The Case Files: Vision Loss in a Pregnant Patient
Davis, Frederick DO; Trivedi, Shefali MD; Glantz, Sanford MD
Clinicians must consider a number of worrisome causes when a pregnant patient presents with vision changes. But what should one do when the patient has no evidence of preeclampsia and a normal ophthalmic exam?
A 22-year-old woman G1P0 at four weeks gestation presented to the emergency department for painless vision loss that had progressed over the previous 24 hours. The patient noted that she could see shapes but no longer read. She denied any floaters, headache, or head trauma. She noted recently changing medication from metoclopramide (Reglan) to an ond...
Source: The Case Files - May 25, 2012 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Case Report: Pain and Swelling of a Prince Albert Piercing
Patee, Allen MD; Farrah, Hillary MS-IV; Strony, Robert DO
A 25-year-old man presented to the ED complaining of pain, swelling, and erythema of his glans penis. The patient reported that this developed after having a new bar penile piercing five days earlier.
He had increased penile pain in his glans and swelling with painful bilateral inguinal lymphadenopathy for three days. The pain made it difficult for him to walk, and he was concerned because he felt his urine stream was obstructed and spraying. The patient reported that each night he was wrapping his penis in toilet paper and then placing a condom over the toilet pape...
Source: The Case Files - May 21, 2012 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Black and Blue: A Case Report of a Spontaneous Right Internal Jugular Vein Thrombus
Keehn, Steven DO; Margulies, Jeffrey MD; Levy, David DO; Dvorkin, Ronald MD
A 74-year-old man was brought to the ED by ambulance complaining of swelling and ecchymoses to his arms and left knee beginning on the same day. He also complained of mild, dull, intermittent right-sided neck pain, and had noticed some “extra heart beats.”
He denied abdominal pain, chest pain, dyspnea, headache, nausea, vomiting, diarrhea, and fever, but he had been released earlier that day from the same hospital after an admission for evaluation of chest pain, during which he had had a negative stress test. He was discharged on warfarin...
Source: The Case Files - May 14, 2012 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Necrotic Penile Lesion: What a Culture Swab Will Not Reveal
McGregor, Alyson J. MD; Ruskis, Jennifer MD
A 42-year-old man presents complaining of a painful penile lesion. There are no associated fevers, rashes, or recent illness. He denies penile discharge, dysuria, and hematuria. He is sexually active with one female partner. He has no history of sexually transmitted infections. The patient revealed that five days prior to presentation, the dorsum of the penile body (shaft) skin became entrapped in his pants zipper. He spent three hours attempting to disengage the zipper by forcibly removing the skin from the zipper teeth. A closer examination of the wound reveals granulation tiss...
Source: The Case Files - May 7, 2012 Category: Emergency Medicine Tags: Blog Posts Source Type: research
