Rosen's Emergency Medicine: Concepts and Clinical Practice

Sepsis Syndrome

Key Concepts Sepsis is a progressive disease due to a dysregulated inflammatory cascade, leading to organ dysfunction and circulatory compromise in severe cases. Older adults, immunocompromised and neutropenic patients, and patients with multiple comorbidities are at increased risk for the…

Skin and Soft Tissue Infections

Key Concepts Bacterial skin infections such as cellulitis and abscess are common and are rarely life-threatening. Necrotizing infection is suggested by pain out of proportion to physical findings, crepitance, gas seen on imaging studies, or clinical instability. Suspected necrotizing infection…

Bone and Joint Infections

Key Concepts Skeletal infection should be considered in the differential diagnosis of all patients who present with bone or joint pain. Laboratory evaluation is of little value in the diagnosis of bone and joint infections, with the exception of the…

Tuberculosis

Key Concepts Early recognition of patients with risk for TB should begin at ED triage. Patients with possible active pulmonary TB should be placed in respiratory isolation promptly. TB should be considered in the differential diagnosis of patients who present…

Tickborne Illnesses

Key Concepts Tickborne illnesses frequently are misdiagnosed as common viral or bacterial infections. Diagnosis can be facilitated by considering tickborne illnesses in patients who recently have been in endemic areas and routinely asking for a history of recent tick or…

Parasites

Key Concepts Parasitic diseases may manifest with almost any constellation of signs and symptoms. The combination of presenting signs and symptoms and a history of recent travel to specific geographic regions can lead to early diagnosis and the initiation of…

HIV

Key Concepts HIV/AIDS can affect any organ system, and the nonspecific complaints seen with viral illness are common. Consider acute HIV infection in the evaluation of patients with mononucleosis-like syndromes in the presence of risk factors. The presenting illness may…

Coronaviruses

Key Concepts Coronaviruses infect humans and animals and have the ability for recombination, generating novel viruses. Most human coronaviruses cause mild disease. Three coronaviruses, severe acute respiratory syndrome (SARS) associated virus, Middle East respiratory syndrome (MERS), and severe acute respiratory…

Viruses

Key Concepts Recent outbreaks of vaccine-preventable childhood infections have occurred secondary to unvaccinated individuals and travel to areas where disease is still endemic. Emergency clinicians should recognize the possibility of these once rare diseases. Herpes simplex encephalitis is fatal if…

Bacteria

Key Concepts All septic patients should be treated with antibiotics as soon as possible, even before a definitive diagnosis is made. Patients with pneumococcemia, meningococcemia, and aggressive soft tissue infections can decompensate rapidly. The source of sepsis should be identified…