Tag Archives: pain
(A and B) Large eschars on bilateral medial thighs with mild erythema; corresponding plain radiographs with vascular and soft tissue calcifications are shown in the inset. (C) 99mTc-sestamibi parathyroid scintigraphy demonstrating hypermetabolic activity posterior to the superior pole of the right thyroid lobe suggestive of parathyroid adenoma.

Classic Lesion, Not-So-Classic Cause

Calciphylaxis (also known as calcific uremic arteriolopathy) is a serious disorder characterized by skin necrosis secondary to reduction in the blood flow caused by calcification, fibrosis, and thrombus formation in the dermohypodermic arterioles. While calcific uremic arteriolopathy has been reported in nonuremic patients, it is primarily observed in patients with end-stage renal disease, especially those […]

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Nonanesthetic Effects of Ketamine: A Review Article

Ketamine is considered a dissociative anesthetic medication, and it is commonly administered by a parenteral route. It works mainly by blocking the N-methyl-D-aspartate receptor. It inhibits the voltage-gated Na and K channels and serotonin and dopamine reuptake; also, it affects specific receptors, such as α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid, kainate, and aminobutyric acid A receptors. Ketamine appears to […]

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A rattlesnake bite wound hours after the incident. There is swelling of the digit and palm with hemorrhagic bullous formation circumferentially around the finger. Erythema is present in the affected digit. The patient reported pain. Presentations like this may lead to unnecessary use of antibiotics. In this case, no antibiotics were administered and no infection developed.

Prophylactic Antibiotics Are Not Needed Following Rattlesnake Bites (video)

Antibiotics are sometimes administered to victims of rattlesnake bites in the hope of preventing infections. Experts in the field recommend that prophylactic antibiotics not be used because secondary infections are rare. Current recommendations are based on a small number of studies conducted in the United States. We decided to reexamine the issue by taking advantage […]

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Adult-Onset Still’s Disease: A Classic Presentation of a Rare Illness

Adult-onset Still’s disease is a rare inflammatory disorder of unclear etiology. Here, we highlight a classic presentation of this disorder. Case Description A 30-year-old woman presented with a 1-month history of daily fevers, myalgias, 7.5-kg unintentional weight loss, and a 2-week history of diffuse skin rash. Her medical history was notable for Hashimoto’s thyroiditis, and […]

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Acute Epigastric Pain as the Cause of Urgent Gastrectomy in a Healthy Patient

A 63-year-old man with no surgical history, taking no medication,was referred to the emergency department for epigastric pain and nausea that had started afew hours earlier. A sore throat had begun 24hours previously. Physical examination revealed normal temperature, hemodynamic stability, a distended abdomen with abdominal guarding that was very painful on palpation, and no mass […]

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(A) Ultrasonography demonstrated a linear hypoechoic structure (arrows) in an area of tissue breakdown in the left lobe of the liver. (B) Magnetic resonance imaging (MRI) showed a hypointense, coiled structure (arrows) in an abscess in the liver's left lobe. (C) MRI disclosed a linear hypointense structure—a worm, which is denoted by the arrow—in the abscess in the liver parenchyma. (D) MRI with contrast identified the liver abscess (asterisk) and the nonenhancing, hypointense worm (arrow).

A Worm Hole: Liver Abscess in Ascariasis

A patient with an infection that is often asymptomatic developed an uncommon complication. The 60-year-old woman presented with fever and pain in the epigastrium and right hypochondrium, symptoms that had existed for the previous 5 days. On touch, she was clearly febrile. Her temperature was 38.6°C (101.5°F). Her blood pressure and pulse rate were within […]

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