Properly Naming the Sinusitis-Otitis-Conjunctivitis Syndrome
One of our nonphysician providers recently announced, “This kid has that double-sickening thing you talk about all the time." She was referring to the sudden worsening of signs and symptoms (e.g., onset of fever) in a patient who had had an upper respiratory tract infection for several days.The majority of links in a Google search for “double-sickening" are references for sinusitis, but new-onset pneumonia is another double-sickening event. The Infectious Diseases Society of America guidelines for sinusitis acknowledge double-sickening and concur that pneumonia can present similarly. I investigate for sinusit...
Source: M2E Too! Mellick's Multimedia EduBlog - November 1, 2021 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Weekly Overseas Health IT Links – 25th January, 2020.
Here are a few I came across last week.Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.-----https://www.digitalhealth.net/2020/01/electronic-prescription-error-lead-to-womans-death-coroner-finds/Electronic prescription error lead to woman ’s death, coroner findsA woman died after a mix-up with an electronic prescription caused her to continue taking the wrong medication for an infection, a coroner has found.Andrea Downey – 15 January, 2020David Urpe...
Source: Australian Health Information Technology - January 24, 2020 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs

Antibiotic-resistant urinary tract infections are on the rise
There is a global crisis of antibiotic resistance, and urinary tract infections (UTIs) may be the canary in the coal mine. UTIs are one of the most common types of infections; at least one in two women and one in 10 men will experience a UTI in their lifetime. Like many human infections, UTIs are usually caused by bacteria living on or in our bodies, and require treatment with antibiotics. What’s alarming the medical community now is that UTIs are becoming ever harder to treat with common antibiotics. Antibiotic overuse leads to antibiotic resistance At some point, most people have taken a course of trimethoprim/sulfamet...
Source: Harvard Health Blog - October 14, 2019 Category: Consumer Health News Authors: Lisa Bebell, MD Tags: Drugs and Supplements Health Infectious diseases Kidney and urinary tract Women's Health Source Type: blogs

Co-trimoxazole
CLASS 2 antibiotics (sulfamethoxazole and trimethoprim) MECHANISM OF ACTION sulfamethoxazole -> inhibits bacterial synthesis of dihydrofolic acid trimethoprim -> blocks production of tetrahydrofolic acid -> blocks two consecutive steps in the biosythesis of nucleic acids and proteins essential to bacteria. PHARMACEUTICS PO – each tablet = 80mg trimethoprim and 400mg sulfamethoxazole IV – 5mL contains […] The post Co-trimoxazole appeared first on Life in the Fast Lane • LITFL • Medical Blog. (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - April 13, 2019 Category: Emergency Medicine Authors: Hamish Cadogan Tags: CCC Source Type: blogs

Pediatric Conjunctivitis a Simple Diagnosis Until It Isn’t
​Conjunctivitis is a common condition and easy enough to treat, but several uncommon conjunctivitis syndromes require more care and should not be missed.Conjunctivitis is either infectious (viral or bacterial) or noninfectious (allergic or nonallergic). Viral infections are more common in adults, bacterial ones in children, usually caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Adults tend to have more S. aureus infections, while the other pathogens are more common in children. An adenovirus is typically responsible for viral-associated infections in conjunct...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

MKSAP: 35-year-old woman is evaluated for intermittent fever
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks’ duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of pretransplant testing for tuberculosis were negative. She received valganciclovir prophylaxis for 3 months after transplantation. Medications are tacrolimus, prednisone, mycophen...
Source: Kevin, M.D. - Medical Weblog - May 12, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Allergies & Immunology Infectious Disease Source Type: blogs

MKSAP: 32-year-old man with a rash on his face and midchest
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old man is evaluated for a 2-week history of a rash on his face and midchest. He describes the rash as consisting of small, reddish “lumps” that are intensely itchy; they develop and begin to resolve with development of new lesions. He otherwise feels well. Medical history is significant for a recent diagnosis of HIV infection. Medications are tenofovir, emtricitabine, efavirenz, and trimethoprim-sulfamethoxazole. On physical examination, vital signs are normal. The patient has 1- to 3-mm papules a...
Source: Kevin, M.D. - Medical Weblog - November 11, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Dermatology Infectious Disease Source Type: blogs

MKSAP: 20-year-old male college student with a superficial skin infection
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 20-year-old male college student on the wrestling team is evaluated for a superficial skin infection. He has a history of several episodes of folliculitis and furunculosis over the past year that has required systemic treatment. His recurrent infections were treated with various oral antibiotics, including cephalexin, clindamycin, and trimethoprim-sulfamethoxazole. He currently takes no medications, has no drug allergies, and is otherwise in good health. On physical examination, vital signs are normal. There a...
Source: Kevin, M.D. - Medical Weblog - July 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Infectious disease Source Type: blogs

Oldie but Goodie Pediatric Clinical Concepts
​A number of older clinical concepts may be unfamiliar to younger clinicians, but these clinical concepts are useful in pediatric medicine. Some of these concepts showed up in the medical literature for the first time nearly a century ago. Physicians should feel free to question the potential value and validity of older clinical concepts that aren't at the forefront of medical education, but my experience of more than 30 years practicing pediatrics and emergency medicine has repeatedly affirmed to me that these are valuable in emergency medicine.​Parenteral DiarrheaThe concept of parenteral diarrhea has been around for...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Oldie but Goodie Pediatric Clinical Concepts
​A number of older clinical concepts may be unfamiliar to younger clinicians, but these clinical concepts are useful in pediatric medicine. Some of these concepts showed up in the medical literature for the first time nearly a century ago. Physicians should feel free to question the potential value and validity of older clinical concepts that aren't at the forefront of medical education, but my experience of more than 30 years practicing pediatrics and emergency medicine has repeatedly affirmed to me that these are valuable in emergency medicine.​Parenteral DiarrheaThe concept of parenteral diarrhea has been around for...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

MKSAP: 32-year-old man with a rash on his face and midchest
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old man is evaluated for a 2-week history of a rash on his face and midchest. He describes the rash as consisting of small, reddish “lumps” that are intensely itchy; they develop and begin to resolve with development of new lesions. He otherwise feels well. Medical history is significant for a recent diagnosis of HIV infection. Medications are tenofovir, emtricitabine, efavirenz, and trimethoprim-sulfamethoxazole. On physical examination, vital signs are normal. The patient has 1- to 3-mm p...
Source: Kevin, M.D. - Medical Weblog - June 4, 2016 Category: Journals (General) Authors: Tags: Conditions Dermatology Source Type: blogs

Research and Reviews in the Fastlane 127
This study didn’t look at simple abscesses but rather at ones that most clinicians would have given antibiotics to and in spite of that, they found only a relatively modest benefit. Despite the headline, this is NOT practice changing. Recommended by: Anand Swaminathan Further reading: Are Antibiotics Back in Favor for Abscesses? (EM Literature of Note), Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses? (R.E.B.E.L. EM) The Best of the Rest Emergency Medicine Martin SP, et al. Double-dorsal single-volar digital subcutaneous anaesthetic injection for finger injuries in the emergency department: A r...
Source: Life in the Fast Lane - March 23, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Anaesthetics Emergency Medicine Infectious Disease Neurology R&R in the FASTLANE Resuscitation EBM Education literature recommendations research and reviews Source Type: blogs

LITFL Review 222
Welcome to the 222nd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Josh Farkas explains his top 10 issues/problems with the new Sepsis-3 definitions. [SR] The Best of #FOAMed Emergency Medicine First 10 EM drops their articles of the month as February comes to a close. [AS] Cameron Berg discusses another way ...
Source: Life in the Fast Lane - March 6, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Funtabulously Frivolous Friday Five 122
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 122 Question 1 What is a Clay-shoveler’s fracture and how do you get one? + Reveal the Funtabulous Answer expand(document.getElementById('ddet1948481060'));expand(document.getElementById('ddetlink1948481060')) Fracture through the spinous process of a vertebra occurring at any of the lower cervical or upper thoracic vertebrae, classically at C6 or C7. Originally described in Australia associated with (no prizes for...
Source: Life in the Fast Lane - October 23, 2015 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five adrenal crisis adrenal insufficiency botulism clay shoveler's fracture erythema multiforme rhabdomyolysis Source Type: blogs

MKSAP: 25-year-old woman is evaluated for redness at mosquito bite
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman is evaluated for redness that developed over her right leg at the site of a mosquito bite. She is otherwise healthy and takes no medications. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 120/70 mm Hg, pulse rate is 70/min, and respiration rate is 14/min. There is an erythematous 3 × 3-cm patch on the right thigh. The area is warm to the touch with no evidence of purulence, fluctuance, crepitus, or lymphadenopathy. Which of the following is the most appropria...
Source: Kevin, M.D. - Medical Weblog - May 23, 2015 Category: Journals (General) Authors: Tags: Conditions Infectious disease Source Type: blogs