Infectious Disease

Point-of-care Ultrasound for the Diagnosis of a Gluteal Abscess

Kevin Roy, BS^*, Robert Rowe, MD^* and Maili Alvarado, MD^{^}

DOI: https://doi.org/10.21980/J8VH1W Issue 3:1 No ratings yet.

POCUS reveals a large, hypoechoic soft tissue abscess with debris and tracks extending to the bottom of the image. Furthermore, when compressed, movement of the abscess contents is appreciated. There is also superficial cobble-stoning consistent with overlying cellulitis and soft tissue edema.

Perianal Abscess

Luke Walls-Smith, BS^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J8QP81Issue 3:1 No ratings yet.

Computed Tomography (CT) of the Pelvis with intravenous (IV) contrast revealed a 5.7 cm x 2.4 cm air-fluid collection in the right perianal soft tissue along the right gluteal cleft, with surrounding fat stranding, consistent with a perianal abscess with cellulitis.

Abdominal/Gastroenterology Infectious Disease Visual EM

Acute Pyelonephritis with Perinephric Stranding on CT

Ronald Goubert^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J8BH0VIssue 3:1 No ratings yet.

A CT abdomen and pelvis with IV contrast showed neither nephrolithiasis nor diverticulitis, and instead showed heterogeneous enhancement of the left kidney with mild edematous enlargement and striated left nephrogram. Significant perinephric stranding (red arrows) was also noted and was consistent with severe acute pyelonephritis.

Renal/Electrolytes Infectious Disease Visual EM

Empyema

Jonathan Patane, MD^* and Daniel Ritter, BS^{^}

DOI: https://doi.org/10.21980/J86P9RIssue 3:1 No ratings yet.

The chest X-ray shows a large fluid collection in the right lung demonstrated by the opacification that blunts the costophrenic angle on the right side. There is also a meniscus present, which is generally indicative of fluid. Chest computed tomography (CT) demonstrated an infiltrate with a mixture of densities within the same collection, consistent with a loculated effusion and concerning for an empyema.

Respiratory Infectious Disease Visual EM

Pediatric Toxic Shock Syndrome

Jennifer Yee, DO^* and Andrew King, MD^*

DOI: https://doi.org/10.21980/J8WK8J Issue 2:4 No ratings yet.

By the end of this simulation session, the learner will be able to: 1) Recognize toxic shock syndrome. 2) Review the importance of a thorough physical exam. 3) Discuss management of toxic shock syndrome, including supportive care and the difference in antibiotic choices for streptococcal and staphylococcal toxic shock syndrome. 4) Appropriately disposition a patient suffering from toxic shock syndrome. 5) Communicate effectively with team members and nursing staff during a resuscitation of a critically ill patient.

Infectious Disease Pediatrics Simulation

Bedside Ultrasound for the Diagnosis of Peritonsillar Abscess

Harshal Bhakta, BS,^* Maili Alvarado, MD^{^} and Daryn Towle, MD*

DOI: https://doi.org/10.21980/J8N33N Issue 2:4 No ratings yet.

The first video is an intraoral ultrasound using the high frequency endocavitary probe demonstrating an anechoic fluid collection adjacent to the patient’s enlarged left tonsil. The second video shows real-time ultrasound-guided successful drainage of the PTA.

Ultrasound ENT Infectious Disease Visual EM

Subcutaneous Emphysema in Non-Necrotizing Soft Tissue Injury

Hamid Ehsani-Nia, MS, DO^* and Lauren Sylwanowicz MD^{^}

DOI: https://doi.org/10.21980/J8432M Issue 2:4 No ratings yet.

X-Rays of the elbow revealed diffuse striated lucencies throughout the soft tissue, consistent with extensive subcutaneous air throughout the superficial and deep tissues. There was no evidence of a fracture.

Infectious Disease Orthopedics Visual EM

Erythema Migrans

Daniel Polvino, MD^* and Grant Wei, MD^*

DOI: https://doi.org/10.21980/J8QW7QIssue 2:4 No ratings yet.

History of present illness: A 28-year-old male presented to the emergency department with a chief complaint of two weeks of headache, chills, and numbness in his hands. He reported removing a tick from his upper back approximately two weeks ago, but did not know how long the tick had been embedded. His review of symptoms was otherwise unremarkable. Significant findings:

Dermatology Infectious Disease Visual EM

Chancre of Primary Syphilis

Adnan Riaz MD^* and Grant Wei MD^*

DOI: https://doi.org/10.21980/J83342 Issue 2:4 No ratings yet.

Physical examination revealed a non-tender, erythematous lesion on the glans penis, two similar adjacent satellite lesions, as well as tender inguinal lymphadenopathy. No penile discharge was noted.

Infectious Disease Dermatology Genitourinary Visual EM

Using Bedside Ultrasound to Rapidly Differentiate Shock

Mohamad Moussa, MD^*, Jacob Willen, BS^* and Sudipa Biswas, BS, MS^*

DOI: https://doi.org/10.21980/J8S047 Issue 2:3 No ratings yet.

A RUSH exam demonstrated hyperdynamic cardiac contractility and collapse of the inferior vena cava (IVC) with probe compression more than 50% suggesting hypovolemia likely secondary to sepsis. Incidentally, Morrison’s pouch revealed a large right renal cyst but no signs of free fluid. A computed tomography of abdomen/pelvis showed a 10.8 x 9.5 cm right renal cyst and left lower lobe pneumonia.

Ultrasound Infectious Disease Visual EM