Primary Infection Site as a Predictor of Sepsis Development in Emergency Department Patients.

Background: Sepsis is a life-threatening condition but predicting its development and progression remains a challenge.

Objective: This study aimed to assess the impact of infection site on sepsis development among emergency department (ED) patients.

Methods: Data were collected from a single-center ED between January 2016 and December 2019.

High risk and low prevalence diseases: Flexor tenosynovitis.

Introduction: Flexor tenosynovitis (FTS) is a deep space infection of an upper extremity digit which carries a high rate of morbidity.

Objective: This review highlights the pearls and pitfalls of FTS, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.

Discussion: FTS typically occurs after direct penetrating trauma to the volar aspect of an upper extremity digit.

Impact of norepinephrine on immunity and oxidative metabolism in sepsis.

Sepsis is a major health problem in the United States (US), constituting a leading contributor to mortality among critically ill patients. Despite advances in treatment the underlying pathophysiology of sepsis remains elusive. Reactive oxygen species (ROS) have a significant role in antimicrobial host defense and inflammation and its dysregulation leads to maladaptive responses because of excessive inflammation.

Increased Body Mass Index and Metabolic Syndrome Are Associated with Poor Outcomes in SARS-CoV-2-Positive Emergency Department Patients.

Background: Increased body mass index (BMI) and metabolic syndrome (MetS) have been associated with adverse outcomes in viral syndromes. We sought to examine associations of increased BMI and MetS on several clinical outcomes in patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods: The registry of suspected COVID-19 in emergency care (RECOVER) is an observational study of SARS-CoV-2-tested patients (n=27,051) across 155 United States emergency departments (EDs).

Emergency department management of cellulitis and other skin and soft-tissue infections.

Cellulitis and other skin and soft-tissue infections (SSTIs) are common presentations in the emergency department. This review describes the varied etiologies and patient presentations of the more common SSTIs: cellulitis, abscesses, and necrotizing soft-tissue infections. A discussion of the common diagnoses masquerading as SSTIs is presented, as well as a stepwise approach to avoiding misdiagnosis.

SARS-CoV-2 Positivity in Ambulatory Symptomatic Patients Is Not Associated With Increased Venous or Arterial Thrombotic Events in the Subsequent 30 Days.

Background: COVID-19 has been associated with increased risk of thromboembolism in critically ill patients.

Objective: We sought to examine the association of SARS-CoV-2 test positivity and subsequent acute vascular thrombosis, including venous thromboembolism (VTE) or arterial thrombosis (AT), in a large nationwide registry of emergency department (ED) patients tested with a nucleic acid test for suspected SARS-CoV-2.

Methods: The RECOVER (Registry of Potential COVID-19 in Emergency Care) registry includes 155 EDs across the United States.

Tetanus: A Rare Complication of Black Tar Heroin Use.

Tetanus is associated with high morbidity and mortality, although this is rarely encountered in high-income countries. We present a case of tetanus in an unvaccinated patient secondary to black tar heroin use that highlights the importance of considering tetanus in appropriate clinical contexts, harm reduction interventions, and universal tetanus vaccination campaigns.

Hand Compartment Syndrome Due to -acetylcysteine Extravasation.

-acetylcysteine (NAC) is the antidote for acetaminophen (APAP)-induced hepatotoxicity. Both intravenous (IV) and oral (PO) NAC formulations are available with equal efficacy. Adverse events from either preparation are rare.