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 revisi…

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 th…

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…

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 hur…

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…

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?

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%….

Sinai Daily Pearl 10/25

An infant is brought in with increased irritability x 2 days. The parents note that she hasn’t had any remarkable symptoms – no fever, cough, congestion, vomiting, diarrhea. She is tolerating feeds, but more fussy than usual. Your initial e…

Derm Pearl

A 36 year old male presents to your resus bay complaining of allergic reaction, took first dose of Bactrim last night, started having pruritis, chills, body aches last night and now entire face, chest and back are erythematous and warm. No…

Daily Em Pearl, 5/6/12

A middle aged male p/w L-great toe pain for 3days, unresponsive to acetaminophen and ibuprofen. He denies fever or other complicating sx. On exam, the medial aspect of the L-great toe is erythematous w/TTP. No areas of fluctuance are apprec…

July 2024