Characteristics of patients with upper respiratory tract infection presenting to a walk-in clinic.

OBJECTIVE: To profile patients with upper respiratory tract infection (URI) presenting to a walk-in clinic, to quantify their perspectives on the need for antibiotic therapy, and to find out their predictions of future behavior for similar illnesses. PATIENTS AND METHODS: In the spring of 1998, previsit and postvisit questionnaires were distributed at the clinic to patients 18 years of age or older with URI symptoms. RESULTS: Based on 210 completed previsit questionnaires, 161 respondents (77%) had been ill 5 or more days, 200 (95%) had cough, 177 (84%) had phlegm, 132 (63%) had sinus pain, and 79 (38%) had fever. Additionally, 54 patients (26%) reported a history of chronic obstructive pulmonary disease, asthma, or chronic sinusitis, and 37 (18%) were smokers. Most patients were between 18 and 40 years of age. The 210 patients were categorized into 2 groups: those who believed that antibiotics were necessary (157 [75%]) and those who believed antibiotics were unnecessary (53 [25%]). The only statistically significant difference between the 2 groups was in patients with sinus pain: 109 (69%) wanted antibiotics compared with 23 (43%) who did not (P<.001). Of the 210 patients, 130 completed postvisit questionnaires, 129 (99%) of whom reported satisfaction with the clinic visit. All patients who either desired or received antibiotics indicated they would likely seek medical care for future URIs. CONCLUSIONS: The majority of patients with presumed URI presenting to this walk-in clinic expect to receive treatment with antibiotics. Of our 130 study patients, 83 (64%) received antibiotics regardless of their desire for antibiotic treatment. Satisfaction with the office visit was independent of patients' initial beliefs about antibiotics and whether antibiotics were prescribed.

Venous obstruction due to a distended urinary bladder.

Bladder distention is an infrequently reported cause of venous obstruction that may be confused clinically with deep venous thrombosis or congestive heart failure. Urinary symptoms may be minimal or absent. Herein we describe a 73-year-old man with unilateral lower extremity edema caused by a distended urinary bladder. In addition, we review the clinical manifestations of 15 previously reported cases of venous obstruction due to urinary retention. Of the 15 patients, all but 1 had painless bilateral lower extremity edema. In most cases, the cause of bladder distention was benign prostatic enlargement.