Archives

A Case Report of Acute Motor and Sensory Polyneuropathy as the Presenting Symptom of SARS-CoV-2

Michael R. Kopscik, BS

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically presents with respiratory illness and fever, however some rare neurologic symptoms have been described as presenting complaints. We report a case of an acute motor and sensory polyneuropathy consistent with Miller-Fisher Syndrome (MFS) variant of Guillain Barre Syndrome (GBS) as the initial symptom.

Read More

Acute Transverse Myelitis Secondary to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Case Report

Muhammad Durrani, DO, MS

Respiratory viral illnesses are associated with diverse neurological complications, including acute transverse myelitis (ATM). Among the respiratory viral pathogens, the Coronaviridae family and its genera coronaviruses have been implicated as having neurotropic and neuroinvasive capabilities in human hosts.1 Despite previous strains of coronaviruses exhibiting neurotropic and neuroinvasive capabilities, little is known about the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its involvement with the central nervous system (CNS). The current pandemic has highlighted the diverse clinical presentation of SARS-CoV-2 including a possible link to CNS manifestation with disease processes such as Guillain-Barré syndrome and cerebrovascular disease. It is critical to shed light on the varied neurological manifestation of SARS-CoV-2 to ensure clinicians do not overlook at-risk patient populations and are able to provide targeted therapies appropriately.

Read More

Optimizing Non-invasive Oxygenation for COVID-19 Patients Presenting to the Emergency Department with Acute Respiratory Distress: A Case Report

David Zodda, MD, FACEP

The novel coronavirus (COVID-19) pandemic has led to an increase in the number of patients presenting to the emergency department (ED) with severe hypoxia and acute respiratory distress. With limited resources and ventilators available, emergency physicians working at a hospital within the epicenter of the United States outbreak developed a stepwise, non-invasive oxygenation strategy for treating COVID-19 patients presenting with severe hypoxia and acute respiratory distress.

Read More

An Unusual Case Report of COVID-19 Presenting with Meningitis Symptoms and Shingles

Rebecca Packwood, MD

As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads across the globe, physicians face the challenges of a contagious pandemic including which patients to isolate, how to conserve personal protective equipment, and who to test. The current protocol at our hospital is to place anyone with new cough, dyspnea, or fever into airborne and contact precautions and consider them for testing. Unfortunately, the symptomatic presentations of coronavirus disease 2019 (COVID-19) are proving more variable than previously thought.

Read More

Urethral Calculi

Lee, MD, et al.

Urolithiasis is a common condition seen in the emergency department (ED) that most often presents with calculi located in the kidney, ureter, or bladder. An obstructing calculi located at the urethra is an uncommon presentation where the management options are unique to its location.

Read More

Topical Tranexamic Acid for Hemostasis of an Oral Bleed in a Patient on a Direct Oral Anticoagulant

Boccio, MD, et al.

Tranexamic acid (TXA) is an antifibrinolytic agent currently approved and utilized in the treatment of dysfunctional uterine bleeding, traumatic extracranial hemorrhage, anterior epistaxis, and dental procedures on patients with hemophilia. There is a paucity of literature evaluating the use of TXA for hemostasis in patients on direct oral anticoagulants (DOACs).

Read More

Open Dorsal Proximal Interphalangeal Dislocation

Derrah, MD, et al.

We report a case of a 44-year-old male with an uncommon case of an open dorsal proximal interphalangeal (PIP) dislocation. Although open PIP dislocations are often volar, dorsal dislocations are fraught with complications due to the potential for infection and damage to supportive structures.

Read More

An Atypical Presentation of Cystic Echinococcosis

Tetali, BS, et al.

We report the case of a 34-year-old patient who immigrated from Yemen six years earlier. She presented with acute onset dysuria, suprapubic pain, and fever. Imaging revealed a primary multicystic mass on the right renal pole with a secondary lesion in the right hepatic lobe.

Read More

Pyogenic Flexor Tenosynovitis as a Rare Complication of Dyshidrotic Eczema

Nimjareansuk, DO, et al.

We report the case of a 23-year-old male who presented with right middle finger pain and swelling and an overlying eczematous rash. The use of point-of-care ultrasound was performed to aid in the diagnosis of pyogenic flexor tenosynovitis. An incision and drainage was performed with deep wound cultures positive for Staphylococcus aureus.

Read More

Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

3800 W Chapman Ave Ste 3200
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org

CC-BY_icon.svg

WestJEM
ISSN: 1936-900X
e-ISSN: 1936-9018

CPC-EM
ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.