Christopher J. Nelson

EM@3AM: Hiccups

A 73-year-old male with a history of hypertension presents to the ED with a 2-month history of hiccups. He reports difficulty eating and sleeping secondary to hiccups. He has tried multiple maneuvers from breath holding to biting lemons to drinking water upside-down. His vital signs and exam are normal, including neurologic exam. What is your diagnosis?

EM@3AM: Hiccups Read More »

EM@3AM: Tetanus

A 38-year-old male with a history of injection drug use presents with one day of progressively worsening, pressure-like chest pain radiating to his back. He appears diaphoretic and in moderate distress. He has had new difficulty opening his mouth. On exam, he is tachycardic, diaphoretic, and in acute distress. He endorses tenderness throughout his thoraco-lumbar spine. Neurological evaluation demonstrated increased tone in all extremities. Skin exam reveals two abscesses on his upper extremities. An MRI of the spine is unremarkable. Reexamination reveals new spasmodic neck stiffening, jaw clenching and arching of his back. What is the likely diagnosis?

EM@3AM: Tetanus Read More »

Com artificial intelligence search engine. โน. miss cool cool.