A Physician With Thigh Pain.

To prevent death, necrotizing soft-tissue infections should be diagnosed quickly and treated with broad-spectrum antibiotics and surgical debridement.

Predicting bacteremia based on nurse-assessed food consumption at the time of blood culture.

Background: Bacteremia and its complications are important causes of morbidity and mortality in hospitalized patients. However, the yield of blood cultures is relatively low, with many false-positive results from bacterial contamination.

Methods: We investigated the relationship between patient food consumption and the presence of bacteremia.

Perspective: Uses and misuses of thresholds in diagnostic decision making.

The concept of thresholds plays a vital role in decisions involving the initiation, continuation, and completion of diagnostic testing. Much research has focused on the development of explicit thresholds, in the form of practice guidelines and decision analyses. However, these tools are used infrequently; most medical decisions are made at the bedside, using implicit thresholds.

Paraneoplastic leukemoid reaction as marker for transitional cell carcinoma recurrence.

A case of a 78-year-old man with transitional cell carcinoma and a paraneoplastic leukemoid reaction. The leukocytosis was present at the diagnosis of carcinoma. It dissipated with complete tumor resection, was absent when a surveillance computed tomography scan showed no evidence of recurrence at 6 months, and had returned with tumor recurrence at 8 months.

Hemolytic anemia.

Hemolysis presents as acute or chronic anemia, reticulocytosis, or jaundice. The diagnosis is established by reticulocytosis, increased unconjugated bilirubin and lactate dehydrogenase, decreased haptoglobin, and peripheral blood smear findings. Premature destruction of erythrocytes occurs intravascularly or extravascularly.