Clinical Practice and Cases in Emergency Medicine最新文献_第10页

Loculated Fluid Visualized in Hepatorenal Space with Point-ofcare Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus A 组链球菌引起的盆腔炎患者肝肾间隙的定位超声显像液

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-09 DOI: 10.5811/cpcem.6663

Neil Makhhijani, Samuel E. Sondheim, T. Saul, Elizabeth Yetter

引用次数: 0

Community-Acquired Candida albicans Empyema Leading to Tension Physiology: A Case Report. 社区获得性白色念珠菌气肿导致张力性生理学：病例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.19426

Jason Cinti, Paula Gomez, Suneil Agrawal

{"title":"Community-Acquired Candida albicans Empyema Leading to Tension Physiology: A Case Report.","authors":"Jason Cinti, Paula Gomez, Suneil Agrawal","doi":"10.5811/cpcem.19426","DOIUrl":"10.5811/cpcem.19426","url":null,"abstract":"Introduction: A tension empyema, in which purulent material accumulates in the chest cavity and leads to cardiopulmonary dysfunction, is a rare complication of empyemas. Moreover, fungal empyemas that grow Candida albicans and cause tension physiology have not yet been previously described.Case report: In this report, we present an immunocompetent 30-year-old male who presented to the emergency department with worsening shortness of breath and was found to have a left-sided fungal empyema causing tension physiology. Left chest thoracostomy yielded approximately 4 liters of purulent fluid. Pleural cultures eventually grew C albicans, and after antifungal therapy, surgical decortication of the lung, and a prolonged intensive care unit stay, the patient was discharged home in stable condition.Conclusion: While mortality from C albicans empyemas that cause respiratory compromise is exceedingly high, our case highlights that aggressive management with rapid chest thoracostomy and antifungal therapy can lead to a favorable outcome.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"8 3","pages":"273-276"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-altitude Cerebral Edema and High-altitude Pulmonary Edema Diagnosed in the Desert: A Case Report. 在沙漠中诊断出的高海拔脑水肿和高海拔肺水肿：病例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.3851

Bryn Walsh, Suneil Agrawal

引用次数: 0

Spontaneous Hemothorax from Pulmonary Intralobar Sequestration: A Case Report. 肺叶内嵌塞引起的自发性血胸：病例报告

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.3259

Clayton Korson, Jasmine Yu, John M Pester

{"title":"Spontaneous Hemothorax from Pulmonary Intralobar Sequestration: A Case Report.","authors":"Clayton Korson, Jasmine Yu, John M Pester","doi":"10.5811/cpcem.3259","DOIUrl":"10.5811/cpcem.3259","url":null,"abstract":"Introduction: Pulmonary sequestration is a rarely reported phenomenon where aberrant lung tissue exists independently from the rest of the tracheobronchial network. Complications may include hemothorax; however, there is a paucity of descriptions of this condition in the literature.Case report: We describe a case of a pulmonary intralobar sequestration resulting in atraumatic tension hemothorax. A 73-year-old woman presented to our facility in extremis and with complaints of acute-onset flank pain. Her evaluation was notable for a large pulmonary sequestration with a presumed, moderate-sized effusion; however, initial review did not reveal an obvious underlying cause for her symptoms. Shortly after her arrival to the emergency department (ED) she experienced a cardiac arrest. On secondary review of her computed tomographic angiography, it was determined that what was previously thought to be a pleural effusion was a large hemothorax. Following this finding, a finger thoracostomy was performed, which resulted in the immediate evacuation of hemothorax. The thoracostomy was then converted into an ED thoracotomy to assess for active hemorrhage with brief return of spontaneous circulation. Prior to proceeding with emergent operative intervention, the patient's spouse requested that all further resuscitative efforts cease, and the patient was allowed to expire. In a review of the case, it was determined that the patient suffered from cardiac arrest due to a spontaneous hemothorax secondary to a large intralobar pulmonary sequestration.Conclusion: Pulmonary intralobar sequestration can result in spontaneous hemorrhage with fatal results. Early and correct interpretation of imaging and surgical intervention are crucial in ED management.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"8 3","pages":"287-290"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Atraumatic Infected Septal Hematoma in a Pediatric Patient. 一名儿科患者的外伤性感染性房间隔血肿

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.19476

Osher Shefer, Jacqueline Le, Eshaan Daas, Eugene Hu

引用次数: 0

Brugada Syndrome and Sudden Cardiac Death: An Electrocardiographic History. Brugada 综合征与心脏性猝死：心电图病史。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.19477

Mark L Moubarek, Gordon X Wong, James S Ford

{"title":"Brugada Syndrome and Sudden Cardiac Death: An Electrocardiographic History.","authors":"Mark L Moubarek, Gordon X Wong, James S Ford","doi":"10.5811/cpcem.19477","DOIUrl":"10.5811/cpcem.19477","url":null,"abstract":"Case presentation: A 22-year-old male with a history of anti-neutrophil cytoplasmic antibody vasculitis, renal transplant, hypertension, and no known family history of sudden cardiac death suffered a witnessed cardiac arrest. An initial rhythm strip recorded by emergency medical services revealed ventricular fibrillation. Return of spontaneous circulation was achieved after three rounds of cardiopulmonary resuscitation, defibrillation, and intravenous epinephrine. The patient was brought to the emergency department and admitted to the intensive care unit. He was diagnosed with Brugada syndrome, and an automatic implantable cardioverter-defibrillator (AICD) was placed after discharge.Discussion: Brugada syndrome is characterized electrocardiographically by ≥2 millimeters (mm) ST-segment elevation in leads V1-V2 with either \"coved type\" (type 1) or \"saddleback\" (type 2) ST-segment morphology, or ≤2 mm ST-segment elevation in V1-V2 with either \"coved\" or \"saddleback\" morphology (type 3). The absence of these patterns on isolated electrocardiograms (ECG) does not exclude the diagnosis, as dynamic fluctuations in ECG patterns are well-documented and can be induced by various physiologic stressors. This case provides an uncommon, complete electrocardiographic history of Brugada syndrome, from out-of-hospital cardiac arrest to AICD placement and depicts dynamic fluctuations between Brugada patterns and normal ECGs. This highlights the importance of serial ECGs in diagnosis, as sudden cardiac death is often the first or only presentation of Brugada syndrome.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"8 3","pages":"314-317"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Painful Enlarging Cervical Mass in Young Male. 年轻男性颈部肿块增大，疼痛难忍

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.6664

Jacob Lawing, Jeremy Towns, Matthew A Heimann

引用次数: 0

Pupil Unleashed: Unraveling the Enigma of an Unusual Traumatic Head Injury: A Case Report. 瞳孔释放：揭开异常头部创伤之谜：病例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.20308

Akash Daswaney, Shuchi Abhishek, Sanjan Asanaru Kunju, Priya Pattath Sankaran, Ahlam Abdul Rahman

{"title":"Pupil Unleashed: Unraveling the Enigma of an Unusual Traumatic Head Injury: A Case Report.","authors":"Akash Daswaney, Shuchi Abhishek, Sanjan Asanaru Kunju, Priya Pattath Sankaran, Ahlam Abdul Rahman","doi":"10.5811/cpcem.20308","DOIUrl":"10.5811/cpcem.20308","url":null,"abstract":"Introduction: Isolated oculomotor nerve palsy after mild traumatic brain injury is unusual and prognostically significant due to unclear mechanisms and recovery challenges. We present a case of isolated oculomotor nerve palsy following minor head trauma, shedding light on this unusual occurrence.Case report: A 24-year-old male experienced severe vision loss and right-sided oculomotor nerve palsy after a motor vehicle collision. Initial imaging showed a hemorrhagic focus in the left posterior fossa and a contusion in the corpus callosum, yet no direct cause for the nerve palsy was found. Partial recovery was observed after 12 months.Conclusion: This case underscores the importance of maintaining a heightened suspicion for occult intracranial findings, especially when the initial non-contrast computed tomography was inconclusive. Timely clinical assessment and appropriate radiological investigations by emergency physicians are crucial for improving the prognosis.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"8 3","pages":"282-286"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal Artery Aneurysm Rupture as a Dangerous Mimic of Ovarian Cyst Rupture: A Case Report. 肾动脉动脉瘤破裂是卵巢囊肿破裂的危险假象：病例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.1585

Lauren Kaplan, Kaushal H Shah, Christie Lech, Mary-Kate Gorlick

引用次数: 0

Testicular Traction Technique with Intact Cremasteric Reflex, a Novel Approach for Manual Detorsion: Case Report. 睾丸牵引技术与完整的偃师反射，一种手动脱肛的新方法：病例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2024-08-01 DOI: 10.5811/cpcem.1568

Garrett Trang, Taz Brinkerhoff

{"title":"Testicular Traction Technique with Intact Cremasteric Reflex, a Novel Approach for Manual Detorsion: Case Report.","authors":"Garrett Trang, Taz Brinkerhoff","doi":"10.5811/cpcem.1568","DOIUrl":"10.5811/cpcem.1568","url":null,"abstract":"Introduction: Recognizing testicular torsion is extremely important in patients presenting to the emergency department (ED) with acute scrotal pain. Traditional manual detorsion techniques are frequently employed by emergency physicians but are not always successful. Delays in detorsion increase the risk of testicular infarction and infertility, and the need for orchiectomy. Novel techniques such as the testicular traction technique have been described as a potential solution for difficult-to-detorse testicles.Case report: Our case report describes a 20-year-old male with no significant past medical history who presented to a rural ED with acute, atraumatic testicular pain secondary to testicular torsion with an intact cremasteric reflex. After confirming the diagnosis using Doppler ultrasound, manual detorsion using the traditional \"open book\" technique was attempted and unsuccessful. The patient was subsequently successfully detorsed using the novel testicular traction technique.Conclusion: The testicular traction technique is a safe, rapid, and effective primary or adjunctive technique in manual testicular detorsion. Given the time-sensitive nature of testicular torsions, adjunctive techniques play a crucial role in managing challenging detorsions, particularly in resource-limited rural settings with limited access to urologic services. Although it is commonly thought that the cremasteric reflex is absent in testicular torsions, it may be present in rare circumstances, and its presence should not be an absolute in ruling out torsion.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"8 3","pages":"226-230"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0