J Emerg Med
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Right-sided diverticulitis is a rare source of right lower quadrant pain in Western society; however, it is quite common in Asian societies. Right-sided diverticulitis presents very similarly to appendicitis, with right lower quadrant pain, fever, nausea, and laboratory abnormalities, and is often seen in young patients. ⋯ Severe right lower quadrant pain in young patients of Asian descent can be right-sided diverticulitis. Right-sided diverticulitis is a benign condition managed medically that mimics appendicitis. CT imaging seems to be the best way to avoid unnecessary surgery.
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Risk factors for exacerbation of congestive heart failure have not been consistently validated. ⋯ Patients with chronic congestive heart failure who presented to the Emergency Department with acute decompensated heart failure were no more likely to report consuming a greater number of high-sodium foods in the 3 days before than were patients with chronic congestive heart failure who presented with unrelated symptoms. On the other hand, those who presented with acute decompensated heart failure were significantly more likely to report nonadherence with medications.
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Case Reports
Instability of gait as an extrapulmonary sequela in acute Legionella pneumonia: a case report.
Legionnaires disease is a potentially fatal infection often associated with permanent pulmonary fibrosis in survivors. Although neurological complications are not infrequent, chronic peripheral neuropathy in the absence of pulmonary abnormalities is an uncommon consequence of Legionnaires disease. ⋯ The outcome of this case confirms that the early exudative phase of ARDS in the absence of bronchial dilatation on chest CT scan is not always related to pulmonary fibrosis in survivors at follow-up. It also demonstrates that peripheral neuropathy can persist despite tailored treatment.
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Reintroduction of nutrition to the chronically starved patient presents a constellation of metabolic challenges termed "refeeding syndrome." The consequences of this syndrome--principally hypophosphatemia--may be life threatening. Although previously described in the nutritional literature, little information exists on this syndrome written from the perspective of the emergency physician. ⋯ The acute complications of refeeding syndrome may present during a patient's stay in the ED or during the transition from the ED to a critical care area, and thus this syndrome deserves consideration from the moment a starved patient presents to our triage desks.
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Urinary incontinence is not a common emergency department (ED) complaint, and it is hard to imagine that a case involving this complaint could turn out to be interesting. We report the case of a patient who presented with the complaint of sudden onset of painless urinary incontinence for 1 day, who had an unexpected diagnosis. ⋯ Emergency physicians frequently see patients with ureteral stents, but may not be aware of how frequently those stents can migrate or malfunction. Our experience suggests that radiologic determination of stent location may be helpful in patients who present with new-onset stress or overflow incontinence.