Annals of emergency medicine
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Multicenter Study
Do All Children Who Present With a Complex Febrile Seizure Need a Lumbar Puncture?
We assess the prevalences of bacterial meningitis and herpes simplex virus meningoencephalitis (HSV-ME) in children with a complex febrile seizure and determine these prevalences in the subgroup of children with a clinical examination result not suggestive of meningitis or encephalitis. ⋯ In children with a complex febrile seizure, bacterial meningitis and HSV-ME are unexpected events when the clinical examination after complex febrile seizure is not suggestive of meningitis or encephalitis.
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Observational Study
Clostridium difficile Infection Among US Emergency Department Patients With Diarrhea and No Vomiting.
The incidence of Clostridium difficile infection has increased and has been observed among persons from the community who have not been exposed to antibiotics or health care settings. Our aims are to determine prevalence of C difficile infection among emergency department (ED) patients with diarrhea and the prevalence among patients without traditional risk factors. ⋯ Among mostly adults presenting to US EDs with diarrhea and no vomiting, C difficile infection accounted for approximately 10%. More than one third of patients with C difficile infection lacked traditional risk factors for the disease. Among participants without traditional risk factors, prevalence of C difficile infection was approximately 7%.
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Requests for observation experiences are common in the emergency department and other medical settings. There is little guidance in the literature or in professional societies' polices about who should be granted this privilege. ⋯ At the heart of the issue is patient privacy. This article recommends that institutions have policies in place that address these activities and suggests content for such policies.
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Editorial Comment
Are Antibiotics a Feasible Therapeutic Option for Appendicitis?