ECG Cases 46 ECG in Fever and Infectious Disease
Emergency Medicine Cases
OCTOBER 17, 2023
The post ECG Cases 46 ECG in Fever and Infectious Disease appeared first on Emergency Medicine Cases.
SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis
The Skeptics' Guide to EM
FEBRUARY 22, 2025
Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis. Background: Rapid and accurate diagnosis of sepsis is critical, as early intervention can significantly reduce patient mortality. Reference: Agnello et al. His WBC is elevated at 23,000 with a left shift.
Sepsis 
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EM@3AM: Leukopenia
EMDocs
JANUARY 25, 2025
PCP Pneumonia, Sepsis) can be discharged with initiation of Antiretroviral Therapy in consultation with Infectious Disease (ID) physician with full ID evaluation outpatient. General approach to infectious diseases evaluation. A Rational Approach to Clinical Infectious Diseases. In: Temesgen Z, ed.
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emDOCs Podcast – Episode 115: Adult Meningitis
EMDocs
MARCH 4, 2025
The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults [published correction appears in J Infect. What about a CT before a Lumbar puncture? Clin Infect Dis. 2004;39(9):1267-1284. PMID: 15494903 McGill F, et al. 2016 Jun;72 (6):768-769].
EM@3AM: Pediatric Osteomyelitis
EMDocs
MARCH 9, 2025
Other children at risk for osteomyelitis include those with sickle cell disease , sepsis , an indwelling catheter , and immunodeficiency (e.g., due to chronic granulomatous disease). Children with sickle cell disease are at higher risk of osteomyelitis from Salmonella or Streptococcus pneumoniae. Pediatr Emerg Care.
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EM Topic – Infectious Diseases
EMergucate
MAY 17, 2016
Blood Cultures Cellulitis Dengue Fever HIV Human Herpes Viruses Infection Control Lyme Disease Malaria Needlestick Notifiable Diseases SARS Sepsis STDs … Continue reading →
2023 Critical Care Year in Review (Part 1)
PulmCCM
DECEMBER 11, 2023
Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. Either approach in severe sepsis with shock seems reasonable.
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Fever in the Asplenic Patient
Mount Sinai EM
JULY 27, 2023
sickle cell anemia) Hyposplenia (from atrophy, infarction, engorgement, or infiltration of the spleen in chronic dz such as thalassemias, chronic liver disease, HIV/AIDs, immune disorders, or malignancies) If splenic function is in question, you can obtain a peripheral blood smear and check for Howell-Jolly bodies.
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Professional Medical Societies Call for Elimination of SEP-1
PulmCCM
APRIL 29, 2024
The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1). The stakes are going up.
Diagnostics: Inflammatory Markers
Taming the SRU
AUGUST 30, 2023
Spinal Infection: According to the Infectious Disease Society of America’s (IDSA) 2015 guidelines for native vertebral osteomyelitis, CRP and ESR in the setting of protracted back pain have sensitivities ranging from 94 to 100% for ruling out infection and malignancy in these patients. days (secondary endpoint) [51]. Procalcitonin.
The Latest in Critical Care, 2/5/24 (Issue #28)
PulmCCM
FEBRUARY 5, 2024
Fever in the ICU: Guideline Update The Society of Critical Care Medicine (SCCM) and the Infectious Diseases Society of America (IDSA) issued an interim update to their 2008 recommendations for the management of fever in the ICU. PulmCCM is not affiliated with SCCM or IDSA. CRP performed adequately, but less accurately than PCT.)
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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures
Taming the SRU
FEBRUARY 5, 2024
Scandinavian journal of infectious diseases , 45 (9), 657–663. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. Glimåker, M., Johansson, B., Ericsson, M., Bläckberg, J., Lindquist, L., & Sjölin, J. Heyderman, R. Michael, B.
PEMPix 2023 Online Case 3: The Only Thing We Have to Fear
PEMBlog
OCTOBER 18, 2023
rectally, prompting a sepsis workup given his age. The patient was ultimately discharged on a seven-day total course of cephalexin per Pediatric Infectious Disease recommendations. Exanthematous disease induced by toxic shock syndrome toxin 1 in the early neonatal period. Labs were notable for: WBC 9.1 Nishida, H.,
#FOAMed Review 51st Edition
EM Curious
JULY 8, 2015
More FOAMed INFECTIOUS DISEASE SMORGASBORD CORE EM PODCAST EPISODE 3 [PODCAST]: Swami sits down to run over some high yield EM topics in the arena of infectious disease, from antibiotic choice in HCAP, to new paradigms in soft tissues infectious. With a bonus brief on disaster management.
Diagnosing Lower Urinary Tract Infections
ACEP Now
MAY 10, 2024
Patients with flank pain (which would suggest pyelonephritis) as well as patients meeting two or more SIRS criteria (which would suggest sepsis) comprise a higher risk group. Clinical Infectious Diseases. For simplicity, we will focus only on the patients with suspected lower urinary tract infection (UTI). 2012;55(6):771-777.
These are the ‘Roids you are looking for – Steroids in the ED
EM Ottawa
JANUARY 9, 2025
In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED).
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Dacryocystitis
Don't Forget the Bubbles
APRIL 22, 2024
Sepsis: The spread of infection through the bloodstream, known as sepsis, is a critical condition that can lead to organ failure and death if not promptly treated. Current Infectious Disease Reports. BMC ophthalmology. 2021 Dec;21(1):1-7. Dacryocystitis: systematic approach to diagnosis and therapy. 2012 Apr;14:137-46.
EM@3AM: Kawasaki Disease
EMDocs
JULY 1, 2023
Early consultation with a specialist is recommended in these cases 7,8 Workup: Lab tests can support the diagnosis of KD, especially in incomplete KD cases as above. He has had a high fever of > 103°F (39.4°C) C) for the past week.
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Medical Malpractice Insights: A Rare Presentation – Groin pain? Nec fasc? Diabetes? Appendicitis?
EMDocs
OCTOBER 10, 2024
Sepsis is diagnosed and antibiotics started for the first time. High level amputation is considered, but she dies of sepsis and multiorgan failure on hospital day 7. It reveals a 7.5 cm abscess in the R thigh and retro-cecal appendicitis with retro-peritoneal perforation. An I & D of the thigh produces foul-smelling pus.
The Latest in Critical Care, 10/30/23 (Issue #18)
PulmCCM
OCTOBER 30, 2023
Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).
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The Latest in Critical Care, 7/10/23 (Issue #8)
PulmCCM
JULY 10, 2023
Continuous meropenem infusion for critically ill patients with sepsis Antibiotics have a time-dependent effect on bacteria; maintaining bacteriocidal concentrations of antibiotics should help subdue infections better than intermittent dosing. Mortality was about 30% in each group, and most patients had hospital-acquired sepsis.
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Symptomatic Bradycardia: Considering the Differential Diagnosis
Northwestern EM Blog
JUNE 16, 2024
Myocardial Infarction Medication Sinus node dysfunction Infectious Disease Hypothermia Metabolic Abnormalities (hypothyroidism, hyperkalemia, ect.) For example, hypothyroidism, adrenal insufficiency, sepsis, neuromuscular disease, malnutrition, thiamine deficiency, hypoglycemia can all lead to hypothermia [11-13].
What Are Underlying Risk Factors for Liver Abscesses?
Pediatric Education
AUGUST 20, 2023
.” In the Belgium study, the most common underlying risk factor was hepatobiliary disease (e.g. In the US study, the most common underlying PLA risk factor was liver transplant with biliary disease, malignancy and intrabdominal pathology and severe sepsis being other common factors in this population.
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Case Report: A Rare, Urgent Testicular Complication
ACEP Now
MAY 4, 2023
Early treatment with broad-spectrum antibiotics is essential to prevent sepsis and preserve testicular function. Some patients will end up with orchiectomy. 1,2 Teaching points: Scrotal pyocele can mimic other testicular etiologies, but should always be included in the differential, as it is a urologic emergency.
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Are we on the right TRACT?
Don't Forget the Bubbles
JANUARY 10, 2024
These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. Sepsis indicators and malaria positivity did not modify the risk. Do you believe the results?
Fourteen Emergency Medicine Research Gems from 2023
ACEP Now
MARCH 6, 2024
A Myriad of Infectious Disease Papers The use of steroids in severe sepsis remains challenging, primarily as proper patient selection is necessary to tease out those with the greatest likelihood of benefit. Survival to hospital discharge favored the “standard care” group, 47.9 percent to 38.3
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Sepsis Updates Relevant to the Emergency Physician
EMDocs
DECEMBER 18, 2023
Introduction Sepsis and septic shock are life-threatening conditions characterized by severe systemic inflammation and organ dysfunction due to a dysregulated host response to infection. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. vs. 0.91), positive predictive value (0.27
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Kruser – The Role of Language
University of Maryland CC Project
DECEMBER 31, 2023
Jacqueline Kruser, MD MS is an assistant professor of medicine in the Division of Allergy, Pulmonary & Critical Care at the University of Wisconsin. In her lecture today, she talks about the role of the language in the intensive care unit, using examples of specific phrases such as “goals of.
EM@3AM: ESBL-Producing Organisms and Their Management
EMDocs
OCTOBER 5, 2024
8 Workup and Diagnosis Evaluation should be tailored to the patient presentation, but may include studies such as: CBC, CMP, UA, lactate (if concern for sepsis), Cultures (blood, urine, etc.) Consider Infectious Disease consultation prior to any potential discharges.
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The 79th Bubble Wrap x Bristol Royal Hospital For Children
Don't Forget the Bubbles
MARCH 4, 2024
Reviewed by: John Coveney Article 2: How do we define sepsis in children? International Consensus Criteria for Pediatric Sepsis and Septic Shock. The aim of this paper was to update and evaluate the criteria for sepsis and septic shock in children. It doesn’t help to diagnose or exclude sepsis. doi:10.1001/jama.2024.0179
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REBEL Core Cast 122.0 – Neutropenic Fever
RebelEM
MAY 15, 2024
Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Improving the immediate management of neutropenic sepsis in the UK: Lessons from a national audit. Neutropenic Fever: Fever (one reading of 38.3C Check old blood cultures and obtain new cultures prior to starting treatment. Clarke, R.
EM@3AM: Erysipelas
EMDocs
JULY 15, 2023
sepsis), immunocompromised patients, IV drug users, patients with prosthetic heart valves or any intravascular device Clinical features may not abe enough to differentiate erysipelas from cellulitis, and in such cases the treatment should be targeted towards cellulitis Labs No laboratory evaluation is required for the diagnosis of erysipelas.
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Travel-Related Illnesses in Children
Pediatric EM Morsels
FEBRUARY 2, 2024
A “Syndromic” Approach for Diagnosing and Managing Travel-Related Infectious Diseases in Children. Infectious Disease Acquisition in Pediatric International Travelers: A 10-Year Review at a Canadian Tertiary Care Hospital. Glob Pediatr Health. 2021 May; 8:1-16. PMID: 34423077 Flores MS, Hickey PW, Fields JH, Ottolini MG.
Antibiotics in the paediatric emergency department
Don't Forget the Bubbles
SEPTEMBER 18, 2023
This is true in life-threatening conditions such as sepsis. However, when children do not have features of sepsis, oral antibiotics are equally effective. The take home is that although IV antibiotics are key in sepsis management, oral antibiotics are equally as effective as IV antibiotics for children without critical illness.
Going beyond the surface material: A podcast episode on cellulitis
PEMBlog
JANUARY 17, 2024
Camargo, Clinical Trial: Comparative Effectiveness of Cephalexin Plus Trimethoprim-Sulfamethoxazole Versus Cephalexin Alone for Treatment of Uncomplicated Cellulitis: A Randomized Controlled Trial, Clinical Infectious Diseases, Volume 56, Issue 12, 15 June 2013, Pages 1754–1762, [link] Liu C, Bayer A, Cosgrove SE, et al.
When Should We Consider A Rickettsial Disease?
Pediatric Education
DECEMBER 17, 2023
The admitting team was concerned about travel-based causes of meningitis and consulted an infectious disease specialist who felt that the patient should also be given acyclovir and doxycycline in addition to cover for potential herpes simplex and also various rickettsial diseases.
Issue #5: The Latest in Critical Care, 6/19/23
PulmCCM
JUNE 19, 2023
Read in Lancet Infectious Diseases Severe hypothyroidism, although rare, may be under-recognized in the ICU and lead to worse outcomes during critical illness, authors of a case series argue. Sepsis was a main trigger, and hypothermia and shock were as common (>50%) as coma. and FT4 (0-7.8
Leucodepletion in Bordetella Pertussis
Don't Forget the Bubbles
FEBRUARY 24, 2025
Because of this possible diagnosis, they were commenced on a macrolide antibiotic (azithromycin) in addition to treatment for neonatal sepsis +/- meningitis (ceftriaxone and acyclovir). Post-ET, careful monitoring is essential, particularly for secondary bacterial infections and sepsis. Pediatrics. 2010;126:e81627 Cherry et al.
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Melioidosis
Life in the Fast Lane
FEBRUARY 21, 2025
Chris Nickson Melioidosis Melioidosis is a severe infectious disease caused by the bacterium Burkholderia pseudomallei. It presents with a wide range of clinical manifestations, from localized infections to severe sepsis and septic shock.
EM@3AM: High Priority Fungal Pathogens and Empiric Treatment in the ED
EMDocs
FEBRUARY 8, 2025
Empiric treatment with voriconazole 6 mg/kg twice daily intravenously for 2 doses should be started immediately based on Infectious Disease Society of America (IDSA) guidelines. 22-28 Disposition Consult infectious disease for all IFI patients to ensure appropriate antifungal stewardship. Open Forum Infectious Diseases.
Settling the Cefepime versus Piperacillin-Tazobactam Debate
ACEP Now
NOVEMBER 7, 2024
If you work in the emergency department, you’re out there in the trenches “suspecting sepsis” on a daily basis. These are among the questions at the forefront in the exciting world of infectious disease. Considering the wide usage of these antibiotics in the current approach to sepsis, an urgent answer ought be sought.
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Caring for children after a kidney transplant
Don't Forget the Bubbles
SEPTEMBER 23, 2024
Consider sepsis and treat it accordingly. Changes in TAC concentrations related to changes in haematocrit should not lead to a prompt dose adjustment. Urinary tract infection (UTI): more likely in cases of urologic comorbidities and operations (e.g. CAKUT, catheterization requirement).
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Animal Bites
Mind The Bleep
SEPTEMBER 17, 2024
Always consider management as per ATLS protocol and SEPSIS 6 if relevant. Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections. Ensure the wound has been adequately washed out. link] Quinn, J. McDermott, D., Stein, J., & Kramer, N.
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Applying to Infectious Disease: A great and fun career!
Mind The Bleep
NOVEMBER 20, 2024
Infectious disease (ID) is much more than simply collecting blood cultures; it’s a dynamic and exciting specialty that offers the opportunity to work with patients of all ages, varying acuities, and diverse clinical presentations. Contents What makes ID a great career choice? What makes ID a great career choice?
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