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…
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…
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…
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…
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…
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…
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…
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…
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…
Key Concepts Hyperthyroidism Hyperthyroidism induces a hypermetabolic state and increases β-adrenergic activity. The resulting clinical manifestations range from vague constitutional symptoms to more organ-specific symptoms (see Box 117.1 ). BOX 117.1 Symptoms of Thyrotoxicosis Constitutional: Weight loss despite hyperphagia, fatigue,…