Richardson A, Tewelde SZ, Dezman ZDW. 48-year-old Man with Fevers, Chest Pain, and a History of Substance Abuse.
Clin Pract Cases Emerg Med 2018;
2:297-299. [PMID:
30443610 PMCID:
PMC6230364 DOI:
10.5811/cpcem.2018.8.39252]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/10/2018] [Accepted: 08/20/2018] [Indexed: 11/11/2022] Open
Abstract
A 48-year-old male with a history of intravenous (IV) drug use presented to the emergency department (ED) for an area of mild pain and erythema on his chest. He was then triaged to the urgent care, or fast track, area of the ED. He was well appearing with normal lab findings and vital signs, but his workup revealed mediastinitis with osteomyelitis of the manubrium and clavicles, a surgical emergency. His treatment course included IV antibiotics and operative intervention with thoracic surgery. The patient looked too good to be sick, yet he had a life-threatening infection.
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