Author: Dr. Tisma Background/Study Question How often do septic patients receive their second antibiotic dose later than they should? What are the risk factors for these delays? And do these delays affect patient outcomes? Leisman et. al. published a study in 2017 that examined these important inquiries. These questions are particularly interesting to me as…
Author: Vanessa I. Petrak, M.D. Background: Septic Shock is a dysregulated host response to infection, resulting in life-threatening circulatory, cellular, and metabolic abnormalities. Sepsis is associated with a dysregulated response of the hypothalamic-pituitary-adrenal axis that may involve any of the steps from cortisol production to cortisol use by cells. Short term mortality is approximately 45-50%, and…
Author: Dr. Jeny Tan-Creevy Background: Necrotizing soft tissue infections more commonly known as necrotizing fasciitis is a life-threatening diagnosis with a high risk for morbidity and mortality. Gold standard for diagnosis is surgical exploration, which unfortunately is difficult in the Emergency Department. The study is a meta-analysis to investigate the accuracy of physical examination, imaging, and…
Author: Dr. Stephen Gore
In the spirit of antibiotic stewardship and limiting the side effects of said antibiotics, we took a critical look during our last Journal Club session at the utility of urinalyses, urine cultures and vague symptoms like confusion/altered mental state in diagnosing UTI.
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Author: Dr. Trevor Landas Defined as inflammation of the meninges, or covering layers of the central nervous system, meningitis has a high morbidity and mortality if not identified and treated promptly. The incidence is approximately 1.38 per 100,000 people. Clinical Presentation: Presenting symptoms include the classic triad of fever, neck stiffness, and altered mental status,…
Dr. Somy Thottathil did an awesome lecture on bioterrorism this past week. And although it is hopefully something we never have to see, as one of the major hospitals designated as a bioterrorism site in Chicago, it is something that we should be prepared to recognize and treat. It’s also good review for all the med school knowledge we haven’t needed (thankfully) for some time now. The main topics we’ll focus on are the Category A agents: Botulism, Plague, Anthrax, Smallpox, and Viral Hemorrhagic Fevers (which includes Ebola, Marburg, Lassa Fever, and Crimean-Congo Hemorrhagic Fever). We are only going to discuss Ebola as current outbreaks are still occurring.
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This week’s 5-minute Journal Article discussion covered
“Validation of a Clinical Prediction Rule for the Differentiation Between Septic Arthritis and Transient Synovitis of the Hip in Children” by Kocher et al.
Why is it important to differentiate between septic arthritis and transient synovitis in pediatric patients? Because both diseases can present similarly with acute onset of pain, fever, limp or inability to bear weight and patients holding their hip in the flexed, abducted, externally rotated (FABER) position. The difference is transient synovitis is exactly that, transient, while septic arthritis can lead to permanent joint damage and disability if not treated aggressively with surgical intervention and IV antibiotics.
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