Journal of Urgent Care Medicine

A 32-Year-Old with Fever, Cough, Arthralgia, and Photophobia

A 32-year-old immunocompetent male presents with fever, cough, arthralgia, and photophobia for a few days. On examination, he had a temperature of 100°F (37.8°C) and conjunctival injection. There was a widespread erythematous macular rash on his wrist. When asked about travel, the patient mentioned that he recently visited his family in the Dominican Republic. During his travels, he drank local water and sustained a few mosquito bites. His symptoms began approximately 4 days after his …

A 42-Year-Old with Swelling After a Kick to the Face

The patient is a 42-year-old male who presents with nose and facial swelling after being kicked in the face while wrestling with his teenage son. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

An 83-Year-Old Female with CHF, A-Fib, and New-Onset Confusion and Syncope

An 83-year-old female with past medical history of congestive heart failure and atrial fibrillation presents to urgent care with confusion and syncope. She reports intermittent dizziness, but denies chest pain or shortness of breath. There is no evidence of trauma on exam. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Jonathan Giordano, DO, MEd, McGovern …

A 9-Year-Old Girl with a New Rash on Her Face

A mother brings her 9-year-old girl daughter to your urgent care center because she’s concerned about a rash that developed on the girl’s face over the past week. On examination, you find a fine, scaly, pigmented plaque with pink and violaceous hues on her lower cheek. The lesion has a linear configuration. The patient and her family have a history of atopy, but the girl is well-appearing and has no systemic symptoms. View the photo …

A 40-Year-Old with Back Pain After a Fall

The patient is a 40-year-old male who presents to urgent care with lower-left back pain after an alumni soccer game during his high school reunion weekend. 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 45-Year-Old Male with Palpitations

The patient is a 45-year-old male who presents with palpitations for the past 30 minutes. He denies chest pain, dizziness, or syncope. His vital signs are normal aside from tachycardia and he appears to be in no acute distress. View the ECG taken and consider what your diagnosis and next steps might be. Resolution of the case is described on the next page.

A 43-Year-Old with a New Rash on the Trunk

A 43-year-old man presents to urgent care with a rash that he noticed a couple of days ago on his trunk. On exam, there is skin atrophy and multiple smooth papules and hypopigmented oval macules. Upon palpation of the lesions, you find that the examining finger “sinks” into a pit with distinct edges, like the ring of a hernia. The patient is immunocompetent, and his medical history is unremarkable except for lichen planus. He patient …

A 55-Year-Old Female with 1 Hour of Chest Pain

A55-year-old female presents to urgent care with chest pain that started 1 hour prior. On exam, she appears diaphoretic with normal vital signs. 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 4-Week-Old Girl with a New Rash on Her Back

A mother brought her 4-week-old daughter to the doctor concerned about a vesicular rash that developed on the girl’s back within the last day. On examination, tiny vesicles in a primarily truncal distribution were seen. The patient had no systemic symptoms and appeared well. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

An 87-Year-Old Male with Chest Pain, SOB, and a History of Valvular AFib, Stroke, and Heart Failure

An 87-year-old male with past medical history of valvular atrial fibrillation, prior stroke, and heart failure presents to urgent care with chest pain and shortness of breath for 3 days. The pain and difficulty breathing are associated with bilateral lower extremity swelling for 1 week. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.