Chikungunya
Fig. 59.1 Maculopapular rash (Courtesy of Dr. Jorge Hidalgo, from Karl Heusner Memorial Hospital Belize) Question What diagnostic approach should be undertaken? Answer The presence of fever and arthralgias is…
Management of Acute Liver Failure
Fig. 64.1 Non-contrast head CT at initial presentation. There was no evidence of cerebral edema despite markedly impaired mental status Broad-spectrum antibiotics consisting of vancomycin and cefepime were started given…
Abdominal Sepsis and Complicated Intraabdominal Infections
Fig. 79.1 Perforated diverticulitis in the transverse colon Question How should this patient’s intraabdominal condition be managed? Answer This patient has an intraabdominal infection from a perforated transverse colon, as…
Hemophagocytic Lymphohistiocytosis
Fig. 73.1 Chest radiograph on admission (a) demonstrated bilateral infiltrates, which corresponded to bilateral ground glass opacities and interstitial thickening on a CT performed the same day (b). After 1…
Acute Lower Gastrointestinal Bleeding
Fig. 65.1 Mesenteric angiography with coil embolization. Angiography of the colic branches with positive blush sign (Panel A and B) and following coil embolization (Panel C) Principles of Management Definitions…
Acute Pancreatitis
Fig. 63.1 Axial contrast-enhanced CT showing a mildly enlarged pancreas (A), with normal contrast enhancement and peripancreatic fat stranding and fluid (B), consistent with acute interstitial edematous pancreatitis These recommendations…
Management of Acute Upper Gastrointestinal Hemorrhage
Clinical factor Pretest probability of an UGIB Likelihood ratio Posttest probability of an UGIB Melena on exam 63 % 25 98 % BUN/sCr >30 63 % 7.5 93 % Prior…
Adrenal Insufficiency
Albumin >2.5 g/dl Albumin <2.5 g/dl Total cortisol (μg/dl [nmol/l]) Baseline 15 (410) 10 (275) Stimulated 20 (550) 15 (410) Free cortisol (μg/dl [nmol/l]) Baseline 1.8 (50) 1.8 (50)…
Immunocompromised Pneumonia
Fig. 24.1 Chest X-ray Fig. 24.2 High-resolution CT scan Question Should the patient’s antimicrobial regimen be changed? What diagnostic test should be performed? Answer The patient’s antimicrobial regimen should be…
