examination are important to rule out more threatening diagnoses. SHRINESH V. PATEL, MD Overview In late winter/early spring, urgent care providers often encounter patients with flu or flu-like illnesses. It is easy to assume that an individual with a typical pattern of flu-like symptoms has the flu and not consider other pathologic processes.However, alternative diagnoses should always be in the differential, and careful history, …
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Urgent message: Clinical suspicion of CA-MRSA should be high for any skin wound or soft tissue infection with delayed healing, abscess, or persistent cellulitis. RALPH S. BOVARD, MD, MPH, and ANNE REINER, MD, MPH Introduction Caregivers need to remain vigilant and challenge diagnoses to avoid complacency in the treatment of “common” problems. We all need to foster the habit of systematic and meticulous clinical evaluation. As Goethe said: “We see what we know.” Case Presentation …
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Urgent message: Close follow up is necessary for pediatric patients with vague presentations, lest a diagnosis of childhood cancer be missed. JANET D. LITTLE, MD Introduction This case presentation reflects the challenge of diagnosing childhood cancers in a timely and accurate way. The presenting signs and symptoms are oftentimes nonspecific and can mimic those of common childhood conditions.1 The frequency of delayed diagnosis for childhood cancers is high, and reflects the importance of close follow-up …
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Urgent message: Runners who train too much too soon risk serious injury. Prompt and thorough evaluation is necessary to spot CECS masquerading as “shin splints.” MATTHEW SPEER and JOHN SHUFELDT, MD, JD, MBA, FACEP Overview Running is one of the world’s most popular exercises, with millions across the globe participating and training for events from 5K races to ultramarathons of over 100 miles. Despite the fact that more than 10 million people run over 100 …
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Urgent message: Accurate, early diagnosis and appropriate antibiotic treatment of MRSA is essential to prevent subsequent morbidity and mortality. SAMINA YUNUS MD, MPH, and DONNA GOETSCH, MSN, CNP Case Presentation A 22-year-old white female presents to the urgent care clinic with a complaint of an infected spider bite on her left upper thigh. She first noted a pimple-like lesion approximately a week before presentation. The lesion has subsequently grown and developed a central, black area …
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Urgent message: Early diagnosis is crucial in patients with this rare – but potentially fatal—condition. RACHEL CETTA, BSBE, MSBE, and JOHN SHUFELDT, MD, FACEP Overview Stevens-Johnson Syndrome (SJS) is a rare and potentially life-threatening condition. While the exact etiology is unclear, SJS often is associated with an adverse drug reaction to an assortment of drugs ranging from nonsteroidal anti-inflammatory drugs (NSAIDs) to anticonvulsants.1 SJS involves blistering and sloughing off of necrosed skin, leaving a burn-like …
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