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em@3am

EM@3AM: Bartholin’s Abscess

A 36-year-old female presents to the ED with vaginal pain. She initially noticed a small bump one week ago that was only painful with sexual intercourse, but it has grown and now causes discomfort even when walking. Her temperature is 98.9oF, heart rate 78, and blood pressure 126/84. On exam she has a large, soft mass protruding at the 8 o'clock position of the vaginal opening that is painful and fluctuant to touch. There is some induration around the mass, but no vaginal discharge is noted on the pelvic exam. What is most likely causing this woman's pain? How would you manage this diagnosis to provide some relief?

em@3am

EM@3AM: Infectious Mononucleosis

A 17-year-old male with history of asthma presents to the ED with a chief complaint of sore throat for the past 3 days, associated with decreased oral intake. He denies sick contacts. Vital signs include Temp 100.6F, BP 124/78, HR 92, RR 16, 96% on RA. On exam the patient has swollen, erythematous tonsils with grayish exudate, as well as enlarged, tender anterior and posterior cervical chain lymph nodes. What is the most likely diagnosis?