Skip to content Skip to sidebar Skip to footer

Blood test and urgent abdominal conditions

A 44 YO man presents to the ED complaining of abdominal pain. He was well until 4 hours ago, when he developed diffuse abdominal pain. This is the first time he suffers abdominal pain. He has not history of surgery. The patient is afebrile, HR is 80, BP is 180/100, ECG is normal. The abdomen…

ByCiro Paolillo1 January 20160Comments

Abdomen

Does procalcitonin have a role in the management of acute appendicitis?

A 18 yo man comes to the ED in the morning because of low abdominal pain, fever and nausea. At palpation there is mild pain in the right inferior quadrant, not guarding. Could procalcitonin (PTC) helps to exclude quickly an acute appendicitis? Conclusion The figures are clear. We cannot use the PCT to…

ByCiro Paolillo10 October 20120Comments

Skin and soft tissue

Cellulitis and the role of laboratory

A 72 y/o woman presented to the ED for swollen and painful leg. Physical examination shows an erythematous, tender and warm leg. Probably it is a cellulitis. In previous post we stressed the US use to increase diagnostic accuracy. Can WBC or CPR help in the differential diagnoses? Do they have a role…

ByCiro Paolillo10 August 20120Comments

Abdomen

Is CRP correlated to CT result in the evaluation of abdominal pain?

A 74 yo/man complained of diffuse abdominal pain. The pain was intermittent and accompained by vomiting. He has no history of abdominal pain or abdominal surgery. On examinations the patient presented non icteric, afebrile, not tachicardic. The abdomen was mildly distensed with midline tenderness. The US evidenced a normal aorta diameter. Abdominal…

ByCiro Paolillo10 May 20120Comments

Bones and joints

Septic Arthritis

A 33 y/o male comes to the ED for fever, knee swelling and pain. He has a history of joint surgery because of trauma, and prothesis, dating 4 years before. He is HIV positive He presents feverish (38°C), the left knee is swollen and hot. WBC 34.000/μL CRP 109 mg/L PCT 0,05 ng/mL Are history,…

ByIlenia Spallino18 January 20120Comments

Abdomen

Intestinal Ischemia and Lactate

A 84 y/o woman comes accompained by relatives for abdominal pain. She is oriented and cooperative, she suffers pain (NRS 10/10). Abdomen is treatable, but very painful in the lower quadrants, you see green watering diarrhea, she has not fever. Abdominal Radiograph shows air/fluid levels WBC: 35000/μl PCR: 22 mg/L Lactate: 1,7 Can you rule…

ByIlenia Spallino23 November 20110Comments

Blood

CD4 and Lymphocyte count

A 30 yo man from Zambia comes to the ED accompained by his girlfriend, he is HIV positive and he has pneumonia, he never done CD4 count. CD4 count of < 200 signifies a greater risk for opportunistic infections = recovery. I can’t wait for the reponse of the CD4 count… How much an absolute…

ByCiro Paolillo12 July 20110Comments

Chest

D-dimer and Aortic dissection

It’s 3.00 am when a 55 yo man is accompained to the ED by his wife because of sudden onset precordial pain, he has not clinical history, he does not smoke and he has an active life style, you find a normal blood pressure and clinical examination and a normal ECG, but the pain is…

ByIlenia Spallino17 May 20110Comments