Journal of Urgent Care Medicine

15-Year-Old With Fever

A 15-year-old girl presents to urgent care with complaints of fever, arthralgia, abdominal pain, and a widespread rash that developed over the last 2 days. The patient says that the pain in her knees is severe and debilitating. On examination, the patient has a temperature of 100.3°F (37.9°C) as well as maroon and violaceous, purpuric papules and plaques on the legs, buttocks, and face. Laboratory examination shows elevated erythrocyte sedimentation rate and C-reactive protein, proteinuria, …

Fever of Unknown Origin: A Case Report of Babesiosis Infection

Batsheva R. Sholomson, DO; Danielle Langan, DO; Abbas Husain, MD; Shorok Hassan, DO Urgent Message: With the incidence of babesiosis rising, clinicians are encouraged to consider the totality of presentation including risk factors based on endemic region, recent travel or tick bite, and clinical signs and symptoms. Citation: Sholomson BR, Langan D, Husain A, Hassan S. Fever of Unknown Origin: A Case Report of Babesiosis Infection. J Urgent Care Med. 2024; 18(10):17-21 Key Words: Babesiosis, …

An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism Diagnosis

Francesca Cocchiarale, DO; Alexa Bailey, MS-3; Michael Weinstock, MD Urgent Message: Pulmonary embolism can be frequently missed as a diagnosis because it can present with a variety of signs and symptoms. Understanding clinical decision rules and myriad presentations can help urgent care providers determine when patients benefit from immediate referral to an emergency department. Citation: Cocchiarale F, Bailey A, Weinstock M. An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism …

Schools Ease Student Return Protocol, Perhaps Too Much

The American Academy of Pediatrics offers recommendations for parents with sick kids, saying they should stay home for fever, vomiting, or diarrhea in the past 24 hours or when kids aren’t well enough to participate at school. But many school districts have their own sets of rules for when a child can or cannot come to class. According to AP News, 25% of California students missed 10% of class days last school year, and the …

Incomplete Kawasaki Disease Clinically Diagnosed From Urgent Care: A Case-Report-Based Review

Urgent Message: The accurate and prompt diagnosis of Kawasaki disease depends on clinicians’ familiarity with the diagnostic criteria and ability to recognize the waxing and waning manifestations of this pediatric condition. Dominic K. Hardatt, DMSc, PA-C Citation: Hardatt DK. Incomplete Kawasaki Disease Clinically Diagnosed from Urgent Care: A Case Report Based Review. J Urgent Care Med. 2024;18(5);34-39. Keywords: Kawasaki disease, mucocutaneous lymph node syndrome, incomplete Kawasaki disease, febrile illness, fever, polymorphous rash, pediatric, coronary artery …

When a Fever is Not a URI: If It’s Not in the Differential, It Won’t Be in the Diagnosis

Urgent message: Fever in patients presenting to UC is often attributable to viral infections, urinary tract infections, otitis media, cellulitis, or pneumonia. When the source is not apparent after the initial evaluation, however, it is important to expand the differential in order to avoid missing less common, serious diagnoses. Samidha Dutta, DO; Caleb Marsh, OMS-IV, UP-KYCOM; Michael Weinstock, MD CASE PRESENTATION A 74-year-old man with a history of Parkinson’s disease and diabetes presented with 2 …

Abstracts in Urgent Care – November 2022

Fever: To Treat or Not to Treat? Distinguishing Viral from Bacterial Conjunctivitis Scapular Fractures and Blunt Chest Trauma in Children Sterile vs Nonsterile Gloves for Laceration Repair Bronchiolitis Care: An Update Antibiotic Stewardship and Children Post Paxlovid Rebound Ivan Koay MBChB, FRNZCUC, MD What Are the Consequences of Treating Adult Fever? Take-home point: Fever therapy in adults does not seem to affect the risk of death and serious adverse events. Citation: Holgersson J, Ceric A, …

A 13-Year-Old Girl with Fever, Chills, Dry Cough, and Myalgia

A mother brings her 13-year-old daughter to your urgent care center with a complaint of fever, chills, dry cough, and myalgia for 3 days. On exam, the patient is febrile (101°F). In addition, there is conjunctival injection and blanching erythematous patches on the face and neck. The mother mentions that the family returned from a trip to Brazil 10 days prior. While traveling they ate local food, drank local (unfiltered) water, sustained a few mosquito …

Approach to Fever and Drooling in Infants and Toddlers

Urgent message: Typical drooling is no cause for alarm in infants and toddlers. However, excessive drooling accompanied by fever or other various red flags could be signs of more serious concerns such as retropharyngeal abscess, Ludwig angina, or upper airway obstruction. Recognition should trigger a thorough evaluation by the urgent care provider. Katherine P. Dureau, MD CASE A 24-month-old previously full-term and vaccinated male presents to an urgent care center with 24 hours of fever …

A 73-Year-Old Man with a 2-Week History of Palpitations

Case The patient is a 73-year-old male smoker who complains that he has had intermittent palpitations for the past 2 weeks. He denies chest pain, diaphoresis, fever, or dizziness. He uses home oxygen, 2 L/min, but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented x 3 Lungs: Scattered minimal wheezing, which is symmetric Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, …

« Previous