Healthcare-associated acute pyelonephritis is associated with inappropriate empiric antibiotic therapy in the emergency department Seong Yeon Park, Won Sup Oh, Yeon-Sook Kim, Joon Sup Yeom, Hee Kyoung Choi, Yee Gyung Kwak, Jae-Bum Jun, Jin-Won Chung, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.018
Publication stage: In Press Accepted Manuscript
The American Journal of Emergency Medicine
Published online: April 13 2016
x Acute pyelonephritis (APN) is one of the most common bacterial infections. Because healthcare-associated (HCA) infections in the community setting have similar characteristics to hospital-acquired infections, HCA infections should be distinguished from community-acquired (CA) infections. However, the impact of HCA-APN on treatment outcomes has not been clearly defined. This study aimed to analyze the impact of HCA-APN on the appropriateness of empiric antibiotic therapy and outcomes in community-onset APN.
Procalcitonin-guided therapy for the initiation of antibiotics in the emergency department: a systematic review Yuri van der Does, Pleunie P.M. Rood, Juanita A. Haagsma, Peter Patka, Eric C.M. van Gorp, Maarten Limper
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.065
Publication stage: In Press Accepted Manuscript
The American Journal of Emergency Medicine
Published online: April 3 2016
x Procalcitonin (PCT) is a new biomarker with a higher accuracy in the diagnosis of bacterial infections. Utilization of PCT may reduce the number of unnecessary antibiotics prescribed to patients, and consequently may decrease the rise in antibiotic resistance. The aim of this systematic review is to determine if a PCT-guided algorithm can safely reduce the number of antibiotics prescribed to all patients with a suspected of infection in the emergency department(ED).
Efficacy of non–vitamin K antagonist oral anticoagulants for Lemierre syndrome Masayuki Kubota, Hiroaki Daidoji, Nobuhiro Takaya, Kurato Tokunaga, Tomohiro Sonoo, Kensuke Nakamura
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.040
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: March 19 2016
x The use of anticoagulants for patients with Lemierre syndrome, which consists of pharyngeal infection-related thrombophlebitis of the internal jugular vein and septic embolism, is controversial. In this study, we report a 65-year-old woman with Lemierre syndrome in whom anticoagulant therapy was effective for thrombotic occlusion involving the sigmoid sinus. She consulted our hospital with pharyngeal pain and dyspnea. Contrast-enhanced cervical computed tomography revealed thrombus formation involving the right internal jugular vein to sigmoid sinus.
Changing epidemiology and management of infectious diseases in US EDs Amir M. Mohareb, Andrea F. Dugas, Yu-Hsiang Hsieh
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.024
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: March 11 2016
x The rise of antibiotic-resistant pathogens is believed to have influenced the emergency department (ED) epidemiology and management of infectious diseases (IDs) since 2000.
High-impact hepatitis C virus testing for injection drug users in an urban ED Erik S. Anderson, Sarah K. Pfeil, Laura J. Deering, Tamara Todorovic, Suzanne Lippert, Douglas A.E. White
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.004
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: March 3 2016
x We implemented the “High-Impact Testing for Injection Drug Users”, or the “HIT IDU” initiative, an emergency physician (EP)–based hepatitis C virus (HCV) testing program. The objective of this study was to evaluate the outcomes of this clinical protocol.
Negative pressure wound therapy for serious dog bites of extremities: a prospective randomized trial Chen Rui-feng, Huang Li-song, Zheng Ji-bo, Jia Yi-qing, Liu Yu-jie, Shan Yi
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.043
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: February 20 2016
x The objectives were to investigate the emergency treatment of serious dog bite lacerations on limbs and to identify whether negative pressure wound therapy (NPWT) was beneficial in these instances.
Failure of outpatient antibiotics among patients hospitalized for acute bacterial skin infections: What is the clinical relevance? Timothy C. Jenkins, Bryan C. Knepper, Bruce D. McCollister, S. Jason Moore, Sean W. Pawlowski, Daniel M. Perlman, Carla C. Saveli, Sean T. O'Leary, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.013
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: February 11 2016
x Infectious Diseases Society of America guidelines recommend that patients hospitalized for acute bacterial skin infections after failure of outpatient antibiotic therapy be managed as “severe” infections; however, the clinical relevance of apparent failure of outpatient therapy is not clear.
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.
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.
Diagnosing poststernotomy mediastinitis in the ED Jan J. van Wingerden, Mario Maas, Richard L. Braam, Bas A. de Mol
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.048
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 21 2015
x Poststernotomy mediastinitis (PSM), the severe chest wall and mediastinal infection that may arise at any time after a sternotomy, causes significant morbidity and mortality globally. Late recognition and diagnosis are the major contributors to a poor outcome. This review focuses on recent advances in diagnosing PSM (particularly after cardiovascular surgery) at the earliest opportunity—in the emergency department.
Copper-coated thermometer for the prevention of cross-infections: preliminary results Panos Efstathiou, Evangelia Kouskouni, Zaharoula Manolidou, Maria Tseroni, Katerina Karageorgou, Helena C. Maltezou, Athanasios Chalkias, Seraphim Papanikolaou, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.028
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 17 2015
x Research has shown that axillary thermometers are contaminated at a rate of 80% to 100% [1–3]. Although the common digital thermometer is always disinfected with an alcohol solution after each use, disinfection is only partially achieved or fails, potentially leading to resistant bacteria and sepsis [4–6].
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
Clinical application of rapid B-line score with lung ultrasonography in differentiating between pulmonary infection and pulmonary infection with acute left ventricular heart failure Zhi-peng Liu, Yu Zhang, Hong Bian, Xiao-ran He, Ya-jing Zhou, Li-jun Wang, Ning Ding
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.050
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: November 3 2015
x We have found that there are usually 2 causes of acute dyspnea in our emergency department: (1) pulmonary infection only and (2) pulmonary infection in the setting of acute left ventricular heart failure (LVHF). These conditions are sometimes difficult to differentiate. Lung ultrasonography (LUS) is easily performed at the bedside and provides accurate information for diagnosis. In this study, we propose a simple B-line score to allow rapid differential diagnosis between these 2 lung conditions.
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.
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.
The prognostic role of non-critical lactate levels for in-hospital survival time among ED patients with sepsis Adam R. Aluisio, Ashika Jain, Bonny J. Baron, Saman Sarraf, Richard Sinert, Eric Legome, Shahriar Zehtabchi
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.006
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 12 2015
x This study describes emergency department (ED) sepsis patients with non-critical serum venous lactate (LAC) levels (LAC <
Evaluation of hidden HIV infections in an urban ED with a rapid HIV screening program Yu-Hsiang Hsieh, Gabor D. Kelen, Kaylin J. Beck, Chadd K. Kraus, Judy B. Shahan, Oliver B. Laeyendecker, Thomas C. Quinn, Richard E. Rothman
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.002
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 8 2015
x To investigate the prevalence of undiagnosed HIV infections in an emergency department (ED) with an established screening program.
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.
Synthetic cannabinoid hyperemesis resulting in rhabdomyolysis and acute renal failure Jacqueline R. Argamany, Kelly R. Reveles, Bryson Duhon
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.051
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: September 7 2015
x Synthetic cannabinoid usage has increased in the past decade. Concurrently, emergency management of associated adverse effects due to synthetic cannabinoid usage has also risen. Reported toxicities include psychosis, seizures, cardiotoxicity, acute kidney injury, and death. While cannabis was first described as a cause of acute hyperemesis in 2004, a more recent case series also describes the association between cannabinoid hyperemesis and risk of acute renal failure. Synthetic cannabinoids have also been reported to cause acute hyperemesis and acute renal failure; however, the risk of rhabdomyolysis-induced renal failure has yet to be elucidated.
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.
