Journal of Urgent Care Medicine

A Cause of Dizziness Not to Be Missed

Urgent message: Most cases of vertigo are benign. This includes etiologies such as benign paroxysmal position vertigo, labyrinthitis, and psychogenic causes. However, there are serious, “can’t miss” etiologies which should be considered during the urgent care evaluation of a dizzy patient. Cody McCoy, DO and Michael Weinstock, MD Citation: McCoy C, Weinstock M. A cause of dizziness not to be missed. J Urgent Care Med. 2023;17(5):13-16. Key words: dizziness, vertigo, disequilibrium, BPPV INTRODUCTION Dizziness presents …

A Comparison of Chief Complaints, Specific Diagnoses, and Demographics of Pediatric Urgent Care Visits Before and During the COVID- 19 Pandemic: A Retrospective Study

Zaharoula A. Viennas, MD; Julie Martin, MAEd, MMS, PA-C; Benjamin Klick, MD; Tammy Speerhas, DNP, FNP-C, RN, CEN, CME; Turaj Vazifedan, DHSc; Danielle Millspaugh, DNP, FNP-C; Jennifer Ferris, MD; Margret Bedle, MD; Lauren Paluch, DMSc, PA-C; and Theresa Guins, MD Urgent message: Research has shown distinct differences in patterns of children presenting to emergency rooms during COVID-related lockdowns. However, data specific to urgent care have been lacking previously. Citation: Viennas ZA, Martin J, Klick B, …

A 28-Year-Old with Tibial Pain After Prolonged Exercise

A 28-year-old male presents complaining of anterior shin pain. He shares that he is a runner training for a marathon, and that the pain began toward the end of an 18-mile run. There was no direct trauma. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 52-Year-Old Male with Shortness of Breath and a History of Multiple Cardiologic Issues

A 52-year-old male with a history of hypertension, hyperlipidemia, and recent myocardial infarction (1 month ago) presents to urgent care with shortness of breath for the past week. He denies fever, chest pain, or cough. On examination, the patient is breathing comfortably and saturating well on ambient air. Review the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

A 7-Year-Old Boy with New Facial Rash

A woman brings her 7-year-old son to the urgent care center with a rash that had developed “over the past few weeks.” On examination, there are smooth, pink papules around the mouth. The mother reports that the patient has a history of asthma, for which he uses inhalation budesonide daily as maintenance therapy. Otherwise he is healthy, has no systemic symptoms, and is well-appearing. View the photo taken and consider what your diagnosis and next …

Atypical Chest Pain Reveals Rare T-Cell Lymphoblastic Lymphoma: A Case Report

Urgent message: Not all patients presenting to urgent care with chest pain require immediate transfer to a higher-acuity setting. Rather, immediate evaluation in the urgent care center can inform next steps for management on site or, in the event of truly emergent symptoms, transfer. Tushar Menon, MD; Sahil Kapur, DO; Ameera C. Mistry, MD; and David M. Boyd, MD Key words: T-call lymphoblastic lymphoma, non-Hodgkin’s lymphoma, anterior mediastinal mass, chest pain ABSTRACT Chest pain patients …

Abstracts in Urgent Care – February 2023

Ivan Koay MBChB, MRCS, FRNZCUC, MD Quinolone Eardrops and Achilles Tendon-Related Outcomes Take-home point: Quinolone eardrops were associated with an increased risk of all-type tendon rupture, including Achilles tendon (AT), but not AT tendinitis. Citation: Tran P, Antonelli P and Winterstein A. Quinolone ear drops and Achilles tendon rupture. Clin Infect Dis. 2022; ciac709. Epub ahead of print September 6, 2022. Relevance: Systemic quinolones have been known to increase the risk of tendon rupture. Prior …

Investigation of Healthcare Disparities in the Treatment of Bacterial Infections: An Assessment of a Single Urgent Care Clinic

Urgent message: While management of infection is often guideline-dependent, studies have revealed disparities in the treatment and management of several infections among clinical sites in the United States. Current literature suggests social determinants of health and other factors may also influence treatment and management of disease states. Derrick Murcia, BS; Ryan Loh, PhD; Omar Samara, BS; Anthony Monzon, MBA; Sterling Lee, BA; Alex Nguyen, BS; and Lindsey E. Fish, MD Citation: Murcia D, Loh R, …

A 70-Year-Old Male Who Presents in a Confused State

A 70-year-old male presents to urgent care with confusion. On exam, the patient is tachypneic and is, indeed, confused but is able to follow commands. View the initial ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 41-Year-Old Woman with a History of SLE and Sudden-Onset Sores on Her Limbs

A 41-year-old woman with a history of systemic lupus erythematosus presents for evaluation of painful areas that had developed on her upper, outer arms and lateral thighs over the past month. She reports that while the affected areas were initially smooth, some had begun to ulcerate. View the photo taken and consider what your diagnosis and next steps would be.