Measles redux!

A quick search of for the keyword measles brings up a solitary post from 2015, and it’s not actually about measles. With all the attention that measles has been getting in the news recently, now seems like a great time to revisit measles as a disease process, and go a little deeper than justRead more

Dermatologic Emergencies

Case: 40 year old male presenting with rash for one day. Patient recently started Bactrim, endorsing flu-like symptoms for the past 2 days. Chest and back are erythematous and warm. In the ED, patient is febrile and tachycardic. Based on the picture below what should you be worried about? Stevens-Johnson syndrome (SJS) and toxic epidermalRead more

Antibiotics + Abscesses: To I&D and Beyond!

So you’ve I&D’d that abscess, there’s no surrounding cellulitis you’re ready to Treat em’ and Street em’ but the patient asks: “Can I have some antibiotics, please? And maybe a sandwich?” [you probably make the face above right?] Well what a recent study by Talan et al (2016) found is that the answer to thatRead more

Abscess Innovations

Todays pearl was inspired by the amazing and innovative Dr. Vella and Dr. McVane.   We all have had the joy of draining a large pilonidal abscess.  You know the second that abscess opens white pus will flow freely creating mountains of dirty 4x4s and an aroma that may inspire you to vomit.  But whatRead more

Gum pains

25 y/o F with multiple painful lesions of the right gingiva and low grade fever. The symptoms started off as a stinging sensation with sensitivity to the gums on her right side that she noticed 3 days ago, but now there are lesions that hurt to touch, especially when brushing teeth. She has never had this before.Read more

Name That Rash!

A)  B)  C) D) Read more

It Burns!

You have to close a laceration in a 5 year old and you’re preparing your local anesthesia. It’s been shown that buffering lidocaine with bicarbonate decreases the acidity of the solution and improves patient comfort during infiltration, but have you considered warming it?Read more

Ocean Surprise

48 y/o M presents after dredging for clams off the coast of Long Island. He reports finding a metallic object in his net, then throwing it overboard. Over the next two hours he develops the following…. What’s the diagnosis?Read more

Pediatric Fever & Rash

A 3yo M no sig PMH, IUTD, comes into your ED with complaint of 3 days of fevers, diffuse rash worst on the R hip, mild limp, N/V, no urine output today, and lethargy. On exam, found to be febrile to 40.1, tachy to 197, BP 90s/50s, sat 96%. Irritable but awake. HENT with bilateralRead more

Daily Pearl 11/14

Three disorders of hair are shown in the images below. Identify each, and describe the pathophysiology & management. (A) (B) (C)      Read more