Journal of Urgent Care Medicine

Ten-Day Dry Cough in a 36-Year-Old Man

Case A 36-year-old man presents to an urgent care center with a dry cough that he has had for the preceding 10 days. He has mild dyspnea. He has no rhinorrhea, fever, chest pain, blood in the urine or stool, or lower-extremity pain or swelling. He has no history of previous illnesses. He smokes cigarettes, occasionally drinks alcohol, and has a remote history of intravenous drug use. View the image taken (Figure 1) and consider …

Productive Cough and Chills in an Adult

A 37-year-old woman without a significant past medical history presents after 3 days of a cough that produces yellow sputum with some streaks of blood. She has not checked her temperature but says she has “felt warm” and has some chills. She does have associated shortness of breath, but she reports that she has not had chest pain, leg pain or swelling, sweating, or headache. She has a history of hypertension, and she takes an …

Eighteen-Year-Old with Cough and Yellow Sputum

An 18-year-old young woman without a significant past medical history presents after 4 days of a cough productive of yellow sputum. Her mother states that her daughter has felt warm to the touch, but she has not checked her temperature with a thermometer. View the radiograph obtained (Figure 1) and consider what your diagnosis would be.

Fever Phobia: Urgent Fears in Urgent Care

Urgent message: Fear of fever leads many parents to seek urgent care. Addressing their fears should be part of the care of febrile children. DEENA R. ZIMMERMAN, MD, MPH, IBCLC; NAHUM KOVALSKI, MD; BARUCH HAIN, BA; and JOSHUA LIPSITZ, PHD In several studies, researchers have found that a large percentage of parents have fever phobia, or inaccurate beliefs about the harmfulness of an elevated body temperature. Those studies were conducted in primary-care settings, so we …

27-year-old man with a cough and fever

This x-ray was taken on a 27-year-old man with a cough and fever. View the image taken (Figure 1) and consider what your diagnosis would be

3-year-old boy with a cough and fever

This x-ray was taken on a 3-year-old boy with a cough and fever. View the image taken (Figure 1) and consider what your diagnosis would be.

An Age-Based Approach to Fever of Uncertain Origin in the Pediatric Patient

Urgent message: Fever in pediatric patients, while frequent, is rarely the result of a serious illness. Urgent care practitioners must be able to consistently distinguish between serious and benign causes with a minimum of invasive testing. BRENDAN KILBANE, MD, FAAP Introduction Ever is one of the most common chief complaints in pediatric patients who present for urgent evaluation. A surprising number of families continue to suffer from “fever phobia,” with one study noting that 91% …

April 2013

25-year-old female with autism and a 1-week history of fever

The patient, a 25-year-old female with autism, presented with a 1-week history of fever. View the image taken (Figure 1) and consider what your diagnosis would be. Diagnosis: The x-ray reveals a foreign body in the right airway (arrow) and an infiltrate in the right lower lobe (circle). Referral to a hospital for extraction of the foreign body and treatment is necessary for this patient. Case presented by Nahum Kovalski, BSc, MDCM, Terem Emergency Medical …

Clinical Challenge: December, 2012

In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected]. The patient, an 8-year-old male, presented with a cough and fever. Resolution of the case is described on the next page.