recent articles

practice updates

Acute Mastoiditis: Pearls and Pitfalls

Acute mastoiditis is a common complication of acute otitis media. Diagnosis includes clinical evidence of mastoid inflammation and may necessitate further imaging to exclude other complications. IV antibiotics and a surgical consult are required.

practice updates

Cholangitis: Deadly Cause of Right Upper Quadrant Abdominal Pain

Cholangitis should be considered in patients with undifferentiated sepsis. Ruling in or out the diagnosis of cholangitis is no longer based on clinical exam alone. The addition of imaging and bloodwork to the clinical exam are much more reliable. Resuscitation, antibiotics and consultation for early biliary decompression are the mainstays of cholangitis treatment.

practice updates

What’s New: A Review of the Sepsis Literature

There have been a number of new publications reviewing our approach to managing sepsis. Both the ProCESS Trial and ARISE trial published in 2014 editions of the New England Journal question whether invasive procedures and rigid protocols are required to have positive patient outcomes. Other studies included in this power review examine the importance of early antibiotic therapy, effects of different mean arterial pressure parameters, and impact of chloride heavy versus chloride restricted solutions.