Practice Management
Urgent Message: Lymphadenopathy in patients living with HIV is most commonly related to HIV infection, but it may also be related to many forms of systemic infection or malignancy. Definitive diagnosis is most often achieved by fine-needle aspiration. Hana Kusumoto, MD, MPH; Lindsey E. Fish, MD Citation: Kusumoto H, Fish LE. Insidious Unilateral Axillary Swelling in a Patient with Untreated HIV: A Case Report. J Urgent Care Med. 2025; 19(8):31-35 Key words: Diffuse Large B …
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A 17-year-old male presents to urgent care with syncope. He has a family history of sudden cardiac death. He is well appearing and with normal vital signs. 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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Urgent Message: There are limited data on implementation and use of clinical decision support tools for the evidence-based management of asthma in pediatric urgent care settings. In this pilot project, providing reports and feedback to clinicians on their use of order sets increased utilization of order sets but not adherence to best practice guidelines for asthma care. Richmond Darko, MD, MPH; Andrea Aguilera, MD; Gabriela Lins, DO; Maria Ramon-Coton, MD Citation: Darko R, Aguilera A, …
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A 55-year-old woman presents to urgent care with complaints of arthralgia and a pustular rash on her hands. She has a past medical history of Crohn disease and has taken infliximab as treatment for the past year. The patient has no recent history of travel or infections and no history of any skin conditions. On dermatological examination, multiple pustules, some becoming confluent to form “lakes of pus,” were seen on the palms and fingers. Bacterial …
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Which Topical Agent is the Best Choice for Epistaxis? Take Home Point: This study found that oxymetazoline was most effective in achieving hemostasis in cases of epistaxis when compared to tranexamic acid (TXA) and an epinephrine-lidocaine combination (ELC) solution. Citation: Celik T, Altun M, Kudu E, et. al. Comparison of the efficacy of oxymetazoline, tranexamic acid, and epinephrine-lidocaine combination in the treatment of epistaxis. Am J Emerg Med. 2025 Feb 23:91:104-109. doi: 10.1016/j.ajem.2025.02.036 Relevance: Controlling …
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Urgent Message: Metronidazole, even during short courses of therapy, can result in disabling neuropsychiatric symptoms. It is important for clinicians to be knowledgeable about these relatively uncommon but serious adverse medication reactions. Faren Clum, MD; Joshua Russell, MD, MSc, ELS, FCUCM, FACEP Citation: Clum F, Russell J. Recurrent Neuropsychiatric Symptoms in a Patient With Repeated Exposure to Metronidazole: A Case Report. J Urgent Care Med. 2025; 19(7):37-41 Abstract Introduction: Metronidazole is a commonly prescribed antibiotic. …
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Urgent Message: Spontaneous pneumothorax (PTX) occurs unpredictably. Many patients with spontaneous pneumothorax may initially present to urgent care, so it is important for clinicians to include it in the differential diagnosis of patients presenting with acute chest pain and/or dyspnea. Rarely, a spontaneous pneumothorax can progress to a tension pneumothorax if the diagnosis is delayed. Vrunda Patel, BS; Kevin Radecki, MD Citation: Patel V, Radecki, K. Urgent Care Evaluation and Management of Spontaneous Pneumothorax. J …
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Evaluating Interventions for Improving Antibiotic Stewardship in Urgent Care Take Home Point: An antibiotic stewardship intervention was associated with reduced rates of antibiotic prescribing for patients with bronchitis, but not viral upper respiratory infections (URI). Citation: Park D, Roberts A, Hamdy R, et. al. Evaluating an urgent care antibiotic stewardship intervention: a multi-network collaborative effort. Infect Control Hosp Epidemiol. 2025; Jan 8:1-6. doi: 10.1017/ice.2024.213 Relevance: Antibiotic prescribing for conditions not caused by bacterial infection remains …
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A 28-year-old woman presents to urgent care after an indoor rock-climbing event. She fell 10 feet from the wall without any safety gear to break the fall. She describes deep pain in her left foot, and she is limping. An exam reveals dorsal and plantar midfoot tenderness and bruising across the dorsal foot. A 3-view x-ray series is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the …
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A 65-year-old female with a history of hypertension presents with chest pain and dyspnea for 1 day. She denies fever, cough, nausea, vomiting, or abdominal pain. Upon arrival to urgent care, her respiratory rate was 28 breaths per minute, blood pressure 179/102, and oxygen saturation 92% on room air. 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 …
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