Authors: Matthew Schofield, Graham Johnson / Editor: Andrew Tabner / Reviewer: Graham Johnson / Codes: EC14, IC5, SLO1 / Published: 07/01/2018 / Reviewed: 21/06/2024
A 34-year-old male, previously fit and well, presents to the Emergency Department (ED) with general malaise and increasing myalgia for two weeks since returning from a stag do abroad. He is from outside the region attending a wedding and has a 48-hour history of bilateral neck swelling. He is complaining of a dull headache with increasing pain in his right ear associated with muffled hearing. He tells you his ankles have started to ache but puts this down to his new shoes he has worn for the wedding.
He denies any past medical history and takes no regular medications. He works full time as a banker.
On examination he appears anxious and flushed and has bilateral neck/face swellings as illustrated in the image below. He has a temperature of 40.7 degrees, is tachycardic at 120bpm and clammy to touch.
His ECG shows sinus tachycardia.
Image via Wikimedia Commons
Module Content
Primary Headache
Acute, severe headache is a common symptom of patients presenting to the emergency department. In 90% of cases, the cause will be one of the primary headache syndromes.
Non-traumatic Subarachnoid Haemorrhage
This session describes the management of presentations of non-traumatic subarachnoid haemorrhage in the ED.
Common Childhood Exanthems
Children commonly present to the emergency department with a febrile illness and a rash
14 Comments
Excellent knowledge bite. I have never come across a case but it has always interested me as I suffered with it as a child.
Great thanks
Interesting case. I have never seen Mumps in an adult. I had it as a child but do not really have a vivid recollection of the symptoms experience. I am still baffled why/ how he acquired the disease on the stag trip. Any answers?
A good and informative case presentation !
Thanks
Good case and good list of very possible differentials
Interesting
good case
Interesting learning case.
Great
Good ine
Good one
Really Great Topic
thanks
Interesting learning case.
Great