Probe Deeper if Symptoms Just Don’t Add Up

Probe Deeper if Symptoms Just Don’t Add Up

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 …

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Productive Cough and Chills in an Adult

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 …

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Chronic Cough and Shortness of Breath

Chronic 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 …

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Pediatric Abdominal Pain: Consider Pneumonia in the Differential Diagnosis

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 …

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Treatment of Pediatric Community-acquired Pneumonia in an Urgent Care Center

Treatment 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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