Wednesday, December 12, 2007

Vol 1:3 Question






Fever
A 43-year old male IV drug user presents to the ED with 2 weeks of fever, back pain, and progressive weakness in his arms bilaterally. He denies any history of recent trauma. His blood pressure is 130/75 mm Hg, heart rate is 106 beats per minute, temperature is 103°F, and respiratory rate is 16 breaths per minute. On physical exam, he has tenderness to palpation in the mid-thoracic spine, and decreased strength in the upper extremities bilaterally with normal range of motion. Laboratory results reveal a WBC 15,500/µL, hematocrit 40%, and platelets 225/µL. Which of the following is the most likely diagnosis?
a. Thoracic disk herniation
b. Ankylosing spondylitis
c. Spinal epidural abscess
d. Vertebral compression fracture
e. Spinal metastatic lesion


Please submit your answer in the "comment" section. The person with the most correct entries at the end of the month will receive a copy of the book PreTest Emergency Medicine.

For more information about the contest, please click here.

quizzER is a weekly contest consisting of a question selected from various areas of emergency medicine that are central to the education of medical students and residents in training. For more information please refer to the following link.

16 comments:

ditzydoctor said...

c) spinal epidural abscess!

Kelly said...

c. Spinal epidural abscess

NP Ski said...

the answer is C

Carola said...

Spinal epidural abscess
P.S. a comment is visible with the right answer

Cody said...

c

Anonymous said...

c
npg

Helen said...

I'll pick C again.

ERnursey said...

c

Joshua said...

C. Spinal epidural abscess

Nurse K said...

C-Spinal epidural abscess

HicksterAZ said...

C. Spinal epidural abscess

The T-Dude said...

Hmmmm. Given the localized tenderness, fever, and history of drug use, I'd have to go with spinal epidural abscess

creonnoir said...

c. Spinal epidural abscess

Andaleeb said...

C. Spinal Epidural Abscess

NPG said...

C. Spinal epidural abscess (sorry if I posted twice)

Andaleeb said...

c. spinal epidural abscess - i posted this before but i didnt see it posted yet! so sorry if its repeated