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Here’s another case from Medical Malpractice Insights – Learning from Lawsuits, a monthly email newsletter for ED physicians.

Today the emDOCs cast covers the controversy of antibiotics in uncomplicated diverticulitis.

Dr. Pilcher looks at necrotizing fasciitis in this month’s medical malpractice case.

A 3-year-old male presents to the ED with one week of daily fevers >102°F associated with four days of rash on the trunk. His parents have been managing his fevers with acetaminophen and ibuprofen, but became worried today when they noticed redness and swelling of the tongue in addition to swelling in the hands and feet. Vital signs demonstrate a rectal temperature 39.5°C, BP 92/60, HR 130, RR 35, and SpO2 of 98%. Physical exam demonstrates an ill appearing child with bilateral conjunctival injection; erythematous tongue with dry, fissured lips; right sided cervical lymphadenopathy; an erythematous maculopapular rash on the chest, abdomen, and back; and nonpitting edema of the hands and feet. What is the most likely diagnosis?

Today’s podcast covers part II of necrotizing soft tissue infection pearls and pitfalls on imaging and management with Jess Pelletier.

Jess is an emergency medicine physician and Education Fellow at Washington University School of Medicine. This second part looks at imaging and management of NSTI.

Today on the emDOCs cast we discuss necrotizing soft tissue infection pearls and pitfalls with Jess Pelletier. This first part will look at some background, presentation, and laboratory evaluation for NSTI.

Today’s podcast looks at the potentially deadly epiglottitis.

A 26-year-old female patient comes to the ED with an 8-day history of progressive weakness, fevers, and body aches. She reports that 4 days ago she noticed “bug bites” on her face, neck, arm, and hands. Sixteen days ago, she returned from a trip to Los Angeles where she shared a bed with her friend who was ill and had a rash at the time. The patient’s medical history is unremarkable, and she takes no medications. She is in a monogamous relationship with her long-term boyfriend and uses condoms consistently. Her temperature is 38.1º C (100.6ºF). Examination shows bilateral anterior cervical lymphadenopathy, and the lesions appear to be papular in appearance. The lesion resembles others on her face, neck, right upper arm, and other hand.   What is the most likely diagnosis?

The emDOCs podcast returns with spinal epidural abscess.