Today on the emDOCs cast with Brit Long and Rachel Bridwell, we cover Lemierre’s syndrome and retropharyngeal abscess.
emDOCs Podcast – Episode 56: Lemierre’s Syndrome and Retropharyngeal Abscess Read More »
A 33-year-old male presents to the ED for odynophagia and mild dyspnea. He has had pain with swallowing for the past 24 hours and it has gotten progressively worse. He is having difficulty tolerating oral secretions. VS include BP 91/49, HR 130, T 102.2 temporal, RR 25, SpO2 91% on room air. He appears toxic. The ENT exam reveals a midline uvula; cervical lymphadenopathy; soft mouth floor, and no evidence of dental infection, no neck erythema, though voice changes. He has severe pain with palpation of the hyoid bone. What’s the most likely diagnosis?
EM@3AM: Epiglottitis Read More »
A 3-year-old male is brought in by his mother for severe throat pain and lethargy. She notes that he is playing less, refusing to eat, and preferring to lie supine. Review of systems is remarkable for a recent small fall with his toothbrush in his mouth. Triage vital signs include BP 91/49, HR 141, T 103.1 temporal, RR 25, SpO2 96% on room air. He appears toxic and is lying supine. The oropharyngeal exam is normal, but the patient has prominent generalized cervical lymphadenopathy, torticollis, and a painful tracheal rock. The patient has no voice changes but does not want to extend his neck. What’s the most likely diagnosis?
EM@3AM: Retropharyngeal Abscess Read More »
A 23-year-old male presents for severe throat pain and cough. He states that his neck hurts, with left sided redness and pain. Vital signs include BP 91/49, HR 130, T 102.2 temporal, RR 25, SpO2 91% on room air. He appears toxic. The ENT exam reveals a midline uvula; soft mouth floor; prominent generalized cervical, submandibular, and submental swelling with corresponding lymphadenopathy; but no voice changes or difficulty tolerating secretions. His neck is red and tender, with mild swelling overlying the left side of neck and a painful tracheal rock. What is the most likely diagnosis?
EM@3AM: Lemierre’s syndrome Read More »
Rachel Bridwell is back to discuss another ENT emergency: peritonsillar abscess.
emDOCs Podcast: Episode 34 – Peritonsillar Abscess Read More »
A 42 year-old male presents with abdominal pain and fevers for 72 hours, with nausea and vomiting for 24 hours. He has a history of ESRD and has been on peritoneal dialysis for 5 years. Triage vital signs (VS): BP 105/60, HR 121, T 101.4 temporal, RR 24, SpO2 98% on room air. Pertinent physical examination findings include a tender peritoneal dialysis site and diffuse abdominal tenderness, but no erythema overlying the PD site. What’s the next step in your evaluation and treatment?
EM@3AM: Peritoneal Dialysis Emergencies Read More »
This week Rachel Bridwell and Brit Long cover Ludwig’s Angina, a potential ENT and airway nightmare.
emDOCs Podcast: Episode 33 – Ludwig’s Angina Read More »
A 42-year-old male undergoing recent radiation therapy for colorectal cancer presents with pelvic and anal pain and pain with defecation. He experiences extreme pain prior to and during defecation. He has had mucous and blood in his stool. He denies a history of hemorrhoids. Pertinent physical examination findings include fever, tachycardia, and lower abdominal pain to palpation. Rectal exam reveals reveals tenderness. What’s the next step in your evaluation and treatment?
Rachel Bridwell and Brit Long cover pulmonary hypertension in this week’s podcast.
emDOCs Podcast – Episode 32: Pulmonary Hypertension Read More »
A 62-year-old male presents with abdominal pain and fever for 2 days. He has recently completed induction chemotherapy a few days prior. Review of systems is remarkable for vomiting and anorexia. Exam reveals BP 96/69 mm Hg, HR 122, T 101.9 oral, RR 28, SpO2 97% on room air. He is ill appearing and has dry mucous membranes but no mucositis. Abdominal exam reveals guarding and tenderness in the right lower quadrant. What is the diagnosis, and what’s the next step in your evaluation and treatment?