Patient with Sore Throat, Difficulty Swallowing, and Fever
By Joseph Hourizadeh, DO; Richard D. Susi, MD; Joseph Kelly, MD; & Afaq Sharieff, MDA 56-year-old man arrived by car to the emergency department complaining of sore throat, difficulty swallowing, and fever. The patient was previously healthy and up to date with his immunizations. He reported that the pain had started roughly 14 hours earlier and had intensified.He had taken ibuprofen and acetaminophen with no relief. He mentioned that he had pain in his throat, increasing dysphagia, and increasingly difficulty swallowing. He did not complain of any shortness of breath or difficulty breathing. Oral temperature taken at ...
Source: The Case Files - October 15, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
The Case Files: Patient with Sore Throat, Difficulty Swallowing, and Fever
By Joseph Hourizadeh, DO; Richard D. Susi, MD; Joseph Kelly, MD; & Afaq Sharieff, MD
A 56-year-old man arrived by car to the emergency department complaining of sore throat, difficulty swallowing, and fever. The patient was previously healthy and up to date with his immunizations. He reported that the pain had started roughly 14 hours earlier and had intensified.
He had taken ibuprofen and acetaminophen with no relief. He mentioned that he had pain in his throat, increasing dysphagia, and increasingly difficulty swallowing. He did not complain of any shortness of breath or difficulty breathing. Oral temperature take...
Source: The Case Files - October 15, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Serious and Unusual Reaction to Naloxone Administration
By Anthony Congeni, Alex Fox, MD, & Andrew King, MDNaloxone is given routinely in the hospital and prehospital setting without much concern for significant morbidity. Many providers are unaware of its potential complications, including pulmonary edema, and may be caught off guard when respiratory distress occurs in an awake patient who was previously rescued with naloxone.The use of naloxone is now common in anesthesiology and emergency medicine for patients with concern for opiate toxicity. Its use, however, is not without occasional morbidity, particularly cardiopulmonary complications including pulmonary edema. (J T...
Source: The Case Files - July 14, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
The Case Files: Serious and Unusual Reaction to Naloxone Administration
By Anthony Congeni, Alex Fox, MD, & Andrew King, MD
Naloxone is given routinely in the hospital and prehospital setting without much concern for significant morbidity. Many providers are unaware of its potential complications, including pulmonary edema, and may be caught off guard when respiratory distress occurs in an awake patient who was previously rescued with naloxone.
The use of naloxone is now common in anesthesiology and emergency medicine for patients with concern for opiate toxicity. Its use, however, is not without occasional morbidity, particularly cardiopulmonary complications including pulmonary edema. ...
Source: The Case Files - July 14, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Solid Organ Injury and Hemorrhagic Shock after a Fall
BY CHARLES BURTIS, MD; ANN HAYNES, MD; & ANDREW KING, MDA 59-year-old woman presented to the emergency department complaining of worsening abdominal pain and distension as well as four episodes of syncope and lightheadedness. The patient reported a past medical history of hypertension and hypothyroidism, but denied other comorbidities. The patient reported that she was walking her dog the previous night when the dog bolted forward, causing her to lose her balance and fall forward.The patient reported that she was able to tuck into a ball and roll, sustaining minor trauma only to her right side. She denied any ...
Source: The Case Files - June 23, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
The Case Files: Solid Organ Injury and Hemorrhagic Shock after a Fall
By Charles Burtis, MD; Ann Haynes, MD & Andrew King, MD
A 59-year-old woman presented to the emergency department complaining of worsening abdominal pain and distension as well as four episodes of syncope and lightheadedness. The patient reported a past medical history of hypertension and hypothyroidism, but denied other comorbidities. The patient reported that she was walking her dog the previous night when the dog bolted forward, causing her to lose her balance and fall forward.
The patient reported that she was able to tuck into a ball and roll, sustaining minor trauma only to her right side. She denied any hea...
Source: The Case Files - June 23, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Face and Neck Swelling Hint at a Daunting Diagnosis
By Mohammed Hassan-Ali, MSC & Ahmed Raziuddin, MDA 56-year-old black man presented to the ED complaining of face and neck swelling. An initial history was difficult to obtain because the patient did not speak English fluently and had slurred speech. Symptoms started approximately a week earlier when the patient was at his nursing home. He denied dysphagia or odynophagia, he had no rashes, pruritus, dyspnea, or peripheral edema, his face was flushed, and he had visibly-engorged neck veins. He noticed that his tongue was mildly swollen, so he took Benadryl for a week with no relief. The patient said he believed that the ...
Source: The Case Files - May 26, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
The Case Files: Face and Neck Swelling Hint at a Daunting Diagnosis
By Mohammed Hassan-Ali, MSC & Ahmed Raziuddin, MD
A 56-year-old black man presented to the ED complaining of face and neck swelling. An initial history was difficult to obtain because the patient did not speak English fluently and had slurred speech. Symptoms started approximately a week earlier when the patient was at his nursing home. He denied dysphagia or odynophagia, he had no rashes, pruritus, dyspnea, or peripheral edema, his face was flushed, and he had visibly-engorged neck veins. He noticed that his tongue was mildly swollen, so he took Benadryl for a week with no relief. The patient said he believed that th...
Source: The Case Files - May 26, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Unusual Growth Protruding from Patient's Vagina
BY MATTHEW J. LETIZIA, DO; & JOSEPH V. M. KELLY, MD, MBA A 19-year-old woman with no past medical or surgical history presented to the emergency department stating that she had noticed a growth protruding from her vagina. It has been painless except during intercourse and constant in all characterizations since detection three days earlier. She denies vaginal bleeding, urinary retention, incontinence, fever, injury, and back, abdominal, and pelvic pain.Her vital signs are normal, but her physical examination was significant for a 2.5 cm x 4 cm stalk-like, pedunculated, fluctuant, nontender, mobile, cys...
Source: The Case Files - April 16, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research
