Journal of Urgent Care Medicine

Cat Scratch Disease Presenting as Parinaud’s Oculoglandular Syndrome

Urgent message: Cat scratch disease caused by the bacteria Bartonella henselae typically presents as isolated lymphadenopathy in the region draining the inoculation site (cat scratch or saliva), as well as systemic symptoms such as a fever and malaise. In otherwise healthy people, oculoglandular symptoms are occasionally seen as a complicated presentation. CSD should be included in the differential diagnosis of these symptoms. Joseph V.M. Kelly, MD, MBA, Nicholas Baltera OMS I, and Ronald Dvorkin, MD, …

A Pregnant Mother Presenting to Urgent Care with Chickenpox

Urgent message: Failure to correctly diagnose and provide immediate treatment for varicella zoster virus (VZV) infection in pregnant patients can lead to life-threatening complications for the mother, and serious congenital malformations to the fetus. Samrana Arefeen, MD and Khalid Aziz, MD Introduction There are several types of skin lesions and rashes that are common during pregnancy. Some are benign and confer no risk to the expectant mother or the fetus. However, some are symptoms of …

Post Sports Injury Burn Due to Inappropriate Use of Cryotherapy

Urgent message: PRICE (protection, rest, ice, compression and elevation) treatment is often advised to patients as part of sports soft tissue injuries; however, incorrect use of cryotherapy may lead to complications. Amitesh Kumar, MD Introduction Cryotherapy involves application of ice on acute soft tissue injuries in the form of ice cubes, ice packs, ice towels, ice massage, frozen gel packs, ethyl chloride, and other chemical devices. The goal is temperature reduction of 10-15⁰ C1 to …

A 32-Year-Old Male with Unsteady Gait

Urgent message: Early diagnosis and management of multiple sclerosis are crucial for long-term prognosis. Urgent care providers must be vigilant with proper history taking and thorough physical examination when looking for signs and symptoms of early MS. Waqas Memon, MD, Zonaira Shabbir, OMS IV, and Muhammad Akhtar, MD, FACP Introduction In the early course of multiple sclerosis (MS), the initial symptoms are nonspecific and intermittent, which makes the diagnosis challenging.1 Focusing on common symptoms and …

Rhabdomyolysis in a Previously Healthy 33-Year-Old Man

Urgent message: Life-threatening degrees of rhabdomyolysis can be seen in young, healthy patients with stable presentation and nearly normal examination findings. John Shufeldt, MD, JD, MBA, FACEP and Zana Alattar, MS3 Introduction This case demonstrates the importance of considering and ruling out rhabdomyolysis in patients with myalgia. We describe a case illustrating the management and work-up of myalgia in a young, healthy individual to identify the underlying cause. As with many illnesses, the …

Leg Pain in a 34-Year-Old Man

Urgent message: The ability to differentiate deep vein thrombosis from other diagnoses such as cellulitis is important in choosing the correct treatment option. Jeff Heimiller, MD Case Presentation A 34-year-old male presented with a 1-week of right calf pain that was exacerbated by palpation and walking. He was unable to see his primary care physician that day, so he went to urgent care for evaluation. The patient also reported a sensation of shortness of breath …

Cervical Facetitis—An Unusual Cause of Neck Pain

Urgent message: Though neck pain is a common complaint among patients presenting to urgent care centers, cervical facetitis is a relatively uncommon cause. Nonetheless, urgent care providers should consider it in the differential diagnosis for patients presenting with neck pain, even those who are afebrile. Mark Richman, MD, MPH; Brendan Appold, MS; and Jennie Soniega-Sherwood, MPH Case Presentation The patient is a 62-year-old-female with no significant past medical history who presented to a hospital-based urgent …

An Uncommon Clinical Presentation of Ovarian Torsion

Urgent message: Abdominal pain is an extremely common complaint in the urgent care setting. The differential diagnosis of abdominal pain is often a challenge, however, because many symptoms and signs are nonspecific. Ovarian torsion usually presents with sudden onset of severe, unilateral lower abdominal pain, associated with nausea and vomiting; however, in a small percentage of cases, the clinical course is prolonged, as the torsion can be intermittent. While failure to consider ovarian torsion in …

Cardiopulmonary Emergency Masquerading as Gastrointestinal Symptoms

Nihar B. Gala, MD Urgent message: The ability to distinguish between urgent and truly emergent conditions is an essential skill for all urgent care providers. That distinction is especially challenging when symptoms could indicate either a relatively benign diagnosis that is well within the purview of the urgent care setting or a more dire diagnosis better suited for a higher-acuity setting. Introduction “Familiar” symptoms such as vomiting, diarrhea, and abdominal pain could be due to …

A 38-Year-Old Man with Chest Pain

Urgent message: When a relatively young patient presents to urgent care with chest pain, there may or may not be a “typical” cause. Prompt evaluation and accurate assessment of risk factors are essential to efficient care and, often, the patient’s survival. Max Palatnik, MD Case Presentation A 35-year-old male presented at 21:59 with a chief complaint of chest pain; at 22:03, we noted the following: Temp: 98.9 Pulse: 103 Resp: 16 Syst: 122 Diast: 69 …