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

Chest Ultrasound

Diagnosis of pneumonia. Is it the time for a combined imaging strategy?

A 80 yo man is brought from an assisted-living facility because of fever, productive cough, tachycardia and dyspnoea. He has a history of dementia and hypertension. He is cachectic, you hear ronchi on the left side. How should you approach this patient? In the Emergency department setting the pretest probability of pneumonia…

ByCiro Paolillo5 April 20120Comments

Bones and joints Ultrasound

Septic Arthritis and Arthrocentesis

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. As we…

ByIlenia Spallino26 January 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

Skin and soft tissue Ultrasound

Soft tissue abscess: clinical plus ultrasound evaluation

Male 65 y/o, he complains pain and swelling in left groin, he has history of hypertension. He has not fever. Clinical examination shows swelling, skin is hot and eritematous. Is it an abscess, a cellulitis or something else? Conclusion To use ultrasound on eritematous and swelling skin is very helpful Abscesses presents…

ByCiro Paolillo8 January 20120Comments

Skin and soft tissue

Soft tissue abscess the clinical evaluation

Male 65 y/o, he complains pain and swelling in left groin, he has history of hypertension. He has not fever. Clinical examination shows swelling, skin is hot and eritematous. Is it an abscess, a cellulitis or something else? Conclusion Differentiating a soft tissue abscess from cellulitis is important because each disorder requires a different…

ByCiro Paolillo14 December 20110Comments

Head

Clinical Signs and Meningitis

It's 4 in the morning when a 23 y/o female comes to the ED concerning bilteral legs pain and disuria. She has not clinical history, she has fever, the pain is bilteral and diffused, “the whole leg pains” and she has difficult in urine, you think about a radiculopathy due to possible neuro system infection…

ByIlenia Spallino23 August 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