J Emerg Med
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Case Reports
Massive Pneumomediastinum and Subcutaneous Emphysema Secondary to Foreign Body Aspiration.
Spontaneous pneumomediastinum (SPM) occurs in cases of mediastinal leaks that are not caused by trauma, mechanical ventilation, or other surgical procedures. In most cases, in the pediatric population a trigger can be identified, most commonly asthma. SPM caused by foreign body aspiration is not a common entity. It is usually a benign condition that generally resolves without severe sequela, but in some cases, severe morbidity and mortality have been documented. Treatment is usually conservative and includes rest, analgesics, and treatment of any underlying pathologies. ⋯ We report a case of a 19-month-old boy who presented to the emergency department with acute facial swelling and wheezing with no history of foreign body aspiration. This misleading presentation led the medical staff in the emergency department to initially treat the patient for anaphylaxis. The diagnosis was made only after imaging modalities demonstrated SPM with a suspected foreign body in the right main stem bronchus. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Providers should consider SPM from an aspirated foreign body in young children with respiratory distress and acute facial swelling, especially when crepitus is present. © 2021 Elsevier Inc.
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Hyperglycemic hyperosmolar state is a life-threatening complication of diabetes mellitus. Therefore, it is important for emergency physicians to be aware of this unique diagnosis and treatment considerations. ⋯ Hyperglycemic hyperosmolar state is associated with significant morbidity and mortality. It is important for clinicians to be aware of the current evidence regarding the diagnosis, management, and disposition of these patients.
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Background Bilateral ectopic pregnancies (EPs) occur in 1 of 200,000 pregnancies. Evidence suggests that endometriosis is an independent risk factor for unilateral EPs. However, the link between endometriosis and bilateral EPs has not been established. ⋯ Why Should an Emergency Physician Be Aware of This? Although rare, bilateral EP should be on a differential diagnosis in a pregnant patient presenting with abdominal pain or vaginal bleeding. This includes patients presenting with worsening symptoms after the recent surgery for the unilateral EP. Endometriosis as a risk factor for bilateral EP cannot be established based on a single report, but such a report should raise awareness of the issue.
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Background Vaccination is the most important way out of the novel coronavirus disease 2019 (COVID-19) pandemic. Vaccination practices have started in different countries for community immunity. In this process, health authorities in different countries have preferred different type of COVID-19 vaccines. ⋯ Why Should an Emergency Physician Be Aware of This? To the best of our knowledge, this is the first case of allergic myocardial infarction secondary to inactivated coronavirus vaccine. This case demonstrates that KS can occur after inactivated virus vaccine against COVID-19. Although the risk of severe allergic reaction after administration of CoronaVac seems to be very low, people who developed chest pain after vaccine administration should be followed by ECG and troponin measurements.