1 - 0. This patient presents with symptoms concerning for acute CVA versus TIA. General group of diseases that involve the scarring of lung parenchyma. Many of these infections are discussed in detail in other topic reviews; they are briefly. For acute epididymitis most likely caused by enteric organisms. Headache, Nausea, Diarrhea, Dizziness, Sleep Disturbance. It is most often seen in adult men. 5 cc NS. Ensure adequate urine output first. Intertrigo is a sign of inflammation or. Other symptoms may include soreness and problems swallowing. Occurs during tooth eruption through the gingiva. Decreased urobilirubin associated with obstructive biliary disease and severe cholestasis. Intertrigo, or intertriginous dermatitis, is a common inflammatory condition of skin folds characterized by moist erythema, malodor, weeping, pruritus, and tenderness ( picture 1A-D ). 1 This common skin disorder may be localized in a small area or involve larger surfaces. Edema & ecchymosis usually present. Severe gingival disease that may spread to local soft tissue and bone. Also known as ringworm. These options do not cover gonococcal or chlamydial infections. Tinea barbae is a dermatophytosis Overview of Dermatophytoses Dermatophytoses are fungal infections of keratin in the skin and nails (nail infection is called tinea unguium or onychomycosis). Must distinguish from Herpes gingivostomatitis. Physical evidence of trauma above the clavicle. Bowel Sounds. Colloquially known as Pinworm (United States), Treadworm (UK and Australia) or Seatworm. Intertrigo's Latin translation, inter (between) and terere (to rub) helps explain the physiology of the condition. Acute alveolar osteitis of a socket after tooth extraction of all maxillary teeth; note lack of blood clot in socket and exposed alveolar bone. Risk factors (prevalence can reach up to 50% in these populations): Age under 18. Toner. Dental Anesthesia. This process becomes overwhelmed in overdose and metabolism is shifted to the CYP 450 pathway generating toxic NAPQI. Orthopedic emergency. Griseofulvin 500-1000mg (20mg/kg) PO daily for 2-4 weeks. Gatifloxacin 0. Inject ~1mL of anesthetic to block ventral digital nerve. Tinea cruris, also known as jock itch, is a common type of contagious, superficial fungal infection of the groin and buttocks region, which occurs predominantly but not exclusively in men and in hot-humid climates. Keep the area clean, wash it gently with mild soap, and pat it dry. 5mm elevation in V2 and V3. Prep area with betadine or chlorhexadine using circular motion moving away from joint x 3. Inferior alveolar nerve provides sensation to all of the teeth on the ipsilateral side of the mandible as well as the lower lip and chin via the mental nerve. These recommendations (and the characteristic features of candidal skin infections) are based on expert opinion in the Primary Care Dermatology Society (PCDS) information on Intertrigo and Candidal infection [Primary Care Dermatology Society, 2021] and the DermNet NZ information on Candida [DermNet NZ, 2022], in addition to review articles. Closed. Tinea cruris is a dermatophytosis that is commonly caused by Trichophyton rubrum or T. Use an absorbent diaper and wrap it. ↑ Rodrigo GJ, Rodrigo C. [ in″ter-tri´go] an erythematous skin eruption occurring on apposed surfaces of the skin, as the creases of the neck, folds of the groin and armpit, and beneath pendulous breasts. About WikEM; Disclaimers; This page was last edited 22:44, 21 January 2017 by Ross Donaldson. Definition: GCS 14-15. A bulging tympanic membrane which is typical in a case of acute otitis media. Erythematous macules/papules develop into vesicles which become pustular and rupture. The rule stratifies patients < 2 years old and ≥2 years old. Intertrigo is most commonly found in the groin, axillae, and inframammary folds. The first enzyme in the heme production pathway is ALA synthase (ALAS), which controls the rate of heme synthesis in the liver. Intertrigo er ofte genstand for sekundær infektion 1. More common in men than women. Look at palms, soles and mucous membranes. Initial dose 0. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Intertrigo is a common inflammatory skin condition that is caused by skin-to-skin friction (rubbing) that is intensified by heat and moisture. Common fungal infection of the skin, hair and nails. CNS. noun. First published in 1899 as a small reference book for physicians and pharmacists, The Merck Manual grew in size and scope to become one of the world's most widely used comprehensive medical resources for professionals and consumers. Perianal irritant contact dermatitis can be due to: Faecal soiling resulting from an incompetent anal sphincter; Skin irritants in skin cleansers and. Perforation can be due to multiple mechanisms but is generally either mechanical (e. The dosage and length of treatment depends on. Recommendation. 1 Pediatric acute gastroenteritis treatment. Atherosclerotic plaque rupture or intraluminal thrombus in one or more of the coronary arteries. buprenorphine) [1] or as a result of cessation of use. APAP toxic metabolite NAPQI usually quickly detoxified by glutathione stores in liver. Severe Bullous disease. AND, 2 or more of the following symptoms 25% of the time. Utilize fistula clamp to apply small focus of direct pressure. 1. Our highly acclaimed content is. Tinea Cruris (Jock Itch) Tinea cruris is a dermatophyte infection of the groin. Peak in 5-15yr old [1] Rare in <2yr of age [1] Accounts for only 15-30% of pharyngitis [1] Caused by S. Fetal Effects in pregnancy. Associated with DM and Renal Stones. Drug or alcohol intoxication. 25mg/kg) PO q6hrs x 10 days OR. Children (non-permanent) teeth identified by letters. Contents. rubrum and E. Gen: WNWD appropriate for age. Moisture from insensible water loss and sweating cannot evaporate due to occlusion. Dentoalveolar Injuries. Urolithiasis comprises 3 similar clinical entities: Nephrolithiasis. Age> 60. 2-8 weeks. Used when the patient and clinician make a joint decision to stop further attempts to restore and/or maintain sinus rhythm. GCS < 15. After 2yr of age, UTI remains common in girls (but associated with symptoms) Tip: Blow your skin with a hair dryer set at its lowest setting 2 to 3 times a day to keep your skin dry. T-shaped device inserted through cervix, can be used for up to 3-12 years. Andre områder, som kan afficeres, er i albuebøjninger, fingerinterstitser, perineum, nakkefolder (især børn) og folder på øjenlågene. Not considered an STI although it can be transmitted by. Not considered an STI although it can be transmitted by. Nonpregnant: doxycycline 100 mg PO BID x 7 days. Classic symptoms: dysmenorrhea, pelvic pain, dyspareunia, and infertility. Lesions mostly develop in the neck, axilla, sub-mammary fold, and. Generally, the infection occurs as a follicular inflammation, or as a cutaneous granulomatous. In men under 40: 2. Repeat doses of 0. The resulting rash is often red, raw, and stings. Evacuate the clot. associated with change of stool freq. Hailey–Hailey disease (HHD), or familial benign chronic pemphigus [1] : 559 or familial benign pemphigus, [2] : 622 was originally described by the Hailey brothers (Hugh Edward and William Howard) in 1939. Mild Pain, Nonopioid, +/- Adjuvant: Acetaminophen: 650mg q4-q6h PRN or 1000mg q6h PRN - Aspirin: 650mg q4-6h PRN or 1000mg q6h PRNStandard Evaluation. It usually affects preschool-age children . May spread to perineum, perianally, onto buttocks, or into gluteal cleft. 1 Back Pain Risk factors and. Intertrigo (say: in-ter-TRY-go) is caused by wetness and soreness in skinfolds—areas where skin rubs against skin. This breakdown often leads to infection by yeast or bacteria. Evaluate other injuries that may cause immediate loss of life/limb first. 1. Normal menstruation: 28 +/- 7 day cycles. An infection of the connective tissue of the ear that covers the auricle or pinna. Contents. Insert 18ga needle (for larger joints) into joint space while pulling back on syringe. Abdominal Pain ( 3 months - 3 years) _ y/o child presenting with abdominal pain +/- vomiting and fevers. For persons weighing ≥150 kg, 1 g of ceftriaxone should be administered. Apply this medication to the affected skin as directed by your doctor, usually 2 or 3 times a day. Hospital Acquired or Ventilator Associated Pneumonia. 3. org About WikEM; Disclaimers; This page was last edited 23:21, 25 August 2016 by Ross Donaldson. At least 100,000 deaths per year may be directly or indirectly related to DVT and PE. Tetrad of: [5] Altered mental status - agitated delirium progressing to stupor/ coma. aureus and S. 25mg)/5mL. Causes. Treatment for intertrigo can depend on the underlying cause or severity. Initially described by the Hailey brothers in 1939 [ 1 ], this intraepidermal blistering disorder is characterized by painful blistering. According to the American Family Physician, intertrigo mostly occurs between the toes, in the armpits, in the groin area. Common points of entry include intertrigo in the toe webs of the feet, tinea pedis, onychomycosis, and lower extremity ulcers. Due to increased pulmonary vascular permeability. Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. 1 U/kg q2hr and switch IV fluids to Dextrose 5% at 150cc/hr. Low-energy trauma can cause hip prosthetic dislocation. Three months of abdominal pain : relieved by defecation. Pass the peel-away sheath and in-dwelling dilator over the guidewire and into the bladder. Single painless papule that becomes eroded and indurated, cartilaginous consistency on palpation. Initiate nutrition at a maximum of 40%–50% goal, but usually starting the glucose infusion rate around 4–6 mg/kg/min and advancing by 1–2 mg/kg/min daily as blood glucose levels allow until you reach a max of 14–18 mg/kg/min. Control bleeding with pressure applied to puncture site for 5-10min; observe for 1-2hr. Ureterolithiasis. I tried to keep it clean and dry but it just got worse. Note trabeculated wall, which is a sign of urinary retention. Breast abscesses develop most commonly when mastitis or cellulitis does not respond to antibiotic treatment, but an abscess can also be the first presentation of breast infection. Anti-Fungal Powder. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. [4] [5] These areas are red, pink, or purple, dry, itchy, and scaly. Breast cellulitis is a skin infection that occurs as a result of bacterial entry via breaches in the skin barrier. K, oblique fibers of the PDL. Although intertrigo can affect only one skin fold, intertrigo commonly involves multiple sites. In women: 1. Blue - supply from inferior mesenteric artery (IMA) and its branches: left colic, sigmoid, superior rectal artery. It can be regarded as a special sort of dermatosis that occurs within a skin fold (also known as an intertrigo). Background. ingested bones) or via chemical corrosion (e. Intertrigo is an inflammatory rash that occurs between skin folds as a result of friction, moisture, and lack of airflow. 5 mL per kg (maximal dose: 5 mL) via nebulizer. Opioid withdrawal can be precipitated with administration of antagonist (e. In men under 40: 2. Clinical Features. Abdominal distention is frequent complaint. Management. X-ray shows physis compression fracture. Epinephrine (nebulized) Use in moderate to severe cases based on the croup scores. By definition, balanoposthitis cannot occur in a circumcised male, although balanitis (inflammation of the glans. Fluconazole. Sharply demarcated border, erythematous, elevated. WikEM, The Global Emergency Medicine Wiki, is the world's largest and most popular emergency medicine open-access reference resource. Occurs due to sudden change in direction with heel off the ground. In New Zealand, T. Middle Ear inflammation: erythema of TM or otalgia. High-energy trauma is primary mechanism for native hip dislocation. If placenta is not intact, there may be retained products of conception in the uterus requiring manual or surgical removal. . If you are a medical practitioner, join our contributor community and share your important knowledge with. Candidal intertrigo classically presents as erythematous and macerated plaques with peripheral scaling. Background. pyogenes, Streptococcus agalactiae solely or in combination with S. [9] ETIOLOGY. Symptoms of pityriasis rosea. 4. ; The paronychia is the lateral nail folds; The hyponychium is the palmar surface skin distal to the nail. Impetigo on the back of the neck. Skin Exam - moisture, temp, evidence of injection drug abuse. Mode of transmission via direct contact to the organisms (eg. 5mg, max 25mg. Scan from midline to the midclavicular line at the right 11th/12th intercostal spaces. 1:1 dilution of 3% hydrogen peroxide if tympanic membrane is visible and intact. Candidal intertrigo is an infection of the skin by Candida albicans, more specifically located between intertriginous folds of adjacent skin. There are medical treatments and steps for at-home care to alleviate symptoms of intertrigo. DTRs. Pink - supply from superior mesenteric artery (SMA) and its branches: middle colic, right colic, ileocolic arteries. innervates ipsilateral incisors and canine; may provide some sensation to contralateral medial incisor. 2. Common materials based on inflammatory reactions. Use external splinting and/or nasal packing to. Rub erythematous skin to see if it sloughs. Candidiasis is a fungal infection due to any type of Candida (a type of yeast). Identify and treat the underlying disease. 09% from mucous membrane exposure. [4] When it affects the mouth, in some countries it is commonly called thrush. Hydrochlorothiazide 12. The most common cause is infection of residual bladder urine with urea-splitting organisms ( Proteus, Pseudomonas,. Dashboard impact, fall from height, sports injury. 1 Cardiac Arrest; 2. Perform a careful physical exam. Bacterial, viral, or other fungal infection may also occur. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Insert Foley catheter through sheath and into bladder. Impetigo honey-colored scab. Mechanism. Aspirate using 18 gauge needle just lateral to the tonsil. Aloe or Argan Oil. Candida infection (acute onset, bright red skin, satellite pustules, peeling surface); Psoriasis (chronic, bright red, minimal symptoms, often signs elsewhere such as scalp, elbows, knees, flexures, nails)EPIDEMIOLOGY Radiation dermatitis occurs in over 90 percent of patients receiving radiotherapy, especially in patients with breast cancer, head and neck cancer, skin cancer, lung cancer, or sarcoma [ 1,7,23-25 ]. Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation. Arch Pediatr Adolesc Med. Slideshow. Adipose tissue, inferior rectus or inferior oblique can entrap within maxillary or ethmoid sinus. Nonbullous. descends from infraorbital nerve. Neuro: Speech is clear and appropriate. These fat folds can trap heat, moisture, bacteria and yeast inside, and combined with chafing, this leads to a condition called intertrigo. 1 Background. Incise second location <4cm from original incision. Intertrigo is an inflammatory skin condition that can be caused and worsened by many factors. Common side-effects = constitutional, gastrointestinal. Limitation of mandibular movements. Open lesion (day 4): Vesicles break open and merge to create one big, open, weeping ulcer. Use commercially available declogger (Bionix), Clog Zapper. 35, OR blood-ascites pH gradient >0. Menometrorrhagia: excessive irregular vaginal bleeding. Neuroglycopenia. Interpretations of Key Phrases. Press on lesions to see whether they blanch. CO inhibits oxidative phosphorylation. >3 bm per day or < 3 bm per week. These may include sore throat, fever, aches, nausea, and fatigue. "Germ-tube negative yeast" suggests non-albicans Candida yeast. Bodily secretions, including. Pelvic anatomy including organs of the female reproductive system. 33% are associated with ocular trauma. 5 ml of 10mg/ml phenylephrine, and dilute in 9. Treatment for heat rash typically involves preventive steps, such as: wearing clothing that allows the skin to dry and stay cool. 3 Complications; 2 Clinical Features. May confuse for Type 1 injury: differentiation based on clinical presentation, history, and exam. Ocular foreign bodies are a high-risk chief complaint because of short and long-term threats to vision loss. Donate. Copper IUD (Paraguard): lasts up to 12 years, no hormones, usually cheaper. Neutropenic patients: micafungin 100 mg/d IV or other echinocandin (anidulafungin, caspofungin) Patients with fluconazole resistant candida can be treated with amphotericin B. Dose (Ketamine): Start with 0. 1 General; 3 Pediatric Dosing; 4 Special Populations; 5 Contraindications; 6 Adverse Reactions. Proteins. Hydrocortisone Cream. Secondary infection with bacterial or fungal infection is common. Lift depressed nasal bone anteriorly and laterally in one fluid motion. Back pain (red flags) (Redirected from Back Pain (Red Flags)) Contents. 3% (1 in 300) and 0. Adrenal Insufficiency. Proximal humerus is divided into four "parts" based on epiphyseal lines: Articular surface of humeral head. Worldwide distribution. Hyperthermia >38C (87%); >40C (40%)1 WikEM. Intertriginous skin, also known as skin folds, are sites in which opposing skin surfaces come into contact while at rest, resulting in chronic skin occlusion. g. Type: Antifungal, azole Dosage Forms Topical:1% cream; Vaginal: 100mg supp, 200mg supp; 1% cream, 2% cream; Oropharyngeal: 10mg troche; Routes of. Dermatology (152 pages) Emergency Medical Services (81 pages) Endocrinology (52 pages) Environmental Disorders (92 pages) Fluids, Electrolytes, and Nutrition (89 pages) Gastroenterology (235 pages) Head and Neck (127 pages) Hematology and Oncology (139 pages) Infectious Disease (674 pages)Toxicologic Pathophysiology. Open fractures (excluding distal phalanx fractures) require immediate IV antibiotics and urgent surgical washout. Skin prep agent dried: skin prep agent completely dried prior to procedure. Contents. Diagnostic of portal hypertension with 97% accuracy [7] SBP rarely develops in patients without portal hypertension. Intertrigo leads to an itchy rash that can. May be acute or chronic. Physical exam 4. doi. Humans only known reservoir. Blockage or congestion of nose. When to See a Doctor. in· ter· tri· go -ˈtrī-ˌgō. "Germ-tube negative yeast" suggests non-albicans Candida yeast. Also occurs due to bacteremia with hematogenous seeding (Staph) Emphysematous pyelonephritis. 5% ophthalmic solution 1 drop QID for 7 days. Deviated trachea, flail chest, sucking chest wounds, asymmetric breath sounds, chest wall crepitus, etc. 3. Type: Amino-PenicillinDosage Forms: oral suspension, tablet, extended release tablet, chewable tablet; Dosage Strengths: oral suspension: (125/31. Other names. Intertrigo is a common inflammatory skin disorder caused by skin-on-skin friction within skin folds, as a result of moisture becoming trapped because of poor air circulation. Our highly acclaimed content is freely available via the internet and our dedicated mobile applications. Imipenem 500mg q6hr + cipro 400mg q8hr + vanco 15mg/kg q12 OR. Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients. Consult Interventional Radiology for clot thrombolysis. Perception of movement (rotational or otherwise) where no movement exists. Authors: Ross Donaldson. These may include sore throat, fever, aches, nausea, and fatigue. Serious complications are rare, <1% of women with IUDs. Generalised myasthenia gravis. Look at palms, soles and mucous membranes. As rupture release yellow fluid which dries to form stratified golden crust. Levofloxacin 500 mg orally once a day for 10 days. These stones cause the majority of all biliary tract problems, and depending on where the stone become impacted, specific problems occur. Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Humans only known reservoir. Contact dermatitis of the perianal skin Irritant contact dermatitis. Idiopathic anal pruritus likely results from perianal fecal contamination and resultant trauma from wiping and scratching. Sinus pressure while bending forward to changing head position. The role of anticholinergics in acute asthma treatment: an evidence-based evaluation. Infection thrombophlebitis - Associated with prolonged IVs and is the only thrombophlebitis to require antibiotics. Ear anatomy. Giant cell arteritis on histopathology. Background. You need to shower every day (especially after excessive sweating or physical activity) and properly dry yourself with a clean towel by gently tapping it on your skin, rather than rubbing it forcefully. NOTE: it takes time to set up nitroglycerin drip, so consider SL nitroglycerin in interim. In rapid accumulating effusion (left curve), even a small effusion volume can exceed the limit of parietal pericardial stretch and finally causes a steep rise in pressure. Placing gauze or cotton in between the folds of skin where intertrigo has developed keeps the folds from rubbing together and creating friction that can worsen your rash. Sign/symptoms similar to pyelo ( fever, CVAT, dysuria) Occurs in setting of ascending infection with obstructed pyelo. Regional lymphadenopathy that is painless and firm. Intertrigo er inflammation i hudområder, der ligger mod hinanden (intertriginøse hudområder) Ses i lysken, axillerne, under mammae og i navlen. At a point 1 cm proximal to tibial plafond space between tib/fib should be ≤6mm. Symptoms usually constant but can vary from day. Mental status changes. Staphylococcal scalded skin syndrome ( SSSS) is a dermatological condition caused by. Intertrigo under the breasts is common among people who are overweight or obese. Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. Intertrigo is an inflammatory condition of skinfolds caused by skin-on-skin friction. doi. Doctors examine the affected areas and view skin samples under a microscope or in a culture. Clin Toxicol. It belongs to a group of medications called antifungals. Penetrating trauma to the lower third of the face frequently requires intubation or a surgical airway [1] Place a protective shield over an eye suspected to have a ruptured globe. Our highly acclaimed content is freely available via the internet and our dedicated mobile applications. Bodily. Common landmarks: : Right upper wisdom. WikEM, The Global Emergency Medicine Wiki, is the world's largest and most popular emergency medicine open-access reference resource. Episodes may recur with variable frequency. The main goal is to determine superficial vs. Phosphate ≥ 4. Occurs during tooth eruption through the gingiva. The arteries that supply Kiesselbach's plexus (responsible for anterior nosebleeds). Background. Dosage Forms. 4 Cellulitis and Other Skin Infections; 3 Pediatric Dosing. Intertrigo frequently is worsened or colonized by infection, which most commonly is candidal but also may be bacterial or viral or due to other fungal infection. Cephalexin 500mg (6. altered stool passage. 1 Colitis; 3 See Also; Types Colitis. Treatment is with topical antifungals. Vascular injury that reduces cerebral blood flow to specific region of brain causing neuro impairment. Bleeding from the uterine corpus that is irregular in volume, frequency. Reduction of native hip should occur within 6hr due to high risk of avascular necrosis. Indications: vascular access. Urine dipstick become positive the protein >300-500mg/d. Traumatic superficial thrombophlebitis - Associated with limb injury from blunt trauma, IV catheters or chemical treatment. The rash may be sore or itchy. Infants are especially susceptible to this inflammatory condition because of their flexed posture, relatively high percentage of body fat, and short neck. Abdomen: Neg rebound murphy or pain over Mcburneys point. It is caused by an enterovirus, primarily coxsackievirus A6. Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection [1] The infection is most commonly by bacteria, but can also be by fungi, viruses, or parasites [2] Risk of death from sepsis being as high as 30%, severe sepsis as high as 50%, and septic shock as high as 80% [3] The most common. Subtypes of infections include: Tinea corporis (ringworm)Candidiasis is infection with the yeast Candida. Cephalexin. Initiating factors include moisture and friction associated with an absence of air circulation in deep skin folds. Administration. Occurs at point of contact: penis, rectum, mouth, external genitalia, cervix, or labia. Clindamycin 450mg (5mg/kg) PO q8hrs x 10 days (if PCN allergic) OR. Type 2: Myocardial Infarction Secondary to an Ischemic Imbalance. Measure SBP from both DP and PT arteries using cuff placed just proximal to the malleoli with Doppler over artery (5-8% of normal patients. Balanoposthitis refers to inflammation of the glans penis and prepuce. Candida is considered part of the normal flora in the gastrointestinal tract, the mouth and the vagina. Intertrigo leads to an itchy rash that can get infected with germs or yeast. Also known as ringworm. Shock delayed until peak of QRS complex in synchronized cardioversion (keep holding button down) Repeat PRN. e. The affected area is red, irritated, itchy, or a combination. Abdominal pain or bleeding; < 20 weeks gestation. It is an uncommon problem in breastfeeding with a reported. Specialty. Inframammary (Figure 1), intergluteal, genitocrural, axillary, and/or interdigital skin folds can be involved in isolation or in combination with other body sites. Candidiasis encompasses a wide array of local or invasive fungal infections caused by the Candida genus and infect more than 250,000 patients worldwide per year [1] Candida yeasts (most commonly Candida albicans) are normal flora that live on the skin and mucous membranes, but may cause infection with overgrowth. Intertrigo results from constant moisture within the skin folds and skin-on-skin friction. Who have begun solid foods [1] Sorbitol-containing fruit purees (e. 0. Sedation and amnesia, no analgesia. Buccal gingiva adjacent to the lower molars will retain normal sensation unless that nerve is anesthetized separately, via a (long) buccal nerve block. WikEM is wiki-based medical website and point-of-care phone application for emergency medicine clinicians. coli is responsible for ~80% of UTIs. Begins with an erythematous patch on the proximal medial thigh.