recent articles

practice updates

Brain Abscess: Pearls and Pitfalls

What do you think of with the patient presenting with fever, headache, and focal neurologic signs? Meningitis? Encephalitis? What about brain abscess? This post is filled with pearls and pitfalls on the pathogenesis, presentation, diagnosis, and treatment of brain abscess.


Pneumonia Mimics: Pearls and Pitfalls

Pneumonia is an illness frequently seen in our emergency departments. But, are all presentations actually pneumonia? Are we missing other illnesses that present similarly to pneumonia? Which ones pose significant morbidity and mortality risk to our patients? What clues are out there that will aid us in making an alternative and critical diagnosis?

In the Literature

Blood cultures: when do they make a meaningful impact on clinical care?

Bacteremia affects 200,000 patients per year, with the potential of causing significant mortality. Blood cultures are considered the most sensitive method for detecting bacteremia and are commonly obtained in patients with fever, chills, leukocytosis, focal infections, sepsis, or suspected endocarditis. However, what is the literature behind obtaining cultures in the ED?

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.