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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.
A 62-year-old woman presented to the urgent care clinic with gingival bleeding after periodontal scaling of her lower-right second molar. She had undergone the procedure 5 hours before arriving at the clinic, and bleeding had persisted despite the application of pressure and ice. The patient recalled a similar episode that had occurred about 6 months earlier, also after a periodontal procedure, in
Commentary
Source Information
From the Clinical Pathological Conference Series, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston (J.M.C., J.T.K., B.D.L., J.L.); and the Department of Medicine, Division of Hematology/Oncology, University of Pennsylvania, Philadelphia (A.C.).
An Interactive Medical Case related to this Clinical Problem-Solving article is available at NEJM.org.
Address reprint requests to Dr. Loscalzo at the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115, or to jloscalzo@partners.org.
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