A case of tetanus infection in an adult with a protective tetanus antibody level Kristan E. Vollman, Nicole M. Acquisto, Ryan P. Bodkin
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.025
The American Journal of Emergency Medicine , Vol. 32 , Issue 4 ,
Published online: November 11 2013
x Tetanus is a bacterial infection caused by Clostridium tetani and most commonly presents as trismus or other muscle spasms. Despite the development of the tetanus toxoid vaccine, tetanus infection has not been eradicated. Additionally, while there are hypothesized protective levels of tetanus antibody, tetanus infection may still occur in properly vaccinated individuals.
Patients with cirrhosis in the ED: early predictors of infection and mortality Rafael Oliveira Ximenes, Alberto Queiroz Farias, Augusto Scalabrini Neto, Márcio Augusto Diniz, Gabriel Taricani Kubota, Maurício Menezes Aben-Athar Ivo, Caroline Gracia Plena Sol Colacique, Luiz Augusto Carneiro D'Albuquerque, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.004
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 10 2015
x Patients with cirrhosis have high risk of bacterial infections and cirrhosis decompensation, resulting in admission to emergency department (ED). However, there are no criteria developed in the ED to identify patients with cirrhosis with bacterial infection and with high mortality risk.
Overtreatment of gonorrhea and chlamydial infections in 2 inner-city emergency departments Colleen E. Holley, Thuy Van Pham, Heather M. Mezzadra, George C. Willis, Michael D. Witting
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.009
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: June 13 2015
x Infections with Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) are the most commonly reported sexually transmitted diseases in the United States.
Iliopsoas abscess associated with endovascular infection: an acute case of chronic Q fever Dennis G. Barten, Donné E.J. Gulikers, Marieke G.J. Versteegen, Willie P.W.L. Thimister, Quirijn de Mast, Chantal P. Bleeker-Rovers
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.043
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: December 30 2014
x Q fever is a zoonosis caused by Coxiella burnetii , which occurs worldwide. After acute Q fever infection, 1% to 5% of patients develop chronic Q fever. Chronic Q fever usually presents as endocarditis or endovascular infection. The diagnosis and localization of chronic Q fever are challenging, as most patients present with nonspecific symptoms. Moreover, it often occurs in patients without a known episode of acute infection.
An unusual infection of cervicofacial area caused by dental pathology: flesh-eating syndrome Serife Ozdinc, Ebru Unlu, Oya Oruc, Nese Nur User, Zeynep Karakaya
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.035
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 21 2015
x Necrotizing fasciitis (NF) of the cervicofacial area is highly rare, but physicians should be familiar with the presentation of this situation owing to the suddenness of its beginning, the rapidness of its spread, and ending with high mortality and morbidity. In this article, 5 patients with NF admitted to emergency department with dental pathology history were discussed with a review of the literature. The purpose of this case series is to raise awareness about NF of the cervicofacial area caused by dental pathologies.
Urinary obstruction is an important complicating factor in patients with septic shock due to urinary infection Karina Reyner, Alan C. Heffner, Colleen H. Karvetski
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.068
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: December 23 2015
x Urinary tract infection (UTI) is a common cause of severe sepsis, and anatomic urologic obstruction is a recognized factor for complicated disease. We aimed to identify the incidence of urinary obstruction complicating acute septic shock and determine the characteristics and outcomes of this group.
Considerations for tetanus infection in an adult with a protective tetanus antibody level Toru Hifumi, Akihiko Yamamoto, Motohide Takahashi, Yuichi Koido, Kenya Kawakita, Yasuhiro Kuroda
DOI: http://dx.doi.org/10.1016/j.ajem.2014.06.008
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: June 12 2014
x We read with interest the article titled “A case of tetanus infection in an adult with a protective tetanus antibody level” by Vollman et al [1]. The authors reported a mild case of tetanus infection despite a markedly higher protective antibody level (8.4 IU/mL). However, there are several serious concerns raised in the study.
Response to considerations for tetanus infection in an adult with a protective tetanus antibody level Kristan E. Vollman, Nicole M. Acquisto, Ryan P. Bodkin
DOI: http://dx.doi.org/10.1016/j.ajem.2014.06.009
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: June 12 2014
x We thank Dr Hifumi et al for continuing discussion regarding our recent case report of tetanus infection despite a protective tetanus antibody level [1].
Presence of crystals is not an evidence of absence of infection Patompong Ungprasert, Quanhathai Kaewpoowat, Supawat Ratapano, Narat Srivali, Edward F. Bischof Jr.
DOI: http://dx.doi.org/10.1016/j.ajem.2012.07.020
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: September 3 2012
x Acute monoarthritis is one of the most common rheumatologic presentations. However, it is clinically difficult to distinguish between an inflamed joint due to crystal-induced arthritis and an inflamed joint due to septic arthritis. Arthrocentesis and synovial fluid analysis are used to differentiate between these 2 conditions. The presence of crystals and positive synovial fluid culture confirm the diagnosis of crystal-induced arthritis and septic arthritis, respectively. Although uncommon, these 2 arthritides can coexist, and presence of crystal does not exclude bacterial arthritis.
Secretory phospholipase A2 : a marker of infection in febrile children presenting to a pediatric ED Karim M. Mansour, Frans A. Kuypers, Tammy N. Wang, Annabeth M. Miller, Sandra K. Larkin, Claudia R. Morris
DOI: http://dx.doi.org/10.1016/j.ajem.2010.06.024
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: August 16 2010
x Fever is a common presenting complaint to the emergency department (ED), and the evaluation of the febrile child remains a challenging task.
Predictors of bacteremia in emergency department patients with suspected infection Maureen Chase, Richard S. Klasco, Nina R. Joyce, Michael W. Donnino, Richard E. Wolfe, Nathan I. Shapiro
DOI: http://dx.doi.org/10.1016/j.ajem.2012.01.018
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: May 25 2012
x The goal of this study is to identify clinical variables associated with bacteremia. Such data could provide a rational basis for blood culture testing in emergency department (ED) patients with suspected infection.
Community-onset febrile illness in HIV-infected adults: variable pathogens in terms of CD4 counts and transmission routes Ching-Chi Lee, Chih-Chia Hsieh, Tsung-Yu Chan, Po-Lin Chen, Chih-Hsien Chi, Wen-Chien Ko
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.013
The American Journal of Emergency Medicine , Vol. 33 , Issue 1 ,
Published online: October 15 2014
x The objective of the study is to investigate the causes of febrile illness among HIV-infected adults visiting the emergency department (ED) of a designated hospital for HIV care in Taiwan, an area of a low HIV prevalence.
Triage sepsis alert and sepsis protocol lower times to fluids and antibiotics in the ED Geoffrey E. Hayden, Rachel E. Tuuri, Rachel Scott, Joseph D. Losek, Aaron M. Blackshaw, Andrew J. Schoenling, Paul J. Nietert, Greg A. Hall
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.039
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: August 26 2015
x Early identification of sepsis in the emergency department (ED), followed by adequate fluid hydration and appropriate antibiotics, improves patient outcomes.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(15)00997-3
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published in issue: December 2015
The meaning of elevated troponin I levels: not always acute coronary syndromes Bryan Harvell, Nathan Henrie, Amy A. Ernst, Steven J. Weiss, Scott Oglesbee, Dusadee Sarangarm, Lorenzo Hernandez
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.037
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 2 2015
x Troponin elevation can be caused by etiologies other than acute coronary syndromes (ACS). Our hypothesis was that elevated troponins occur more frequently in non-ACS cases but that ACS cases (type 1 ST-elevation myocardial infarction [STEMI] and type 1 non-STEMI [NSTEMI]) have significantly higher troponin elevations.
Imported malaria: an update Eric J. Nilles, Paul M. Arguin
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.016
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: September 12 2011
x Evidence suggests that imported malaria is a diagnostic challenge with initial misdiagnosis rates of 40% or greater. Given that prompt diagnosis and appropriate treatment are the only intervention proven to prevent progression to severe malaria and death, these figures are concerning. The purpose of this clinical review is to provide the most up-to-date and practical information on the diagnosis and treatment of imported malaria for the emergency health care provider. We highlight common pitfalls, errors, and mistakes in arriving at the correct diagnosis.
Clinical value of soluble urokinase-type plasminogen activator receptor in the diagnosis, prognosis, and therapeutic guidance of sepsis Mian Zeng, Minchan Chang, Haichong Zheng, Bin Li, Yanzhu Chen, Wanmei He, Chunrong Huang
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.004
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: November 3 2015
x The level of soluble urokinase-type plasminogen activator receptor (suPAR) is significantly increased in sepsis. We investigated whether suPAR could be a valuable biomarker in sepsis.
What diseases are disguised as dengue? Po-An Su, Che-Kim Tan, Chien-Chin Hsu, Kuo-Tai Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.035
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: December 1 2014
x Dengue is the most common arthropod-borne viral disease and is prevalent in tropical and subtropical areas. The typical manifestations of dengue include fever, headache and myalgia, and these symptoms are commonly present in various inflammatory and infectious diseases. Therefore, the accurate diagnosis of dengue relies on laboratory studies [1]. Currently, capture enzyme-linked immunosorbent assay for dengue immunoglobulin M antibody (dengue IgM) is the most widely applied test. However, dengue IgM antibodies cross-react with other flaviviruses, and a number of non-dengue diseases have been reported to produce positive reactions in dengue serological tests [1–5].
Cytokine markers as predictors of type of respiratory infection in patients during the influenza season John Patrick Haran, Rachel Buglione-Corbett, Shan Lu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.01.030
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: March 7 2013
x The objective of this study is to characterize the cytokine response among patients presenting with an influenza-like illness who are infected with the influenza virus, a bacterial pneumonia, or another viral infection. We hypothesize that there are differences in proinflammatory and anti-inflammatory cytokines in relation to cytokines associated with the humoral response during viral and bacterial respiratory infections.
C-reactive protein as predictor of bacterial infection among patients with an influenza-like illness John Patrick Haran, Francesca Lynn Beaudoin, Selim Suner, Shan Lu
DOI: http://dx.doi.org/10.1016/j.ajem.2012.06.026
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: September 3 2012
x During the influenza season patients are labeled as having an influenza-like illness (ILI) which may be either a viral or bacterial infection. We hypothesize that C-reactive protein (CRP) levels among patients with ILI diagnosed with a bacterial infection will be higher than patients diagnosed with an influenza or another viral infection.
Three cases of electrical storm in fulminant myocarditis treated by extracorporeal membrane oxygenation Weihang Hu, Lan Chen, Changwen Liu, Wei Hu, Jun Lu, Yin Zhu, Jianrong Wang, Bingwei Liu
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.025
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: October 20 2014
x Venoarterial extracorporeal membrane oxygenation (V-A ECMO) provides effective circulation support for patients with fulminant myocarditis (FM), and there are very few reports of electrical storm (ES) occurring in FM patients due to inadequate left ventricular unloading during ECMO support. We report the treatment and outcomes of 5 FM patients who were enrolled in our study and treated with V-A ECMO support in our intensive care unit from September 2009 to May 2013. All 5 FM patients (mean age, 19.40 ± 4.80 years) were found to have inadequate left ventricular unloading and significantly reduced myocardial contractility.
Serum procalcitonin level for the prediction of severity in women with acute pyelonephritis in the ED: value of procalcitonin in acute pyelonephritis Jeong Ho Park, Jung Hee Wee, Seung Pill Choi, Kyu Nam Park
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.012
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 22 2013
x Predicting medical outcomes for acute pyelonephritis (APN) in women is difficult. Delay in diagnosis and treatment often results in rapid progression to circulatory collapse, multiple-organ failure, and death. The aim of this study was to investigate the value of procalcitonin (PCT) level in women with APN at ED.
Resistance of Escherichia coli urinary isolates in ED-treated patients from a community hospital Virginia H. Fleming, Bryan P. White, Robin Southwood
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.033
The American Journal of Emergency Medicine , Vol. 32 , Issue 8 ,
Published online: April 25 2014
x The purpose of this study is to provide resistance data for Escherichia coli isolates causing urinary tract infections in emergency department (ED) patients not requiring admission and explore if differences between this subpopulation and the hospital antibiogram exist. Differences between community-acquired urinary tract infection (CA-UTI) and health care–associated (HA-UTI) subgroups were also investigated.
Evaluation of the Mortality in Emergency Department Sepsis score combined with procalcitonin in septic patients Yongzhen Zhao, Chunsheng Li, Yumei Jia
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.008
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 22 2013
x To determine an effective method for predicting severity of sepsis and 28-day mortality of emergency department (ED) patients, we compared the Mortality in Emergency Department Sepsis (MEDS) score with procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) and evaluated the MEDS score combined with relevant biomarkers.
Atypical presentations of dengue disease in the elderly visiting the ED Ching-Chi Lee, Hsiang-Chin Hsu, Chia-Ming Chang, Ming-Yuan Hong, Wen-Chien Ko
DOI: http://dx.doi.org/10.1016/j.ajem.2013.01.011
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: February 11 2013
x The objective was to compare the clinical characteristics of elderly and young adult patients with dengue in the emergency department (ED).
Fulminant dengue myocarditis complicated with profound shock and fatal outcome under intra-aortic balloon pumping support Tzu-Chieh Lin, Hsiang-Chun Lee, Wen-Hsien Lee, Ho-Ming Su, Tsung-Hsien Lin, Po-Chao Hsu
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.039
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: March 19 2015
x Dengue is a worldwide public health problem, and its clinical severity ranges from asymptomatic infection to a fatal disease. Although cardiac involvement of dengue viral infection has been reported in the literature, there were only rare reports of fulminant dengue myocarditis, and no cardiac mechanical support was used in the reported cases. We presented a case of a 55-year-old Taiwanese woman with dengue hemorrhagic fever complicated with profound shock, acute pulmonary edema, and acute kidney injury.
A case of severe rhabdomyolysis with minor trauma: Is sickle cell trait to blame? Paul Krieger, Nathan Zapolsky, Stephen J. Lowery
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.035
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: June 18 2015
x A 37-year-old man with a past medical history of sickle cell trait (SCT) presented to our emergency department (ED) complaining of upper abdominal pain and bilateral shoulder pain, following an assault the prior evening. He reported being pinned on his back with knees on his chest, and repeated punching to his stomach. Physical exam revealed mild tachycardia and diffuse tenderness to palpation of the abdomen, without guarding, rebound, induration, or external signs of trauma. Bilaterally his shoulder exam revealed limited range of motion secondary to pain and tenderness over the trapezius muscles.
Field performance of clinical case definitions for influenza screening during the 2009 pandemic Shey-Ying Chen, Yee-Chun Chen, Wen-Chu Chiang, Hsiang-Chi Kung, Chwan-Chuen King, Mei-Shu Lai, Wei-Chu Chie, Shyr-Chyr Chen, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.02.016
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: May 25 2012
x The aim of this study was to assess the performance of 3 different influenza-like illness (ILI) case definitions, adopted by the European (European-CDC), USA (USA-CDC), and Taiwan Centers for Disease Prevention and Control (Taiwan-CDC), as screening tools for influenza during the 2009 H1N1 pandemic.
Methicillin-resistant Staphylococcus aureus colonization is not associated with higher rate of admission to pediatric intensive care unit Mohammed Naeem, Esam Al Banyan, Sardar Tanvir Sindhu
DOI: http://dx.doi.org/10.1016/j.ajem.2012.12.033
The American Journal of Emergency Medicine , Vol. 31 , Issue 4 ,
Published online: February 11 2013
x Methicillin-resistant Staphylococcus aureus (MRSA) colonization is consistently rising. The question whether the MRSA colonization places the patients at higher risk, requiring higher levels of care when being admitted, has never been studied. We conducted this study to determine the impact of MRSA colonization status on the required level of care upon admission to hospital.
Rhabdomyolysis as presenting feature of acute HIV-1 seroconversion in a pediatric patient Jason Gagnon, Harold Katner, S. Brent Core, Jean Dozier, Chintan Patel, Chanty Davis
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.031
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: August 29 2015
x Acute rhabdomyolysis is a rare phenomenon in the emergency setting almost exclusively associated with trauma, drugs, and recent upper respiratory and gastrointestinal infection. Rare reports in the literature have highlighted adult patients presenting with rhabdomyolysis as 1 component in a constellation of symptoms in acute HIV-1 seroconversion; however, there are few reports of rhabdomyolysis as the sole presenting symptom. This case highlights the importance of investigating HIV and other sexually transmitted diseases in pediatric cases of rhabdomyolysis in the emergency care setting.
Fluid balance in sepsis and septic shock as a determining factor of mortality Josep-Maria Sirvent, Cristina Ferri, Anna Baró, Cristina Murcia, Carolina Lorencio
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.016
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: November 19 2014
x The objective was to assess whether fluid balance had a determinant impact on mortality rate in a cohort of critically ill patients with severe sepsis or septic shock.
d -dimer is a significant prognostic factor in patients with suspected infection and sepsisJoaquín R. Rodelo, Gisela De la Rosa, Martha L. Valencia, Sigifredo Ospina, Clara M. Arango, Carlos I. Gómez, Alex García, Edilberto Nuñez, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.04.033
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: July 16 2012
x The aim of the study was to determine whether C-reactive protein (CRP), procalcitonin (PCT), and d -dimer (DD) are markers of mortality in patients admitted to the emergency department (ED) with suspected infection and sepsis.
The critical care literature 2009 Michael E. Winters, Tsuyoshi Mitarai, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2010.02.009
The American Journal of Emergency Medicine , Vol. 29 , Issue 5 ,
Published online: May 3 2010
x Marchick MR, Kline JA, Jones AE. The significance of non-sustained hypotension in emergency department patients with sepsis. Intensive Care Med 2009;35:1261-1264.
Newly designed delta neutrophil index–to–serum albumin ratio prognosis of early mortality in severe sepsis Yoon Jung Hwang, Sung Phil Chung, Yoo Seok Park, Hyun Soo Chung, Hye Sun Lee, Jong Woo Park, Jong Wook Lee, Jung Hwa Hong, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.012
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: June 13 2015
x We evaluated the ratio of delta neutrophil index (DNI) to albumin (A) in patients receiving early goal-directed therapy (EGDT) to determine the prognostic significance of the DNI/A ratio as a marker of early mortality in critically ill patients with suspected sepsis.
Concurrent infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus bacteremia Li Jun Wang, Xiao Qin Du, Eric Nyirimigabo, Song Tao Shou
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.033
The American Journal of Emergency Medicine , Vol. 32 , Issue 4 ,
Published online: November 25 2013
x It is rare to see a concurrent infection with infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus in Tianjin, China. Until now, there is still no any single recorded case of concurrent infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus bacteremia.
Diagnostic and prognostic value of myeloid-related protein complex 8/14 for sepsis Shanglan Gao, Yan Yang, Yun Fu, Weidong Guo, Guowei Liu
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.025
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: June 17 2015
x The objective of this study is to evaluate the diagnostic and prognostic value of myeloid-related protein complex 8/14 (MRP8/14) in septic patients in intensive care units.
The role of autonomic nervous system function in hypothermia-mediated sepsis protection Yun-Te Chang, Shue-Ren Wann, Jung-Shun Tsai, Chih-Hsiang Kao, Po-Tsang Lee, Neng-Chyan Huang, Cheng-Chang Yen, Mu-Shun Huang, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.08.028
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: November 19 2012
x The objective of this study is to determine whether hypothermia will lessen decreases in heart rate variability and improve outcome in a rat model of sepsis.
Clinical factors in predicting acute renal failure caused by rhabdomyolysis in the ED Chun-Yu Chen, Yan-Ren Lin, Lu-Lu Zhao, Wen-Chieh Yang, Yu-Jun Chang, Han-Ping Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.047
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 22 2013
x This study aimed to determine the clinical factors in predicting acute renal failure (ARF) in rhabdomyolysis and investigate the potential risk of renal replacement therapy (RRT).
Antibiotics for methicillin-resistant Staphylococcus aureus skin and soft tissue infections: the challenge of outpatient therapy Amy J. Pate, Reno Giovonni Terribilini, Farzaneh Ghobadi, Alaleh Azhir, Andre Barber, Julie Marie Pearson, Hossein Kalantari, Getaw W. Hassen
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.026
The American Journal of Emergency Medicine , Vol. 32 , Issue 2 ,
Published online: November 14 2013
x Methicillin-resistant Staphylococcus aureus (MRSA) infections are becoming increasingly prevalent in both community and hospital settings. Certain strains are notorious for causing skin and soft tissue infections in patients with no established risk factors. In this article, we report our findings on the dynamic antibiotic resistance pattern of MRSA and outpatient prescription trend for skin and soft tissue infections within our community.
Laboratory-confirmed gonorrhea and/or chlamydia rates in clinically diagnosed pelvic inflammatory disease and cervicitis Aaron M. Burnett, Christopher P. Anderson, Michael D. Zwank
DOI: http://dx.doi.org/10.1016/j.ajem.2011.07.014
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: October 26 2011
x The aim of this study was to determine the rates of laboratory confirmed gonorrhea (GC) and chlamydia (CT) in emergency department (ED) patients with pelvic inflammatory disease (PID) and cervicitis who were diagnosed clinically and treated empirically. A secondary goal examines which clinical criteria were present in patients with PID testing positive for GC/CT.
Venous lactate in predicting the need for intensive care unit and mortality among nonelderly sepsis patients with stable hemodynamic Khrongwong Musikatavorn, Saranpat Thepnimitra, Atthasit Komindr, Patima Puttaphaisan, Dhanadol Rojanasarntikul
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.010
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: April 9 2015
x Our study aims to investigate the role of initial venous lactate in predicting the probability of clinical deterioration and 30-day mortality in nonelderly sepsis patients with acute infections, without hemodynamic shock.
False positivity of monospot test in an immunocompetent elderly woman with acute cytomegalovirus infection Natanong Thamcharoen, Suthanya Sornprom, Nitipong Permpalung, Charles L. Hyman
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.028
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 21 2015
x A 75-year-old woman presented with altered mental status, septic picture, and influenza-like symptoms. Initial investigations revealed atypical lymphocytosis, thrombocytopenia, elevated liver enzymes, and a positive monospot test result. Further investigation showed the Epstein-Barr virus viral capsid antibody IgM/IgG and Epstein-Barr virus DNA by polymerase chain reaction to be negative; however, interestingly her cytomegalovirus (CMV) IgM and IgG were positive, suggesting that her mononucleosis-like syndrome was due to acute CMV infection.
Prognostic factors of Streptococcus pneumoniae infection in adults Toru Hifumi, Seitaro Fujishima, Takayuki Abe, Nobuaki Kiriu, Junichi Inoue, Hiroshi Kato, Yuichi Koido, Kenya Kawakita, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.025
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 15 2015
x The mortality of severe sepsis has markedly decreased since the implementation of the Surviving Sepsis Campaign guidelines. The next logical step is to examine the necessity of individualized management guidelines for targeted therapy against specific bacteria. Streptococcus pneumoniae is the leading cause of community-acquired severe sepsis; however, little is known regarding the prognostic factors in adult patients with S pneumoniae sepsis. We aimed to identify prognostic factors in patients with S pneumoniae sepsis and to explore a subgroup of patients at high risk for death with detailed Sequential Organ Failure Assessment (SOFA) score analysis.
A comparison of routine, opt-out HIV screening with the expected yield from physician-directed HIV testing in the ED Matthew E. Prekker, Brandi M. Gary, Roma Patel, Travis Olives, Brian Driver, Stephen J. Dunlop, James R. Miner, Sarah Gordon, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.057
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: January 2 2015
x The Centers for Disease Control and Prevention recommends routine opt-out HIV screening in health care settings. Our goal was to evaluate the feasibility and yield of this strategy in the emergency department (ED) and to compare it to the expected yield of physician-directed testing.
Hepatitis C virus infection in the 1945-1965 birth cohort (baby boomers) in a large urban ED Waridibo E. Allison, William Chiang, Ada Rubin, Lauren O'Donnell, Miguel A. Saldivar, Michael Maurantonio, Jeffrey Dela Cruz, Svetlana Duvidovich, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.072
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: December 28 2015
x The US Preventive Services Task Force recommends one-time screening of the 1945-1965 birth cohort (baby boomers) for hepatitis C (HCV) infection. New York State legislation mandates screening of baby boomers for HCV in most patient care settings except the emergency department (ED). This cross-sectional study explores baby boomer knowledge of HCV, prevalence of HCV infection, and linkage to care from a large urban ED.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00518-9
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published in issue: November 2012
Spontaneous septic arthritis in a patient without trauma, coinfection, or immunosuppression Peter L. Griffin, Gregory D. Griffin, Erin L. Simon
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.029
The American Journal of Emergency Medicine , Vol. 31 , Issue 11 ,
Published online: September 23 2013
x Septic arthritis is a rare infection, most often affecting the knee and hip [1]. Infections are often secondary to joint repair or replacement surgery, systemic infection, or intravenous recreational drug use [1,2]. Diabetes, rheumatoid arthritis, hepatic dysfunction, and immunosuppression are common risk factors [1,2]. Although septic arthritis can occur spontaneously, such occurrences are rare. We report a case of a previously healthy 54-year-old woman with no known risk factors presenting to a freestanding emergency department with 5 days of shoulder pain.
Factors associated with pneumonia in post–cardiac arrest patients receiving therapeutic hypothermia Jae-Hyug Woo, Yong Su Lim, Hyuk Jun Yang, Won Bin Park, Jin Seong Cho, Jin Joo Kim, Sung Youl Hyun, Gun Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.035
The American Journal of Emergency Medicine , Vol. 32 , Issue 2 ,
Published online: November 22 2013
x The aim of this study is to investigate risk factors associated with the development of pneumonia during the first 7 days of admission in survivors of cardiac arrest receiving therapeutic hypothermia.
Lower mortality in sepsis patients admitted through the ED vs direct admission Emilie S. Powell, Rahul K. Khare, D. Mark Courtney, Joe Feinglass
DOI: http://dx.doi.org/10.1016/j.ajem.2011.01.011
The American Journal of Emergency Medicine , Vol. 30 , Issue 3 ,
Published online: February 28 2011
x Early aggressive resuscitation in patients with severe sepsis decreases mortality but requires extensive time and resources. This study analyzes if patients with sepsis admitted through the emergency department (ED) have lower inpatient mortality than do patients admitted directly to the hospital.
Identifying patients with cellulitis who are likely to require inpatient admission after a stay in an ED observation unit Kathryn A. Volz, Louisa Canham, Emily Kaplan, Leon D. Sanchez, Nathan I. Shapiro, Shamai A. Grossman
DOI: http://dx.doi.org/10.1016/j.ajem.2012.09.005
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: November 19 2012
x Emergency department observation units (EDOU) are often used for patients with cellulitis to provide intravenous antibiotics followed by a transition to an oral regimen for discharge. Because institutional regulations typically limit EDOU stays to 24 hours, patients lacking a clinical response within this period will often be subsequently admitted to the hospital for further treatment.
