PEM Pearls: 5 Tips to Demystify Amoxicillin in Pediatric Infections

Amoxicillin is a penicillin derivative antibiotic against susceptible gram positive and gram negative bacteria. It has reasonable coverage for most upper respiratory infections and is used as prophylaxis for asplenia and bacterial endocarditis. This post aims to demystify amoxicillin treatment for common pediatric infections.

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2019-09-05T17:59:37-07:00

SAEM Clinical Image Series: Tea & Toast | A Case of an Abdominal Rash

Tea & Toast erythema ab igne rash


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Chief complaint: Abdominal pain, nausea, and vomiting

History of present illness: A 46 year-old female with a past history of fibromyalgia, irritable bowel disease, and chronic abdominal pain presented to the emergency department with abdominal pain, nausea, and vomiting. She reported a one-year history of similar symptoms but states that her symptoms are worse today than usual, and not improved by her home hydrocodone, medical marijuana, or heating pad use – all of which she uses daily. She has not been able to tolerate oral intake today, vomiting up her breakfast of plain toast.

The patient was observed using her home heating pad in the emergency department.

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2019-08-12T07:11:03-07:00

SAEM Clinical Image Series: Rash After a Sore Throat and Ibuprofen Use

Rash

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Chief complaint: Rash

History of Present Illness: The patient is an 18 year-old male who presents with a rash that appeared 7 days ago. The rash is located on his torso, back, and lower lip. It is pruritic. Three days prior to the appearance of the rash, he had a sore throat and intermittently took ibuprofen over the ensuing 3 days. He stopped taking ibuprofen 4 days after his sore throat abated. He denies any fever, nausea, vomiting, shortness of breath, chest pain, abdominal pain, diarrhea, extended travel in the past year, sick contacts, new soaps/detergents, insect bites, chemical exposure, and new foods.

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2019-07-28T21:17:29-07:00

SAEM Clinical Image Series: Flu-like symptoms, oral ulcers, and rash

palmar rash erythema multiforme

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Chief Complaint: Flu-like symptoms, lip pain/swelling, mouth pain, eye redness, and rash

History of Present Illness: Patient is a 35-year-old transgender male with a history of bipolar disorder (taking seroquel/lamotrigine) who presents with 2 days of:

  • Flu-like symptoms
  • Progressive lip pain/swelling
  • Mouth pain
  • Oral ulcers
  • Eye redness
  • New erythematous rash involving the palms/soles and lower extremities

The patient initially noted myalgias, fever, and malaise 2 days ago. Yesterday, the patient woke up with bilateral eye redness and itching, and he developed lip swelling/discoloration and mouth pain throughout the day. He presented to an outside emergency department (ED) 12 hours prior, where he was told that he had a viral infection, given pain medication, and discharged home. He has not taken any other medications. The patient presents to this ED due to progression of symptoms, including the development of a pruritic rash on his palms, soles, and lower extremities. Upon further questioning, the patient also reports vaginal itching and a fishy odor. He has a history of bacterial vaginosis and states that these symptoms feel similar. The patient denies genital sores, vaginal discharge, and vaginal bleeding. He is currently sexually active with men and women, and does not regularly use barrier protection.

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2019-07-28T21:30:17-07:00

SAEM Clinical Image Series: Rash with Blood Pressure Cuff Inflation

Rash with blood pressure cuff inflation - petechiae

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Chief Complaint: Possible seizure, Left arm rash

History of Present Illness: A 29-year-old with a history of migraine headaches, thalassemia of unknown phenotype, and no history of hypertension or epilepsy arrived to the emergency department via ambulance after possible seizure. The patient had nausea and vomiting the morning after a night of heavy drinking. After several rounds of vomiting, she felt shaky, lightheaded and experienced paresthesia in both of her hands and feet. There was no loss of consciousness, confusion or incontinence. EMS reported hypertension and tremors with upper extremity spasms. The patient developed a left upper extremity rash distal to the blood pressure cuff after paramedics did the first blood pressure measurement.

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2019-07-28T21:32:30-07:00

ALiEM AIR | Cutaneous 2019 Module

Welcome to the AIR Cutaneous Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to cutaneous emergencies. 6 blog posts within the past 12 months (as of February 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 3 AIR and 3 Honorable Mentions. We recommend programs give 3 hours (about 30 minutes per article) of III credit for this module.

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AIR Series: Cutaneous Module

Welcome to the Cutaneous Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index the ALiEM AIR Team is proud to present the highest quality cutaneous content. Below we have listed our selection of the 4 highest quality blog posts within the past 12 months (as of February 2015) related to dermatology emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 0 AIRs and 4 Honorable Mentions.

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