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

A Case Report of Acute Lymphoblastic Leukemia Presenting as Bilateral Knee Pain in a Healthy Runner. 急性淋巴细胞白血病一例报告表现为双侧膝关节疼痛的健康跑步者。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.47307

Michael Rosselli, Alejandro Sanoja, Matthew Apicella

引用次数: 0

Case Report: Pediatric Hallucinations and Anti-Neuronal Intermediate Filament Autoimmune Encephalitis. 儿童幻觉和抗神经元中间丝自身免疫性脑炎病例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.48533

Amanda H Bjornstad, Natalie Oberhauser-Lim, Tammy Phan, Emmelyn J Samones, Timothy Young

{"title":"Case Report: Pediatric Hallucinations and Anti-Neuronal Intermediate Filament Autoimmune Encephalitis.","authors":"Amanda H Bjornstad, Natalie Oberhauser-Lim, Tammy Phan, Emmelyn J Samones, Timothy Young","doi":"10.5811/cpcem.48533","DOIUrl":"10.5811/cpcem.48533","url":null,"abstract":"Introduction: Patients with psychiatric concerns often present to an emergency department (ED) for medical evaluation prior to inpatient psychiatry placement. One diagnosis to consider prior to disposition is autoimmune encephalitis (AIE). This report describes a pediatric patient who presented with psychiatric symptoms that required inpatient admission and workup to diagnose a rare form of AIE.Case report: A 16-year-old female with no known past medical history presented as a transfer from an outside hospital for medical evaluation of two days of auditory and visual hallucinations. Initial labs and imaging were unremarkable. Due to the acuity of her symptoms and abnormal vital signs, she was admitted to the hospital for further medical workup. After almost three weeks inpatient and multiple specialist consultations, she was diagnosed with anti-heavy chain neuronal intermediate filament AIE. The next month of admission included treatment with immunomodulators, antibiotics for associated infections, and malignancy evaluation. Symptoms resolved, and the patient was discharged. The patient remained asymptomatic on immunotherapies, and without psychiatric medications, the following year.Conclusion: During evaluation of psychiatric concerns in the ED, it is essential to consider organic causes of behavioral changes, which can be difficult to discern. Autoimmune encephalitis can be subtle. Features such as autonomic dysregulation, acute or subacute symptom onset, recent infection, autoimmune or malignancy history, cognitive deficits, or focal neurologic findings should raise clinical suspicion. For patients with psychiatric symptoms, the role of an emergency physician is not to diagnose autoimmune encephalitis, but to recognize nuances in patient presentations to best direct proper workup, treatment, and disposition.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 1","pages":"68-71"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158641","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

Pleural and Pericardial Effusions Associated with Semaglutide: A Case Report. 与西马鲁肽相关的胸膜和心包积液1例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.48864

Maggie Stark, Nicholas Valentini

{"title":"Pleural and Pericardial Effusions Associated with Semaglutide: A Case Report.","authors":"Maggie Stark, Nicholas Valentini","doi":"10.5811/cpcem.48864","DOIUrl":"10.5811/cpcem.48864","url":null,"abstract":"Introduction: Semaglutide, a glucagon-like peptide-1 receptor agonist, has gained increasing popularity for managing both type 2 diabetes mellitus and obesity. However, as its use increases, new adverse events are emerging. This case report presents a 70-year-old patient who developed pleural and pericardial effusions likely related to semaglutide use.Case report: Four weeks after being prescribed semaglutide, a 70-year-old woman presented to the emergency department (ED) with shortness of breath. Diagnostic testing in the ED and hospital revealed that she had both pericardial and exudative pleural effusions, along with a positive anti-nuclear antibody and elevated inflammatory markers. Her signs and symptoms improved with steroid administration, and no other etiology was identified.Conclusion: The patient was diagnosed with drug-induced lupus, likely triggered by semaglutide. This case underscores the importance of recognizing and investigating uncommon drug-related complications. With the growing use of semaglutide, clinicians must remain vigilant for rare adverse effects such as pleural effusions to ensure prompt diagnosis and treatment.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 1","pages":"93-96"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158666","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

Potassium Overdose in Patient with Chronic Kidney Disease on Losartan: A Case Report. 氯沙坦治疗慢性肾病患者钾过量1例

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.47943

Ahmed Naseem, Mark Schoenborn, James Scheidler, William Hunter Barclay, Garrett Volk

{"title":"Potassium Overdose in Patient with Chronic Kidney Disease on Losartan: A Case Report.","authors":"Ahmed Naseem, Mark Schoenborn, James Scheidler, William Hunter Barclay, Garrett Volk","doi":"10.5811/cpcem.47943","DOIUrl":"10.5811/cpcem.47943","url":null,"abstract":"Introduction: Hyperkalemic emergencies can present with weakness, paralysis, sensorimotor deficits, and potentially fatal cardiac conduction abnormalities even in the absence of an elevated serum potassium. Common antihypertensive medications, such as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, are associated with serum potassium elevations and can exacerbate hyperkalemia, especially in patients with renal impairment.Case report: We report a 49-year-old patient who presented to the emergency department six hours following an intentional ingestion of potassium supplements totaling 600 milliequivalents (mEq). The patient also reported chronic use of ibuprofen and losartan 50 mg. Symptoms on presentation included weakness, chest pain, and shortness of breath. Initial labs revealed a potassium > 10 mEq/L which was beyond the upper limit of assay detection for metabolic testing. Calcium gluconate, insulin with dextrose, albuterol, sodium bicarbonate, calcium chloride, fluids, and furosemide were sequentially administered. Initial electrocardiogram (ECG) showed tachycardia, a widened QRS complex without discernible P waves, and non-specific ST-segment changes. Following treatment, a repeat ECG demonstrated decreased heart rate, normal axis, and a decreased QT interval. Creatinine at presentation was 1.67 mg per deciliter (patient's baseline) with repeat labs revealing a potassium of 9.6 mEq/L. Definitive treatment with placement of a central venous catheter for emergent dialysis was initiated.Conclusion: This case illustrates how a patient's regularly prescribed medication may complicate the management of an acute overdose. Prompt identification of a patient's medications and supplements may expedite potentially life-saving interventions in a hyperkalemic emergency.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 1","pages":"24-27"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158672","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

Ewing Sarcoma in the Cervical Spine Causing Left Lower Extremity Hemiparesis and Left Upper Extremity Hemiplegia: A Case Report. 颈椎尤文氏肉瘤致左下肢偏瘫及左上肢偏瘫1例。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.47332

Alexander Adler, Anne Messman

{"title":"Ewing Sarcoma in the Cervical Spine Causing Left Lower Extremity Hemiparesis and Left Upper Extremity Hemiplegia: A Case Report.","authors":"Alexander Adler, Anne Messman","doi":"10.5811/cpcem.47332","DOIUrl":"10.5811/cpcem.47332","url":null,"abstract":"Introduction: Ewing sarcoma is a relatively common neoplasm occurring in pediatric patients 10-20 years of age, commonly presenting with bone fracture, fever, and pain and swelling at the site of the primary tumor. Here we present an unusual case of Ewing sarcoma in the cervical spine leading to neurological symptoms including left lower extremity hemiparesis and left upper extremity hemiplegia.Case report: A 19-year-old Bengali-speaking male presented to the emergency department with a three-week history of left lower extremity hemiparesis and left upper extremity hemiplegia. Due to concern for spinal cord compression, a computed tomography of the cervical spine without contrast was obtained, which revealed a lucent lesion in the left fifth cervical (C5) vertebral body. Magnetic resonance imaging of the cervical spine revealed a left cervical extradural mass present from C3-C7. The patient subsequently underwent C3-C7 laminectomy with tumor decompression and fusion one week later. Surgical pathology revealed Ewing sarcoma. Following chemotherapy two months later the patient regained complete recovery of motor and sensory function in the left lower and left upper extremities.Conclusion: It is important for emergency physicians to broaden their differential diagnosis when the physical examination reveals neurological deficits as exhibited in this case. A broader workup must be obtained that does not solely consist of head imaging but also includes imaging of the spine to prevent missing the diagnosis.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 1","pages":"35-38"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158659","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

70-year-old Woman with Chest Tightness and Shortness of Breath. 70岁妇女胸闷，呼吸短促。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.47061

Robert E Dunn, Brianna Klucher, Laura J Bontempo, J David Gatz

引用次数: 0

Pediatric Pisiform Dislocation: A Case Report. 儿童梨状脱位1例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.47400

John Wahhab, Iswarya Vimalan Jeya, Jackson R Huttner

引用次数: 0

Recurrent Miller Fisher Syndrome: A Case Report. 复发性米勒费雪综合征1例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.47931

Larry Vernier, Griffin Barnes Gilmore, Kelsey Van Housen, Xiao Chi Zhang

{"title":"Recurrent Miller Fisher Syndrome: A Case Report.","authors":"Larry Vernier, Griffin Barnes Gilmore, Kelsey Van Housen, Xiao Chi Zhang","doi":"10.5811/cpcem.47931","DOIUrl":"10.5811/cpcem.47931","url":null,"abstract":"Introduction: Guillain-Barré syndrome can manifest with progressive paralysis, requiring careful monitoring and treatment with steroids or intravenous (IV) immunoglobin. While this disease can be devastating and require intensive care unit level of care, there are few incidences of relapses.Case report: A 67-year-old man with a past medical history of Miller Fisher syndrome variant of Guillain-Barré syndrome, with complete recovery, presented to the emergency department (ED) with ataxia, ophthalmoplegia, dysphonia, and ambulatory dysfunction. The patient noticed his neurologic symptoms after waking up, and he presented to the ED with physical examination positive for difficulty with upward gaze, mild right lower facial droop, dysmetria with left finger to nose testing, and unsteady gait. A lumbar puncture revealed albuminocytologic dissociation (an elevated cerebrospinal fluid protein count without elevation in white blood cell count) and he was diagnosed with recurrent Miller Fisher syndrome. The patient completed a five-day course of IV immunoglobin with marked improvement of his symptoms. Unfortunately, the patient continued to have ambulatory difficulty, requiring inpatient rehabilitation with residual deficits including ophthalmoplegia and mild dysphonia.Conclusion: Miller Fisher syndrome is an uncommon variant of Guillain-Barré syndrome with atypical neurologic findings that can lead to respiratory distress; it requires high levels of suspicion and diagnostic evaluation. This disease process can recur in a patient's lifetime, contrary to what has been reported in the literature.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 1","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158655","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

Sonographic Evaluation of an Inguinal Bubo from Bartonella henselae: A Case Report. 母鸡巴尔通体腹股沟肿大的超声评价：1例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.47934

Julian Campillo Luna, Robert W Shaffer

{"title":"Sonographic Evaluation of an Inguinal Bubo from Bartonella henselae: A Case Report.","authors":"Julian Campillo Luna, Robert W Shaffer","doi":"10.5811/cpcem.47934","DOIUrl":"10.5811/cpcem.47934","url":null,"abstract":"Introduction: Emergency physicians can use point-of-care ultrasound (POCUS) to identify lymph nodes in certain clinical scenarios, and advanced users can determine significant information (such as concerns for malignancy or differentiating them from abscesses for incision and drainage) based on a large volume of literature and images associated with those pathologies. However, current literature does not contain a similar volume of images and cases of suppurative lymph nodes, or buboes, limiting the ability to make the diagnosis sonographically at the bedside.Case report: We report on a man who presented to the emergency department (ED) with a worsening inguinal mass that changed size with positioning, as well as a 20-pound weight loss occurring over the course of a month. Point-of-care ultrasound of the mass was concerning for a necrotic suppurative lymph node, which was further evaluated with cross-sectional imaging. The patient was admitted for a biopsy to rule out malignancy. He was discharged with serologies for Bartonella henselae pending, which later returned positive. The patient was then switched to azithromycin with significant improvement of his symptoms.Conclusion: As POCUS becomes the modality of choice for rapid assessment of soft tissue masses in the ED, familiarity with less common variants of soft tissue infections such as buboes can help with medical decision-making, risk stratification, and further workup. This sonographic description of a bubo caused by a common zoonotic infection will enable clinicians to familiarize themselves with their appearance.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 1","pages":"16-19"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158661","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

Medial Clavicle Physeal Fracture in a 15-Year-Old Male: A Case Report. 15岁男性内侧锁骨骨骺骨折1例。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-02-01 DOI: 10.5811/cpcem.50643

Rochelle Kofman, Ryan Allen, Addison B Smartt, Kevin M Drechsel, Jordan R Pollock, Douglas Rappaport

{"title":"Medial Clavicle Physeal Fracture in a 15-Year-Old Male: A Case Report.","authors":"Rochelle Kofman, Ryan Allen, Addison B Smartt, Kevin M Drechsel, Jordan R Pollock, Douglas Rappaport","doi":"10.5811/cpcem.50643","DOIUrl":"10.5811/cpcem.50643","url":null,"abstract":"Introduction: Sternoclavicular joint injuries are rare and potentially life-threatening injuries due to their proximity to vital mediastinal structures. In adolescents, skeletal immaturity can add complexity to the injury due to potential involvement of the physis. A physeal fracture with displacement can appear as a dislocation on imaging, also known as pseudo-dislocation. Additionally, this anatomic area is difficult to visualize with plain radiographs, which can result in misdiagnosis and delayed treatment.Case report: We present a case of a 15-year-old male athlete who presented to the emergency department with severe right clavicular pain four hours after sustaining a football injury. Plain radiographs obtained at an outside facility as well as repeat plain radiographs at our facility showed no evidence of fracture or dislocation. The patient's degree of pain and physical exam findings prompted further imaging with computed tomography (CT), ultimately revealing a physeal fracture of the medial right clavicle with posterior and superior displacement.Conclusion: Sternoclavicular joint injuries in skeletally immature patients are complex and require immediate diagnosis and intervention. Plain radiographs are often unreliable in recognizing these injuries and, in our case, the physeal fracture with displacement was not radiographically apparent on two separate occasions. Advanced imaging with CT revealed the diagnosis, highlighting the importance of a detailed physical exam and for physicians to maintain a high index of clinical suspicion when evaluating adolescents with high-impact trauma, even in the setting of negative plain radiographs.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 1","pages":"85-88"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158691","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