Emergency Department Treatment and Disposition

Recognition and treatment of the initial fungal infection (tinea capitis or tinea pedis) is curative. Refer to a dermatologist for follow-up to ensure diagnosis and resolution. SnurcE Knoop KJr Stack LB. Etorrow AB, Thurman RJi The Adas of Emergency Mediane, 3rd Edition iittp j wivw.a cc-EEEmEdicine.com Copyright The McGraw-Hil Companies, Inc. Alt rights resented. SnurcE Knoop KJr Stack LB. Etorrow AB, Thurman RJi The Adas of Emergency Mediane, 3rd Edition iittp j wivw.a cc-EEEmEdicine.com...

Ultraviolet Radiation Exposure Clinical Summary

Ultraviolet (UV) radiation causes both acute and chronic skin changes. Sunburn is a partial-thickness burn, which may become a full-thickness injury if infected. Sun poisoning is a severe systemic reaction to UV radiation. Patients may complain of nausea, vomiting, headache, fever, chills, and prostration. Excessive UV radiation may cause injury to the cornea and conjunctiva, termed ultraviolet keratitis (photokeratitis, snow blindness). This painful condition may occur in skiers, welders, or...

Acid Tooth Erosion Bulimia Clinical Summary

Bulimia nervosa is an eating disorder with significant associated physical complications. It is characterized by binge eating with self-induced vomiting, laxative use, dieting, and exercise to prevent weight gain. Patients with bulimia are at risk for damage to the dental enamel and dentin as a result of repeated episodes of vomiting with chronic exposure to regurgitated acidic gastric contents. The lingual dental surfaces are most commonly affected. In severe cases, all surfaces of the teeth...

Access Emergency Medicines

Impetigo Penis And Testicles

Note Large images and tables on this page may necessitate printing in landscape mode. The Atlas of Emergency Medicine > Part 2. Specialty Areas > Chapter 14. Pediatric Conditions > Newborn Conditions > ERYTHEMA TOXICUM NEONATORUM CLINICAL SUMMARY Erythema toxicum neonatorum is a benign, self-limited eruption of unknown etiology that occurs in up to 70 of term newborns characterized by discrete, small, erythematous macules or patches up to 2 to 3 cm in diameter with 1- to 3-mm firm pale...

Pharyngitis Clinical Summary

Pharyngitis is an inflammation and commonly an infection of the pharynx and its lymphoid tissues. Viral causes account for 90 of all cases. Group A -hemolytic streptococci (GABHS) is responsible for up to 50 of bacterial infections. Other bacterial causes include other streptococci, Mycoplasma pneumoniae, Neisseria gonorrhea, and Corynebacterium diphtheriae. In immunocompromised patients and patients on antibiotics, Candida species can cause thrush. Sore throats that last longer than 2 weeks...

Scarlet Fever Clinical Summary

Scarlet fever manifests as erythematous macules and papules that result from an erythrogenic toxin produced by group A 13-hemolytic Streptococcus. The most common site for invasion by this organism is the pharynx and occasionally skin or perianal areas. The disease usually occurs in children (2-10 years of age) and less commonly in adults. The typical presentation of scarlet fever includes fever, headache, sore throat, nausea, vomiting, and malaise followed by the scarlatiniform rash. The rash...

Peritonsillar Abscess Clinical Summary

Peritonsillar abscess, or quinsy, is the most common deep neck infection. Although most occur in young adults, immune compromised and diabetic patients are at increased risk. Most abscesses develop as a complication of tonsillitis or pharyngitis, but they can also result from odontogenic spread, recent dental procedures, and local mucosal trauma. They recur in 10 to 15 of patients. The pathogens involved are similar to those causing tonsillitis, especially streptococcal species, but many...

Episcleritis Clinical Summary

Episcleritis is a common, benign inflammatory condition of the episclera. It most often affects young adults. Most cases are idiopathic, though up to a third may be associated with systemic conditions, and some cases may also be caused by exogenous irritants or inflammatory stimuli. Associated systemic disorders include gout, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, and herpes zoster. The symptoms, which include foreign body sensation, mild pain,...

Trench Mouth Acute Necrotizing Ulcerative Gingivitis Clinical Summary

Painful severely edematous interdental papillae are characteristic of trench mouth, or acute necrotizing ulcerative gingivitis (ANUG). Other associated features include the presence of ulcers with an overlying grayish pseudomembrane and a punched out appearance. The inflamed gingival tissue is friable, necrotic, and represents an acute destructive disease process of the periodontium. Fever, malaise, and regional lymphadenopathy are commonly associated signs. Patients may also complain of foul...

Aphthous Ulcers Canker Sores Clinical Summary

Aphthous ulcers are shallow painful mucosal ulcers of 1 to 15 mm. A prodromal burning sensation may be noted 2 to 48 hours before an ulcer is noted. The initial lesion is a small white papule that ulcerates and enlarges over 48 to 72 hours. Lesions are typically round or ovoid with a raised yellow border and surrounding erythema. Multiple aphthous ulcers may occur on the lips, tongue, buccal mucosa, floor of the mouth, or soft palate. Spontaneous healing occurs in 7 to 10 days without scarring....

Mastoiditis Clinical Summary

Mastoiditis is an infection or inflammation of the mastoid air cells that usually results from extension of purulent otitis media with progressive destruction and coalescence of air cells. Medial wall erosion can cause cavernous sinus thrombosis, facial nerve palsy, meningitis, brain abscess, and sepsis. With the use of antibiotics for acute otitis media, the incidence of mastoiditis has fallen sharply. Patients present with fever, chills, postauricular ear pain, and frequently discharge from...

Torus Palatinus Clinical Summary

Tori are benign nodular overgrowths of cortical bone. Although their physical appearance can be somewhat alarming to those unfamiliar with this entity, there is generally no need for concern. These bony protuberances occur in the midline of the palate where the maxilla fuses. Tori may also be located on the mandible, typically on the lingual aspect of the molar teeth. Tori are covered by a thin epithelium, which is easily traumatized and ulcerated. These ulcerations tend to heal very slowly...

Oral Herpes Simplex Virus Cold Sores Clinical Summary

Oral herpes simplex may present acutely as a primary gingivostomatitis or as a recurrence. Painful vesicular eruptions on the oral mucosa, tongue, palate, vermilion borders, and gingiva are highly characteristic. A 2- to 3-day prodromal period of malaise, fever, and cervical adenopathy is common. The vesicular lesions rupture to form a tender ulcer with yellow crusting and an erythematous margin. Pain may be severe enough to cause drooling and odynophagia, which can discourage eating and...

Access Emergency Medicine MeBniw Wii

Note Large images and tables on this page may necessitate printing in landscape mode. The Atlas of Emergency Medicine> Part 2. Specialty Areas> Chapter 17. Toxicological Conditions> METHAMPHETAMINE TOXICITY Clinical Summary A white powder easily dissolved in water, methamphetamine may be abused by ingestion, insufflation (snorting), parenteral injection, and smoking. Ice refers to a pure preparation of methamphetamine hydrochloride in large crystalline form. Clinical effects of...