It was a case that easily could have presented in any urgent care center, and one that shows the importance of probing beyond social and medical history, including a patient’s profession and hobbies if necessary. The patient presented with a 7-year history of breathing difficulty that had recently worsened. The only related detail seemed to be that he had been diagnosed with hypersensitivity pneumonitis (HP, also known as farmer’s lung and hot tub lung) 5 …
Read MoreProductive 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 …
Read MoreSudden-Onset Left-Sided Chest Pain
A 32-year-old man with a history of pneumothorax presents to the urgent care after a sudden onset of left-sided chest pain that started 30 minutes earlier when he was inhaling while smoking a cigarette. He reports shortness of breath, dizziness, and diaphoresis. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreChronic Cough and Shortness of Breath
A 74-year-old man without a significant past medical history presents to an urgent care center reporting 3 days of coughing productive of green sputum, shortness of breath that worsens with exertion, and chills. He says he has a chronic morning cough but states that the sputum has changed color and that his dyspnea has increased. He says he has not had any fever, chest pain, or lower extremity pain or swelling. View the image taken …
Read MoreEighteen-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.
Read MoreClinical Challenge: March, 2015
The Case The patient presented with an upper respiratory infection after vertebroplasty. A chest x-ray was ordered to rule out pneumonia. View the image taken (Figure 1) and consider what your diagnosis would be.
Read More58-year-old woman with history of bilateral infiltrates
This x-ray was taken on a 58-year-old woman with a history of “recurrent pneumonia” and bilateral infiltrates that did not resolve with antibiotics. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreNovember 2010
Pediatric Abdominal Pain: Consider Pneumonia in the Differential Diagnosis
Urgent message: Abdominal pain can be a challenging complaint, especially in younger patients. Consider the full range of differential diagnosis in order to initiate prompt, effective management. Curtis Kommer MD, Latha Shankar, MD, MBA and Robert Stuart, MD Introduction Since the time of Hippocrates, the ability of physicians to unravel the mystery of a patient’s abdominal pain has become synonymous with the art and practice of medicine. Pediatric abdominal pain, in particular, with its extensive …
Read MoreTreatment of Pediatric Community-acquired Pneumonia in an Urgent Care Center
Urgent message: Although diagnosis of pediatric community-acquired pneumonia is not always straightforward, most cases can be diagnosed adequately by non-pediatricians and treated in the urgent care center, thereby reducing hospitalization for this condition. By Deena R. Zimmerman, MD, MPH, IBCLC, Scott Fields, MD, Nahum Kovalski, BSc, MDCM Introduction Pediatric community-acquired pneumonia (CAP) is a common illness. Estimates are that the annual incidence of pneumonia per 1,000 children in North America ranges from 30 to 45 cases …
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