Pub Date : 2025-03-01DOI: 10.1016/j.ajem.2025.01.061
Faruk Danış
{"title":"The role of renal replacement therapy in managing SCAPE","authors":"Faruk Danış","doi":"10.1016/j.ajem.2025.01.061","DOIUrl":"10.1016/j.ajem.2025.01.061","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"89 ","pages":"Pages 284-285"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ajem.2024.12.071
Zhuojian Zeng , Minglin Chen , Muyan Diao , Shengyuan Su , Fei Xue , Tuan Li , Yuehui Zhang
Key clinical message
Primary varicella-zoster virus (VZV) infection typically occurs in childhood and is generally mild. However, in immunocompromised patients, VZV-related diseases can be more severe. Fatal cases of disseminated varicella are still rare. We report a fatal case of disseminated varicella in a young adult on long-term oral corticosteroids.
{"title":"Fatal disseminated varicella infection in a patient on long-term oral corticosteroids","authors":"Zhuojian Zeng , Minglin Chen , Muyan Diao , Shengyuan Su , Fei Xue , Tuan Li , Yuehui Zhang","doi":"10.1016/j.ajem.2024.12.071","DOIUrl":"10.1016/j.ajem.2024.12.071","url":null,"abstract":"<div><h3>Key clinical message</h3><div>Primary varicella-zoster virus (VZV) infection typically occurs in childhood and is generally mild. However, in immunocompromised patients, VZV-related diseases can be more severe. Fatal cases of disseminated varicella are still rare. We report a fatal case of disseminated varicella in a young adult on long-term oral corticosteroids.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"89 ","pages":"Pages 311.e1-311.e5"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ajem.2024.12.075
Fatma Tortum
{"title":"The Roth score: A simple tool for assessing acute exacerbations of COPD in emergency care","authors":"Fatma Tortum","doi":"10.1016/j.ajem.2024.12.075","DOIUrl":"10.1016/j.ajem.2024.12.075","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"89 ","pages":"Page 260"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ajem.2025.01.063
Karishma Patel MD, David J. Barton MD
Acquired palpebral ptosis (also called blepharoptosis, or ptosis) is an abnormally low-positioned upper eyelid and occasionally presents as a chief complaint to the emergency department. Due to the wide range of causes and spectrum of severity, emergency physicians must recognize and initiate appropriate diagnostic and treatment pathways to limit the risk of long-term complications in those affected. We report a case of a 19 year old healthy man who presented with a chief complaint of unilateral eyelid droop in the setting of three days of sinusitis symptoms. Neuroimaging revealed invasive sinusitis with leptomeningeal enhancement and extraconal subperiosteal abscess. He was treated with intravenous antibiotics, admitted to the hospital, and discharged home after 7 days. This uncommon cause of ptosis highlights the need for a broad differential diagnosis for this condition and recognition of uncommon complications of invasive sinusitis.
{"title":"An uncommon case of ptosis from invasive bacterial sinusitis","authors":"Karishma Patel MD, David J. Barton MD","doi":"10.1016/j.ajem.2025.01.063","DOIUrl":"10.1016/j.ajem.2025.01.063","url":null,"abstract":"<div><div>Acquired palpebral ptosis (also called blepharoptosis, or ptosis) is an abnormally low-positioned upper eyelid and occasionally presents as a chief complaint to the emergency department. Due to the wide range of causes and spectrum of severity, emergency physicians must recognize and initiate appropriate diagnostic and treatment pathways to limit the risk of long-term complications in those affected. We report a case of a 19 year old healthy man who presented with a chief complaint of unilateral eyelid droop in the setting of three days of sinusitis symptoms. Neuroimaging revealed invasive sinusitis with leptomeningeal enhancement and extraconal subperiosteal abscess. He was treated with intravenous antibiotics, admitted to the hospital, and discharged home after 7 days. This uncommon cause of ptosis highlights the need for a broad differential diagnosis for this condition and recognition of uncommon complications of invasive sinusitis.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"89 ","pages":"Pages 308.e1-308.e3"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ajem.2025.01.007
Sevilay Vural , Merijn C.F. Mulders , Lisanne Boekhoud , Tycho J. Olgers , Jan C. ter Maaten , Hjalmar R. Bouma
{"title":"Clinical prediction models and future directions","authors":"Sevilay Vural , Merijn C.F. Mulders , Lisanne Boekhoud , Tycho J. Olgers , Jan C. ter Maaten , Hjalmar R. Bouma","doi":"10.1016/j.ajem.2025.01.007","DOIUrl":"10.1016/j.ajem.2025.01.007","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"89 ","pages":"Pages 272-273"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ajem.2025.01.036
Skyler Kessler MD , Bernard Weigel MD , Ross Ellison , Roy Gerona PhD , Joshua Zimmerman MD , Michael Nelson MD
{"title":"Maintaining use of the term ketamine toxicity","authors":"Skyler Kessler MD , Bernard Weigel MD , Ross Ellison , Roy Gerona PhD , Joshua Zimmerman MD , Michael Nelson MD","doi":"10.1016/j.ajem.2025.01.036","DOIUrl":"10.1016/j.ajem.2025.01.036","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"89 ","pages":"Pages 304-305"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ajem.2025.01.026
Arian Zaboli RN, MSN , Gianni Turcato MD
{"title":"ChatGPT's ECG interpretations: Sensitivity or specificity? Which matters more in the emergency department?","authors":"Arian Zaboli RN, MSN , Gianni Turcato MD","doi":"10.1016/j.ajem.2025.01.026","DOIUrl":"10.1016/j.ajem.2025.01.026","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"89 ","pages":"Page 283"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ajem.2025.01.017
Sara Lin MD , Phillip Scott MD , Ina Prevalska MD , Mary Haas MD
Bacterial meningitis is an increasingly rare disease that carries significant morbidity and mortality. We describe the case of a 38-year-old male with a past medical history of pituitary macroadenoma with prior endonasal surgeries on prednisone therapy daily for resultant hypopituitarism and juvenile myoclonic epilepsy on lamotrigine daily who was transferred to an academic tertiary emergency department due to concern for developing pituitary apoplexy. At the outside emergency department, the patient presented complaining of sudden onset severe headache. CT scan demonstrated residual pituitary mass but no additional findings. On arrival to our emergency department, the patient was altered and newly febrile. Physical exam was notable for the patient moving all extremities and opening eyes spontaneously but unable to follow commands with a positive Kernig's sign. Broad spectrum antibiotics, antivirals, and stress dosed steroids were started due to concern for meningitis, and Neurology and Neurosurgery were consulted. Repeat CT was obtained prior to lumbar puncture (LP). LP demonstrated bacterial meningitis, which later speciated to Streptococcus salivarius. The patient was admitted to the medical ICU and discharged with full neurologic recovery on hospital day 13. This case demonstrates the variable presentation of bacterial meningitis as the patient was not initially febrile or altered. Emergency physicians index of suspicion for meningitis should be increased with risk factors such as immunosuppression and history of transsphenoidal surgery, as in our patient. Our case is a unique case of Streptococcus salivarius meningitis that has been previously associated with primarily iatrogenic etiologies.
{"title":"What's the bug?: An unusual cause of bacterial meningitis in a patient with history of transsphenoidal surgery","authors":"Sara Lin MD , Phillip Scott MD , Ina Prevalska MD , Mary Haas MD","doi":"10.1016/j.ajem.2025.01.017","DOIUrl":"10.1016/j.ajem.2025.01.017","url":null,"abstract":"<div><div>Bacterial meningitis is an increasingly rare disease that carries significant morbidity and mortality. We describe the case of a 38-year-old male with a past medical history of pituitary macroadenoma with prior endonasal surgeries on prednisone therapy daily for resultant hypopituitarism and juvenile myoclonic epilepsy on lamotrigine daily who was transferred to an academic tertiary emergency department due to concern for developing pituitary apoplexy. At the outside emergency department, the patient presented complaining of sudden onset severe headache. CT scan demonstrated residual pituitary mass but no additional findings. On arrival to our emergency department, the patient was altered and newly febrile. Physical exam was notable for the patient moving all extremities and opening eyes spontaneously but unable to follow commands with a positive Kernig's sign. Broad spectrum antibiotics, antivirals, and stress dosed steroids were started due to concern for meningitis, and Neurology and Neurosurgery were consulted. Repeat CT was obtained prior to lumbar puncture (LP). LP demonstrated bacterial meningitis, which later speciated to <em>Streptococcus salivarius</em>. The patient was admitted to the medical ICU and discharged with full neurologic recovery on hospital day 13. This case demonstrates the variable presentation of bacterial meningitis as the patient was not initially febrile or altered. Emergency physicians index of suspicion for meningitis should be increased with risk factors such as immunosuppression and history of transsphenoidal surgery, as in our patient. Our case is a unique case of <em>Streptococcus salivarius</em> meningitis that has been previously associated with primarily iatrogenic etiologies.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"89 ","pages":"Pages 310.e1-310.e3"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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