The American journal of emergency medicine
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Methicillin-resistant Staphylococcus aureus (MRSA) infections are becoming increasingly prevalent in both community and hospital settings. Certain strains are notorious for causing skin and soft tissue infections in patients with no established risk factors. In this article, we report our findings on the dynamic antibiotic resistance pattern of MRSA and outpatient prescription trend for skin and soft tissue infections within our community. ⋯ Methicillin-resistant Staphylococcus aureus is a particularly virulent, rapidly adaptive pathogen that is becoming increasingly difficult to combat with existing antibiotics. Care must be taken to ensure appropriate treatment and follow-up of patients with known MRSA infections.
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Lower leg weakness is a common and nonspecific complaint that encompasses a broad differential diagnosis at emergency department, which includes neurologic aspect and a wide range of nonneurologic conditions. Infective endocarditis usually presented with variable symptoms emphasizing constitutional complaints, or complaints that focus on primary cardiac effects or secondary embolic phenomena. ⋯ By far, it is rarely considered in the differential diagnosis of lower leg weakness. Herein, we present a case of a 56-year-old man who came to our emergency department with a chief concern of lower leg weakness, which was actually the result of L-spine osteomyelitis and spondylodiscitis as complications of infective endocarditis with septic emboli.
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Case Reports
Massive cerebrovascular air embolism during posttraumatic cardiopulmonary resuscitation.
Air embolism is known to be a complicating factor in several clinical settings, including thoracic, cardiovascular, and neurosurgical operations; central line placement; and penetrating thoracic and cranial trauma. There are, however, only few case descriptions for cardiopulmonary resuscitation massive cerebral air embolism, and the frequency of this supposedly rare complication is unknown. Computed tomography is useful for showing cerebral air embolism. In this report, we present a 16-year-old adolescent girl with cerebrovascular air embolism on computed tomographic examination after a posttraumatic cardiopulmonary resuscitation and discuss the reasonable mechanisms of cerebrovascular air embolism.
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To determine the ability of prehospital end-tidal carbon dioxide (ETCO₂) to predict in-hospital mortality compared to conventional vital signs. ⋯ Of all prehospital vital signs, ETCO₂ was the most predictive and consistent for mortality, which may be related to an association with metabolic acidosis.