The first video is an intraoral ultrasound using the high frequency endocavitary probe demonstrating an anechoic fluid collection adjacent to the patient’s enlarged left tonsil. The second video shows real-time ultrasound-guided successful drainage of the PTA.
X-Rays of the elbow revealed diffuse striated lucencies throughout the soft tissue, consistent with extensive subcutaneous air throughout the superficial and deep tissues. There was no evidence of a fracture.
History of present illness: A 28-year-old male presented to the emergency department with a chief complaint of two weeks of […]
Physical examination revealed a non-tender, erythematous lesion on the glans penis, two similar adjacent satellite lesions, as well as tender inguinal lymphadenopathy. No penile discharge was noted.
A RUSH exam demonstrated hyperdynamic cardiac contractility and collapse of the inferior vena cava (IVC) with probe compression more than 50% suggesting hypovolemia likely secondary to sepsis. Incidentally, Morrison’s pouch revealed a large right renal cyst but no signs of free fluid. A computed tomography of abdomen/pelvis showed a 10.8 x 9.5 cm right renal cyst and left lower lobe pneumonia.
Pediatric sepsis is a low-frequency, high impact condition. Nurses and physicians do not see it often, but must recognize and treat children with sepsis efficiently when they present. This makes pediatric sepsis education particularly amenable to simulation scenarios.
Physical examination revealed inflamed gingiva, ulceration, and soft tissue necrosis (Image 1) along with mandibular lymphadenopathy (not shown). Given her symptoms, poor oral care, and her immunocompromised state, she was given a diagnosis of Acute Necrotizing Ulcerative Gingivitis (ANUG) or Vincent’s Angina.
Her physical exam was significant for bilateral tonsillar exudates, cervical lymphadenopathy, and a morbilliform rash that included the palms (Figure 1-4). Laboratory testing was significant for white blood cell (WBC) count of 16.5 thous/mcl with an elevation in absolute lymphocytes of > 10 thous/mcl. The monospot and EBV (Epstein-Barr virus) panel were positive.
