FIGURE 1 Read MoreA 28-year-old male presents to the emergency department with a chief complaint of chest pain, coughing and shortness of breath. After being discharged with normal x-ray results, he winds up returning to the ED with the same symptoms. 

batt-figure 1a-prevA 23-month-old female presented to a clinic with persistent cough and neck discomfort for more than one month. Additionally, she had difficulty swallowing solid foods but no trouble with liquids. 

visual-dx-90A 33-year-old male presented to the emergency department with left eye pain for one day. The onset was acute, rated at 10/10, constant, and associated with a watery discharge. The patient stated that it felt “exactly like my prior eye herpes.” The patient also noted intermittent vision loss in his left visual field. He denied any fevers, vomiting, history of HIV or oral, facial or genital ulcers. Past medical history was significant for herpes keratitis and IVDA.

necrotizing-90A 32-year-old male presented to the emergency department with concerns about a possible infection in his left lower extremity. The patient had a history of HIV and poorly controlled type 1 diabetes. He presented with a chronic ulcer to the left medial ankle and had an incision and drainage to the area about 45 days prior.

altA 62-year-old African American female with PMHx of HTN, PUD and Graves’ disease s/ p radioactive iodine (RAI), presented to the ED for progression of bilateral vision loss to near-blindness over the past year. She began to lose her vision one year ago, a few months after receiving RAI.

altIt’s midnight on a Friday and your next patient just happens to have been on the wrong end of a left hook. He is a 62 year old man who states he was assaulted with a fist to the face while walking home.

altEMS presents a 47-year-old male with sudden eye pain and decreased visual acuity which occurred while he was putting drops into his left eye. While he was retracting his lids to place the drops, his eye “popped out” with sudden subluxation of the globe.

altThis 29-year-old female presented to the emergency department complaining of feeling weak and dizzy. She admitted to being an IV drug user and believed that someone slipped something into her food several days ago while she had been at a truck stop diner. The patient also stated that she was 10 weeks pregnant and recently restarted on methadone for a “past” heroin addiction.

altA 26-year-old male presented to the emergency department complaining of severe left eye pain and loss of vision to that eye. He explains that while cleaning he dropped a ceramic pot, which shattered, and a piece of shrapnel stuck him in the eye. In addition to his visual complaints, he’s been nauseous, and has vomited several times.

altThe case occurred at the San Antonio Military Medical Center – South Campus (formerly known as Wilford Hall Medical Center) in San Antonio, Texas. At the time of presentation the emergency department was a busy Level II trauma center primarily serving active duty military personnel, military dependents and select civilian personnel.

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