Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Nov 2018
ReviewSkin and Soft Tissue Infections in the Emergency Department.
This article covers the diagnosis and treatment of skin and soft tissue infections commonly encountered in the emergency department: impetigo, cutaneous abscesses, purulent cellulitis, nonpurulent cellulitis, and necrotizing skin and soft tissue infections. Most purulent infections in the United States are caused by methicillin-resistant Staphylococcus aureus. ⋯ Nonpurulent infections are usually caused by streptococcal species and initial empiric antibiotics need not cover methicillin-resistant Staphylococcus aureus. For uncommon but potentially lethal necrotizing skin and soft tissue infections, the challenge is rapid diagnosis in the emergency department and prompt surgical exploration and debridement.
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Infective endocarditis (IE) is an uncommon infection of cardiac valves associated with bacteremia. It increasingly affects elderly patients with chronic disease and artificial cardiac devices. ⋯ IE carries potential to cause significant morbidity and mortality through its impact on cardiac function and from embolic complications. Blood cultures prior to antibiotics and obtaining prompt echocardiography are key diagnostic steps, followed by proper selection of empiric antibiotics and, in many cases, collaboration with infectious disease, cardiology, and cardiothoracic surgery specialists.
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Emerg. Med. Clin. North Am. · Nov 2018
ReviewThe Emergency Department Diagnosis and Management of Urinary Tract Infection.
Urinary tract infection (UTI) is a common infection seen in the emergency department. The spectrum of UTI includes simple versus complicated infection and lower versus upper UTI. No one history or examination finding is definitive for diagnosis. ⋯ Imaging often is not required. Most patients with simple cystitis and pyelonephritis are treated as outpatients. A variety of potentially dangerous conditions may mimic UTI and pyelonephritis.
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Emerg. Med. Clin. North Am. · Nov 2018
ReviewBiothreat Agents and Emerging Infectious Disease in the Emergency Department.
The challenges faced by the emergency physician with recognizing and treating category A biothreat agents and emerging infectious disease are summarized and reviewed.
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Hydrologic disasters, including hurricanes, tsunamis, and severe flooding, have been associated with infectious diseases, particularly among vulnerable and displaced populations in resource-poor settings. Skin and soft tissue infections, gastrointestinal infections, respiratory infections, zoonotic infections, and vector-borne diseases each present unique threats to human health in this setting. Increased emergency physician awareness of these infectious diseases and their diagnosis and management helps optimize medical care for survivors after a hydrologic disaster and safeguard the health of disaster responders.