Incidence of deep venous thrombosis in patients with erysipelas of the leg: prospective study of 30 cases in an emergency department.

The treatment of lower limb erysipelas is based on anti-streptococcal antibiotherapy. The indication of adjuvant anticoagulant therapy is not clear because of the lack of data about the incidence of deep venous thrombosis (DVT) in these patients. We performed a prospective study using a colour Doppler vein exploration combined with ultrasonography within the first 48 h, with evaluation of clinical probability of DVT according to the Wells score to assess the incidence of DVT in patients with erysipelas of the lower limb. Of 30 patients studied, 3 DVT were diagnosed: 2 distal DVT (posterior tibial vein) and 1 proximal DVT (superficial femoral vein) in patients having a clinical score > or = 3. Pulmonary embolism was diagnosed in 2 cases. The incidence of DVTin our study was 10%.DVT should be considered in patients with erysipelas of the lower limb having a high pretest clinical probability.

[Functioning of a university hospital emergency department]. / Fonctionnement d'un service d'accueil des urgences d'un centre hospitalo-universitaire.

BACKGROUND: The emergency department is the part of the hospital where patients with undifferentiated emergencies are triaged and receive their initial resuscitation and treatment. It provides a 24/7 service with doctors and nurses trained in emergency medicine. AIM: We describe our emergency department and its activity to emphasize the difficulties and try to suggest a better emergency department organization. METHODS: descriptive retrospective study of an emergency department and its activity during the year 2004. RESULTS: the department has two units: a reception unit with a resuscitation room,a trauma room, an ambulatory emergencies room, and an observation unit. There is an average of 89 patients a day with peaks in july and august, wednesday and Thursday and between 7.00 and 2.00 pm and even between 5.00 and 9.00 pm. 86.6% of patients have medical pathologies, 60% are graded CCMU II and 11% are admitted in the hospital, half of whom in the emergency observation unit with a 28 hours mean stay. CONCLUSION: emergency department organization must be fit to local requirements. Improvement of emergency functioning requires radiological and biological departments reinforcement and medical seniorisation; which may also reduce medical cost.