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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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Endocarditis III: Medical Management01:18

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Rheumatic Heart Disease III: Medical Management01:21

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Rheumatic Heart Disease IV: Nursing Management01:20

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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
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Related Experiment Video

Updated: Mar 6, 2026

Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
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Lyme Disease: Emergency Department Considerations.

Nathan D Applegren1, Chadd K Kraus2

  • 1School of Medicine, University of Missouri, Columbia, Columbia, Missouri.

The Journal of Emergency Medicine
|March 15, 2017
PubMed
Summary

Lyme disease (LD) is increasing in North America, often presenting in emergency departments. Early recognition and treatment by emergency physicians are crucial to prevent severe complications.

Keywords:
Borrelia burgdorferiIxodes scapularisemergency departmentlyme disease

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Emergency Medicine

Background:

  • Lyme disease (LD) is North America's most common vector-borne illness, with reported cases rising significantly.
  • Increased prevalence is linked to better recognition, surveillance, public education, geographic expansion, and more infected ticks.
  • Children have the highest incidence, and emergency departments (EDs) increasingly see patients with tick bites and LD symptoms like erythema migrans.

Purpose of the Study:

  • Review the etiology, clinical presentations, and sequelae of Lyme disease.
  • Provide a practical classification and approach for ED management of LD-related presentations.
  • Highlight the critical role of emergency physicians in LD recognition, diagnosis, and treatment.

Main Methods:

  • Literature review of Lyme disease etiology.
  • Analysis of clinical presentations and sequelae.
  • Development of ED management strategies.

Main Results:

  • Lyme disease diagnosis and management in the ED setting are detailed.
  • Diagnostic tests and treatment protocols are discussed.
  • Delayed sequelae, including Lyme carditis and neuroborreliosis, are addressed.

Conclusions:

  • The rising prevalence and geographic spread of LD necessitate high clinical suspicion in endemic areas.
  • Emergency physicians are vital for early diagnosis and treatment to prevent long-term morbidity.
  • Prompt management in the ED is key to minimizing delayed sequelae of Lyme disease.