24 y/o F visiting from Guatemala with no medical history presented to the ER after a syncopal event from standing during which she fall backwards hitting her head on a hard surface. Patient was witnessed to be shaking while on the ground per family member. She continued to feel dizzy while in the ED. Her lab work was normal and a head CT was performed which showed the following:
As the weather warms in most parts of the country, we need to begin including tickborne illnesses on our differentials. Read below for a quick summary of some of the most common tickborne illnesses.
Neutropenic Enterocolitis aka typhlitis, necrotizing enterocolitis, ileocecal syndrome
- intestinal mucosal wall edema and disruption of wall integrity in a neutropenic patient
- Weakened immune system --> intestinal overgrowth --> invasion of opportunistic bacteria.
- May lead to sepsis and bowel perforation.
- Mortality 22%-50%.
This week's post comes courtesy of our ED pharmacist Rachel Rafeq. Surprise! Metronidazole is no longer first line therapy for c-diff infections! Check out this handy table for the updated guidelines from the Infectious Disease Society of America for the latest treatment regimens
A 60-year-old male presents with fever, dry cough, headache, nausea, vomiting and diarrhea. He saw his primary care physician who prescribed him Amoxicillin for which he has been taking for 4 days but feeling worse. Labs show a Sodium of 130 and mild transaminitis, other labs are within normal limits. What is the most likely diagnosis?
A 34 year old woman comes to the ER after a few days of nausea, vomiting and diarrhea. She is found to be disoriented and hypotensive, but she isn’t improving with fluid hydration. What gives?