J Emerg Med
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Review Case Reports
Lymphocytic vasculitis associated with the anthrax vaccine: case report and review of anthrax vaccination.
Anthrax is caused by the spore-forming bacteria Bacillus anthracis. It occurs naturally, but recently has been manufactured as a biological warfare agent. ⋯ Side effects to the current anthrax vaccine are usually minor and mainly consist of local skin reactions. Occasionally an unusual complication may occur; a case of a patient with lymphocytic vasculitis temporally associated with the anthrax vaccine is reported.
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Case Reports
Sudden unexplained hemolysis occurring in an infant due to presumed Loxosceles envenomation.
We report the case of a 3-week-old infant referred for evaluation of sudden onset jaundice and unexplained hemolysis. After an exhaustive workup, the most likely etiology was found to be envenomation by a brown recluse spider, Loxosceles reclusa. This case underscores the fact that severe loxoscelism may occur in the absence of the classically described necrotic cutaneous lesion, and represents one of the youngest presumed cases of loxoscelism. We present the case to illustrate the importance of considering loxoscelism in the differential diagnosis of sudden massive hemolysis in children, particularly in endemic areas of the midwestern and southern United States.
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As efforts are made to make Emergency Medicine and the Journal of Emergency Medicine more international, the different systems of medical education and practice trends in other countries should be considered when making suggestions. This article is a personal perspective of a surgeon who has been involved in emergency care in both the United States and South Africa. ⋯ Some of the differences in medical education, postgraduate training, and disease prevalence are highlighted. A significant number of South Africans use the services of traditional healers, and a brief review of their services is included.