Disseminated Lyme

A 33-year-old male presents to the ED with ongoing left lower extremity pain and a few days of malaise. He has a history of bipolar I disorder, as well as chronic alcohol, tobacco and marijuana use. He first presented to his primary care doctor six days ago with erythema and pain over the left medial malleolus. At that time he had no other symptoms and physical exam was otherwise unremarkable. He was treated for presumed cellulitis with doxycycline, which he took at half of the prescribed dose due to a miscommunication with his doctor…

Community EM, Dermatology, Infectious DiseaseKatherine BarrySeptember 26, 2022Lyme Disease, Disseminated LymeComment

Soft Tissue Infection: Diagnosis by Ultrasound

A 31 y.o. male presents to the Emergency Department with a chief complaint of swelling of his right leg. He has no past medical history, and his social history is significant for polysubstance use disorder and housing insecurity. He primarily injects opioids and cocaine and has had periods of time where he received medication assisted treatment with buprenorphine. On exam, there is an area of erythema and swelling on the lower right extremity that does not overly the joints. The area is warm and tender to palpation. There is no obvious wound or purulent drainage. The remainder of a 12 point Review of Systems is negative…

Ultrasound, Infectious DiseaseKeaton Cameron-BurrJuly 16, 2022Ultrasound, Infectious Disease, CellulitisComment

A Case of Recurrent Urticaria

A 50-year-old male with no significant past medical history presents to the Emergency Department with a chief complaint of facial swelling. The patient had been in his usual state of health when he awoke suddenly in the middle of the night just prior to presentation with lip swelling and an urticarial rash on his back and neck. He denies dyspnea, wheezing, trouble swallowing, nausea, vomiting, or diarrhea…

Infectious Disease, Community EMCaroline MeehanMarch 11, 2022UrticariaComment

The Anemic Patient

…The patient’s history of fatigue, dyspnea on exertion, palpitations, and pale coloring can be vague when taken separately but when put together with her pale coloring and tachycardia…

Pediatrics, Infectious DiseaseGiovanna DelucaJuly 5, 2021hematology, pediatrics, anemia, hemolytic anemia, warm AIHA, Cold AIHAComment

Red Hot in the Age of COVID: Comparing MIS-C to Kawasaki Disease

A 6-month-old vaccinated, previously healthy boy presented to the ED with fever, rash, and irritability. He had fever for four days (Tmax 102°F). Three days prior, he also developed a red non-pruritic rash and oral lesions. The rash started on his face and progressed to the rest of his body, sparing his palms and soles. His eyes have been red and irritated. He had decreased oral intake and poor urine output. His mother had been giving acetaminophen and ibuprofen. There had been no known sick or COVID-19 contacts…

Infectious DiseaseCamila TyminskiJuly 2, 2021MIS-C, Kawasaki, COVIDComment

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