Clinical medicine (London, England)
-
Adult-onset measles is rare in the UK, particularly in patients with a complete vaccination history. We present a case of a UK-born patient who received all childhood vaccinations, had no history of recent travel or unwell contacts who was diagnosed with measles complicated by pneumomediastinum. ⋯ The nature of the rash can provide an important clue to the diagnosis. Liaison with infection specialists facilitates early diagnosis, allowing for appropriate initial investigations, improving clinical management and early infection control precautions being instituted.
-
Case Reports
Spontaneous splenic rupture secondary to dabigatran: the last in a series of unfortunate events.
We present the case of a 77-year-old woman who had an accidental fall in her garden, resulting in a fracture of her left ankle. After manipulation of the fracture, she developed sudden onset shortness of breath. An echo led to the diagnosis of Takotsubo cardiomyopathy. ⋯ She was started on dabigatran. A few days later, she developed abdominal pain, and was subsequently diagnosed with a spontaneous splenic rupture. This case was interesting due to the unusual chain of events following a simple fall, and also a rare complication of anticoagulant therapy.
-
Epileptic seizures are a common cause for presentation to acute medical services. Whether presenting with an isolated, unprovoked seizure or with status epilepticus, a good understanding of seizures and their mimics ensures appropriate investigation and treatment. This article describes the practical aspects of the management of patients presenting with seizures to the emergency department or the acute medical unit.
-
Headache is common. Up to 5% of attendances to emergency departments and acute medical units are due to headache. ⋯ The role of the attending physician is to take a comprehensive history to diagnose and treat benign headache syndromes while ruling out sinister aetiologies. This brief article summarises the approach to assessment of headache presenting in acute and emergency care.