By Dr. Alan Goldstein, MD
Medical Director, Bonita Community Health Center Inc.
Snowbirds, part-timers, and vacationers; no matter how they are defined, many people come to our beloved SWFL throughout the year. Often times they bring various viruses and bacterial infections along with them that can have an impact on our year round inhabitants. While some may have a primary care physician, many do not and end up going to urgent care centers to be evaluated. There may be some confusion about terminologies used to diagnose and treat the problems that arise from these illnesses.
The Not So Common Cold
In an Urgent Care setting, the most common things patients are seen for are the flu, bronchitis, bacterial infections, pneumonia, UTI’s (urinary tract infection), and chest pain. Each has their own set of symptoms and treatments. Being aware of your symptoms and informing your medical professional of all of them is the only way a proper diagnosis can be made.
Flu (Influenza Virus)
Flu is a specific virus. Many centers can test for influenza A and B. The treatment is helpful if started early enough. Tamiflu or other antiviral flu medications can be used. The typical presentation is a fever with a bad cough and body aches. Frequently, sore throat and nasal stuffiness is not present. However, remember that children may present with less symptoms.
Bronchitis is an inflammation of the bronchi and the terminology may be confusing there also. It can refer to anything from a chronic lung problem to a short acute infection. It can be viral or bacterial. Symptoms suggesting a bacterial etiology over a viral infection could include fever, green sputum, and chest pain on coughing.
Bacterial infections are treated with antibiotics but viral infections do not respond to antibiotics. Treatment such as mucolytics (mucinex or robitusin) and cough drops or cough suppressants (Delsym) may help the symptoms.
Pneumonia frequently presents with a fever , cough and chest congestion. Colored sputum may suggest pneumonia. Older adults may present with a fever and no cough. If an infection is irritating enough, the person can get concurrent asthma. It is frequently a temporary problem. However, the symptoms could be severe with wheezing and difficulty breathing. It may require a bronchodilator inhaler and or steroids to treat it.
UTI (Urinary Tract Infection)
Urinary tract infections most often present symptoms of frequency and urgency of voiding. The urine can be burning or painful. UTI technically means an infection anywhere in the urinary tract including the bladder or kidney. A kidney infection is called pyelonephritis and is more severe than a bladder infection called cystitis. The idea is always to be seen for an acute urinary infection early to prevent it from becoming a kidney infection. A urinalysis is performed to check the urine for white blood cells, blood, and nitrites which would suggest a urinary tract infection. A culture is usually sent to confirm the infection and it gives information on what antibiotic would be effective to treat the infection. If a lot of red blood cells are seen on the urinalysis a follow-up visit is suggested to repeat the urinalysis to make sure there is no other problem causing blood in the urine. Although blood in the urine is frequently associated with a bladder infection, it can be resulting from a kidney or bladder tumor. That is why follow-up is suggested with a family doctor, urologist or back to the urgent care center.
Chest pain is another frequent complaint in an urgent care center. Severe chest pain may require lab tests to determine if it is a heart issue such as a heart attack or pulmonary embolus (blood clot). Chest pressure that is severe is best seen in an ER. Chest pain that is musculoskeletal from a sprain or bruise can be seen in an urgent care center. X rays can be done. Asthma and coughs that cause chest pain can frequently be taken care of in an urgent care center also. It is a good idea to have a copy of a last EKG so it could be compared to an EKG taken.
Keep in mind that an older adult above age 60 who has a fever should be checked since most infections at this age are bacterial. Either pneumonia or urinary tract infection is common as the cause of a fever in that age group. Younger people tend to get a lot of viral infections.
While these are the most common illnesses seen in an urgent care setting, there are many other illnesses and injuries that can best be served by visiting an Urgent Care Center.
Bonita Community Health Center