A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
PID encompasses all infections of the female upper reproductive tract, including endometritis, myometritis, salpingitis, tubo-ovarian abscess, parametritis, oophoritis, peri-appendicitis, perihepatitis, and pelvic peritonitis. Per CDC guidelines, diagnosis requires at least one of three minimum criteria: cervical motion tenderness (CMT), uterine tenderness, and adnexal tenderness.
Nanditha Ravichandran MD & Eric Leser MD
Read More
Figure 1. Clustered rash with vesicles and scabbed over lesions along C6-7 dermatome.
The Case:
An otherwise healthy 3-year-old presented to the emergency department with a chief complaint of a pruritic rash for 2 days that started on the back and progressed down the arm to the hand. The child and his family were migrants recently arriving in the United States from South America and currently staying at a migrant shelter. The patient’s blood pressure was 104/60 mmHg, heart rate 100 BPM, respiratory rate 22 BPM, oxygen saturation 97% on room air, and temperature 37ºC (98.6ºF). On examination, the child was overall well-appearing, and significant only for a crusted-over patch of lesions was noted at the C6-7 dermatome on the child’s back lateral to midline, clustered papulovesicular lesions along the outer side of the left arm and involving the left hand along the C6-7 dermatome. What is causing the patient’s rash?
Michael Hohl, MD and Alisa McQueen, MD
Read More
The literature on antibiotic prophylaxis for traumatic wounds is usually poor and tends to be left to EM physician gestalt or subspecialty preference. In the case of someone without access to subspecialist consultation in a young, healthy patient, understanding the literature may help us decrease our antibiotic prescribing and become better antibiotic stewards. Here, we review some common clinical conditions in which the ED physician may feel comfortable giving or not giving antibiotics using an evidence-based approach.
Jose Reyes, MD
Read More