End-tidal carbon dioxide is associated with mortality and lactate in patients with suspected sepsis Christopher L. Hunter, Salvatore Silvestri, Matthew Dean, Jay L. Falk, Linda Papa
DOI: http://dx.doi.org/10.1016/j.ajem.2012.05.034
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: August 6 2012
x Exhaled end-tidal carbon dioxide (Etco 2 ) concentration is associated with lactate levels in febrile patients. We assessed the association of Etco 2 with mortality and lactate levels in patients with suspected sepsis.
Right lower quadrant abdominal pain, fever, and hypotension: an atypical presentation of meningococcemia Ryan P. Austin, Adam G. Field, William M. Beer
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.028
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: March 17 2015
x A previously healthy, 33-year-old man presented to our emergency department complaining of right lower quadrant abdominal pain with anorexia, nausea, vomiting, diarrhea, and fever. Physical examination revealed hypotension, with rebound tenderness in the right lower quadrant. A computed tomography scan of the abdomen and pelvis revealed a normal appendix but showed findings suggestive of inflammation within the retroperitoneum. The initial suspected diagnosis was appendicitis with dehydration, but after not responding to initial fluid resuscitation and obtaining a computed tomography scan with only retroperitoneal inflammation, other etiologies of sepsis were considered.
Acute neck infections in children: who is likely to undergo surgical drainage? Michael W. Sauer, Sujit Sharma, Daniel A. Hirsh, Harold K. Simon, Beesan S. Agha, Jesse J. Sturm
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.043
The American Journal of Emergency Medicine , Vol. 31 , Issue 6 ,
Published online: May 15 2013
x Superficial neck infections including lymphadenitis and abscesses are commonly encountered in pediatric emergency departments (PEDs). It is often unclear which patients are likely to develop an abscess that necessitates surgical drainage. In evaluating these patients, computed tomography (CT) and ultrasound are often used to identify/confirm abscess formation. The criteria for determining the need for imaging studies are not well defined.
Different clinical presentation of community-onset bacteremia among human immunodeficiency virus-infected and human immunodeficiency virus-uninfected adults in the ED Ching-Chi Lee, Feng-Yuan Chu, Wen-Chien Ko, Chih-Hsien Chi
DOI: http://dx.doi.org/10.1016/j.ajem.2014.07.028
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: August 2 2014
x The objective of this study is to analyze the differences in clinical presentation and outcome of community-onset bacteremia between human immunodeficiency virus (HIV)-infected adults and HIV-uninfected adults visiting the emergency department (ED).
The characteristics and prognostic predictors of unplanned hospital admission within 72 hours after ED discharge Shih-Yu Cheng, Hui-Ting Wang, Chi-Wei Lee, Tsung-Cheng Tsai, Chi-Wei Hung, Kuan-Han Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.004
The American Journal of Emergency Medicine , Vol. 31 , Issue 10 ,
Published online: September 11 2013
x The aims of this study were (1) to identify the characteristics of patients who return to the emergency department (ED) within 72 hours and are admitted to the hospital and (2) to identify the characteristics and predictors of in-hospital mortality subgroup.
Injury and illness sustained by human competitors in the 2010 Iditarod Sled Dog Race James W. Gallea, George L. Higgins III, Carl A. Germann, Tania D. Strout
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.018
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: February 26 2014
x Alaska's 1049-mile Iditarod Trail Sled Dog Race is the world's longest sled dog race and the flagship event in the sport of sled dog racing. Race conditions are typically harsh. Physicians are not officially enlisted to care for human competitors. Instead, medical needs are met through an informal system of volunteers, local health care providers, and a fleet of bush planes. The goals of this study were to identify the types of human injury and illness experienced and the methods by which these conditions are treated.
Predicting the hyperglycemic crisis death (PHD) score: a new decision rule for emergency and critical care Chien-Cheng Huang, Shu-Chun Kuo, Tsair-Wei Chien, Hung-Jung Lin, How-Ran Guo, Wei-Lung Chen, Jiann-Hwa Chen, Su-Hen Chang, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.010
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: April 22 2013
x We investigated independent mortality predictors of hyperglycemic crises and developed a prediction rule for emergency and critical care physicians to classify patients into mortality risk and disposition groups.
Acute kidney injury and thrombocytopenic fever—consider the infrequent causes Christian S. Haas, Walter Lehne, Philip Muck, Anja Boehm, Jan Rupp, Juergen Steinhoff, Hendrik Lehnert
DOI: http://dx.doi.org/10.1016/j.ajem.2012.04.007
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published in issue: February 2013
x Acute kidney injury (AKI), fever, hepatosplenomegaly, and thrombocytopenia are characteristics of Hantavirus infections and leptospirosis, both worldwide zoonoses. Although AKI is usually the result of tubulointerstitial nephritis, glomerular damage with significant albuminuria and hematuria may be noted in both entities. Although Hantavirus infections are endemic in Western Europe and the United States, leptospirosis is predominantly seen in parts of South America and Asia. We here report 3 cases of thrombocytopenic fever and AKI presenting within several months in Northern Germany with initially suspected Hantavirus infection.
Pediatric abscess characteristics associated with hospital admission from the ED Michael W. Sauer, Daniel A. Hirsh, Harold K. Simon, Shervin A. Kharazmi, Jesse J. Sturm
DOI: http://dx.doi.org/10.1016/j.ajem.2010.05.015
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: August 16 2010
x To determine the characteristics of pediatric soft tissue abscesses that result in hospital admission.
Pitfalls in using serum C-reactive protein to predict bacteremia in febrile adults in the ED Ching-Chi Lee, Ming-Yuan Hong, Nan-Yao Lee, Po-Lin Chen, Chia-Ming Chang, Wen-Chien Ko
DOI: http://dx.doi.org/10.1016/j.ajem.2011.02.012
The American Journal of Emergency Medicine , Vol. 30 , Issue 4 ,
Published online: April 25 2011
x The diagnostic performance of serum C-reactive protein (CRP) in prediction of bacteremia among febrile patients visiting an emergency department (ED) was analyzed.
Comment on: “Atypical presentations of dengue disease in the elderly visiting the ED” Subhash C. Arya, Nirmala Agarwal
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.057
The American Journal of Emergency Medicine , Vol. 32 , Issue 2 ,
Published online: November 11 2013
x To the Editor:
Point-of-care ultrasound differentiates pyomyositis from cellulitis Allison Sauler, Turandot Saul, Resa E. Lewiss
DOI: http://dx.doi.org/10.1016/j.ajem.2014.08.064
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: August 29 2014
x Pyomyositis (PM) is an infection of skeletal muscle, often associated with an abscess. Patients typically have predisposing risk factors or are immune compromised. The disease is often misdiagnosed, mistreated, and goes undetected until late in the patient's clinical course. We present a case of a patient without obvious predisposing risk factors who complained of right thigh pain, swelling, redness, and fevers for 4 days. Point-of-care ultrasound revealed muscle edema and subcutaneous emphysema without signs of an overlying cellulitis.
Epiglottic abscess Jason K. Hsieh, Michael P. Phelan, Grace Wu, Aliye Bricker, Samantha Anne
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.036
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: October 21 2014
x Epiglottic abscess is an uncommon complication of acute epiglottitis that occurs almost exclusively in adults. Because it is a potentially life-threatening condition, prompt diagnosis and appropriate treatment are required. Keys to successful management include assessing the likelihood of the need to secure the airway and potential for airway compromise during intubation, as well as drainage and culture of abscess and institution of appropriate and timely antibiotic therapy. If the patient is considered at risk for complete airway obstruction, prompt institution of a pathway to securing the airway is crucial, including stabilization, notification of surgical and anesthesia teams, and safe transfer to the operating room.
Derivation of a clinical prediction rule to predict hospitalization for influenza in EDs Kuan-Fu Chen, Yu-Hsiang Hsieh, Charlotte A. Gaydos, Alexandra Valsamakis, Richard E. Rothman
DOI: http://dx.doi.org/10.1016/j.ajem.2012.10.010
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: February 4 2013
x Early, rapid, and accurate identification of those patients who have severe influenza is important for emergency physicians. Influenza viral load, which has been proposed as a predictor of severe influenza, could be useful in facilitating decision making of resource use. We aimed to derive a clinical prediction rule to indicate probability for inpatient hospitalization for patients with influenza, which includes influenza viral load in addition to other clinical information commonly collected in the emergency department (ED).
Effect of mild hypothermia on the increase of CD11b+ Gr-1+ myeloid-derived suppressor cells induced by lipopolysaccharide in a mouse model of sepsis Xiaoshuang Li, Li Liu, Feifei Luo, Li Gui, Dazhi Fan, Qilian Xie
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.008
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 16 2015
x This study aimed to investigate the influence of mild hypothermia on the number of CD11b+ Gr-1+ myeloid-derived suppressor cells (MDSCs) induced by lipopolysaccharide (LPS) injection in mice with sepsis.
Validation of an abbreviated version of the Denver HIV Risk Score for prediction of HIV infection in an urban ED Yu-Hsiang Hsieh, Jason S. Haukoos, Richard E. Rothman
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.043
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: March 6 2014
x We sought to evaluate the performance of an abbreviated version of the Denver HIV Risk Score in 2 urban emergency departments (ED) with known high undiagnosed HIV prevalence.
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 <
HIV-positive patient with herpes zoster: a manifestation of the immune reconstitution inflammatory syndrome Nancy Lutwak, Curt Dill
DOI: http://dx.doi.org/10.1016/j.ajem.2010.10.013
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: December 3 2010
x Herpes zoster is a common illness that can lead to serious morbidity. There is now evidence that HIV-infected patients who have been treated with antiretroviral therapy are at greater risk of developing herpes zoster not when they are severely immunocompromised but, paradoxically, when their immune system is recovering. This is a manifestation of the immune reconstitution inflammatory syndrome. The objectives of this report are to (1) inform health care providers that HIV-infected patients may develop multiple infectious, autoimmune, and oncological manifestations after treatment with antiretroviral medication, as they have immune system reconstitution, and (2) discuss herpes zoster, one of the possible manifestations.
Multimodality diagnosis and surgical management of prosthetic valve endocarditis complicated with perivalvular abscess formation Mahmut Yesin, Macit Kalçık, Mustafa Ozan Gürsoy, Süleyman Karakoyun, Emrah Bayam, Mehmet Altuğ Tuncer, Mehmet Özkan
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.041
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: March 19 2015
x Periannular extension of infection is a rare but potentially fatal complication of infective endocarditis. The accurate detection and delineation of periannular complications are crucial in patient management, which may also provide guidance for surgical interventions. Potential complications from a periannular extension of infective endocarditis include periannular abscess, pseudo-aneurysm formation, and subsequent development of aortocavitary fistula. Here, we present a case of a 46-year-old man with prosthetic aortic valve endocarditis complicated with perivalvular abscess formation that was managed with aortic homograft implantation.
Accompanying mild hypothermia significantly improved the prognosis of septic mice than artificial mild hypothermia Xiao-shuang Li, Li Liu, Yu-lian Jin, Fei-fei Luo, Lin Li, Jingfeng Zhu, Qilian Xie
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.003
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: August 5 2015
x Some patients with sepsis are found with accompanying mild hypothermia (ACMH); however, the effects of ACMH on the patients with sepsis are poorly understood.
