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 otherwise healthy 70-year-old, presented with a fever and cough on the right side of the chest. View the image taken (Figure 1) and consider …
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21-year-old patient with chest pain on the left side
This 21-year-old patient presented with chest pain on the left side and fever. View the image taken and consider what your diagnosis would be.
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2-year-old boy with Williams syndrome suffers fever and cough
The patient is 2-year-old boy with Williams syndrome who presents two days after a trip to the emergency room for a three-day history of fever, cough, and wheezing. In the ED, the parents report, he received three doses of nebulized albuterol and was diagnosed with reactive airway disease and bilateral otitis media. He was discharged on oral amoxicillin and albuterol MDI. Today, you find he has similar symptoms, plus vomiting. His parents say he vomited …
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7-year-old boy with persistent fever and cough
The patient is a 7-year-old boy who presents to urgent care at midnight with a four-day history of fever and cough. Two days prior, a throat culture administered elsewhere showed nothing suspicious. The parents brought him to urgent care tonight because of subsequent increasing chest pain. On exam, you find the child is not in respiratory distress, but has decreased air entry on the left side of his chest. His temperature is 101.3 degrees F, …
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32-year old female with fever, rash and scattered vesicles
The patient is a 32-year-old female who presents complaining of a fever and a rash, along with a sore throat, headache, and fatigue. On clinical examination, you note vesicles on the palms and soles. An erosion is present at the labial mucosa. A small vesicle is present on the hard palate. The patient\’s temperature is 100.5°F. Her blood pressure and vital signs are within normal limits. View the photos and consider what your next steps …
Read MoreClinical Challenge: March, 2009
The patient is a 29-year-old white male who presented three weeks after returning from a camping trip, during which he removed three ticks from his chest and back after being bitten. He reports a one-week history of fever, fatigue, hot and cold spells, and arthralgia, and a one-day history of popular rash on the dorsum of his feet (Figure 1 and Figure 2).
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January 2008
The Case of a 17-Year-Old Male with Fever and Headache
This month, we will discuss Question III: What is the incidence of deaths in patients recently discharged from the ED? In May 2007, Sklar et al performed a very interesting study concerning deaths that occurred within seven days of ED discharge. A similar study had been done in 1994 by Kefer et al, looking at medical examiner cases. Sklar’s study, however, is more likely to have captured all unanticipated deaths because it was performed at …
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