The American journal of emergency medicine
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Review Case Reports
Aortic dissection presenting as superior vena cava syndrome.
Aortic dissection usually presents with chest pain, abnormal pulses, and a widened mediastinum on chest radiograph. It is rarely associated with the superior vena cava syndrome (SVCS), which more commonly occurs in the setting of malignant disease. A patient who had SVCS as a result of a painless aortic dissection is presented and compared with other previously reported cases of simultaneous SVCS and aortic dissection.
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Eikenella corrodens, a fastidious, slow-growing, gram-negative, facultative anaerobic bacillus may be encountered in wounds exposed to human saliva, especially human bites and head and neck infections. An unusual case of a mixed flora E corrodens and Streptococcus septic arthritis with adjacent osteomyelitis secondary to saliva contamination from licking an intravenous (i.v.) needle is presented. A literature search showed 53 previous cases of E corrodens infections in i.v. drug users. ⋯ Recommendations for treatment include penicillin or ampicillin. Tetracycline is recommended in the penicillin-allergic patient. This is the first case that draws attention to the connection between E corrodens, i.v. drug use, and septic arthritis and osteomyelitis.
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To improve the prognosis in patients with acute myocardial infarction (AMI) if treatment by early instituting treatment, we initiated a media campaign during 1 year with the intention to reduce delay times and increase ambulance use in patients with acute chest pain. This article describes the outcome during 3 years after the campaign was finished. ⋯ Ambulance use was not affected during or after the campaign. It can be concluded that a media campaign resulted in a reduction of delay times not only during the campaign, but also during 3 years after its performance, whereas ambulance use was not affected.