Fever in the Asplenic Patient Why we care Patient population Role of the spleen Top Infectious Ddx Management **The single most important thing you can do is obtain blood cultures and administer empiric IV antibiotics without any delay…
Why Paxlovid: According to Pfizer’s clinical trial data from 2021 (participants enrolled by 09/29/2021) which it used for FDA approval, subjects who took Paxlovid were 89% less likely to develop severe illness and death from COVID than thos…
Super cool case, admittedly, maybe not a super high yield diagnosis BUT, I hope we can all agree, still very dope. Case: CC: 46yo M p/w worsening b/l vision over 1mo, now blind. Vitals: WNL PMHx: L eye global rupture ~6mos ago 2/2 nail pen…
What do you think is going on here? So if you were the resident who signed up for this patient what would you do? As may be obvious, this is herpes zoster ophthalmicus, which is a reactivation of the VZV in cranial nerve V ophthalmic divisi…
Cefepime + Vanc > Vanc + Cefepime Written by Erena Weathers So you’re in Resus, your very first one. Leibner is yelling, triage is yelling, and your sphincters are *tight*. Suddenly a nurse comes asking about your elderly septic pa…
A quick search of sinaiem.org 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 revisi…
In honor of a rosh review question that I got wrong, lets review Lyme disease! Lyme disease is caused by the spirochete Boriella burgdorferi, transmitted to humans through tick bites from ixodes ticks. Location: US, endemic in NE coa…
Vancomycin and Piperacillin-tazobactam (Zosyn) are two widely used broad spectrum antibiotics most ED providers use severe infections and especially undifferentiated sepsis. These antibiotics together synergistically fight off MRSA, Pseudo…
Have you ever taken care of really critical, undifferentiated patient, only later to find out that they were diagnosed with a serious, contagious illness? We are exposed to innumerable pathogens each day in the ED, but there are only a few…
So you thought I&Ding your abscess was enough? Or your attending told you….no cellulitis so no antibiotics? WRONG! A recent double-blinded randomized-controlled trial of outpatient children and adults with abscesses <= 5cm wh…
An HIV positive patient presents to the ED but doesn’t know his CD4 count. He hasn’t been taking his HAART and you’re rightfully concerned that he might be susceptible to opportunistic infections. Unfortunately, you can…
Today’s TR pearl is brought to you by Drs. Shearer, Hernandez, Sun and O’Halloran and summer in the Northeast. The weather is warm and people are flocking to the great outdoors. This means…ticks, as well as the tick borne diseases the…
The following scenario is based on a case that was seen in the Sinai ED this past week. A 52 yo M with hx of poorly controlled DM and HTN p/w rapidly progressing ulcer over the past 3 weeks of right lower extremity. He has been afebrile an…
De Gans J, Van de Beek, D. Dexamethasone in adults with bacterial meningitis. New Engl J Med. 2002;347(20):1549-56. What we already know about the topic: Bacterial meningitis is a dangerous condition with significant associated morbi…
“I quit school in the sixth grade because of pneumonia. Not because I had it, but because I couldn’t spell it.” – Rocky Graziano Article Citation: Bauer TT, Ewig S, Marre R, Suttorp N, Welte T; CAPNETZ Study Group. CRB-65 predi…
