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.
