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 and joined the MJH Life Sciences team in December 2019. She graduated from Youngstown State University in 2019 with a bachelor's degree in journalism and a minor in political science. Prior to graduating, Morgan worked as the editor-in-chief of her college newspaper. She went on to work as an assignment editor at a broadcast news station in Youngstown, Ohio before joining 

 You can reach her at mpetronelli@mjhlifesciences.com.

Articles

. He joined the brand in March of 2023 as an editor before being promoted to senior editor in January 2024. Fitch graduated from Youngstown State University in Youngstown, Ohio in 2020 with a degree in telecommunications and journalism. He started his career as a news and sports videographer before becoming an on-air sports anchor at the NBC-affiliated news station in Youngstown. Fitch briefly worked as a national content writer for a Chicago-based national television station before joining the 

team. He can be reached at: jfitch@mjhlifesciences.com.

Controlling childhood EoE inflammation improves esophageal flexibility, reduces dysphagia risk, and may predict need for stricture dilation.

Study links pediatric EoE treatment to reduced stiffening

Young females with congenital heart disease face barriers to contraception, increasing their risk during pregnancy despite rising usage over time.

Teens with CHD are less likely than peers to receive contraception

High-dose centanafadine significantly improved ADHD symptoms in children aged 6–12 and was well tolerated, according to a phase 3 clinical trial.

Centanafadine shows efficacy and tolerability for pediatric ADHD in phase 3 trial

Biennial HPV testing and higher vaccination rates could help South Korea eliminate cervical cancer up to a decade earlier than current policy.

HPV screening, vaccination accelerate cervical cancer decline

Contemporary Pediatrics connects pediatricians with peer-reviewed articles, guideline updates, and practice strategies for real-world clinical application.

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An 11-year-old boy with a history of asthma and allergic rhinitis presented to the emergency department (ED) with worsening fatigue, minimal responsivity to external stimuli, and diffuse muscle weakness for 2 months.

Boy presents with fatigue, minimal responsivity, and diffuse muscle weakness

**Editor's Note** Please note that starting January 1, 2025, we will be switching to an online-exclusive publication process. This will allow us to publish case submissions quicker without having to deal with the variables that come along with print publication. All cases will still be eligible for print publication consideration, but publication in our print magazine is not guaranteed and will be up to the editor's discretion. 

Do you have a puzzling pediatric case that you’d like to share with the readers of 

We are looking for intriguing diagnoses that have stumped the experts—a diagnostic “Puzzler”—to help our physicians enhance their day-to-day practices. If you have such a story to tell, tell us.

Here’s what to do: Before you begin, we suggest that first you review the Puzzler 

https://www.contemporarypediatrics.com/case-studies

. Please note the specific style required for writing Puzzler manuscripts.

Next, prepare a draft of your case, including a summary of the presenting symptoms, a case overview, a 

table of the differential diagnosis (MANDATORY)

, and the special aspects of your case that qualify it as a Puzzler, and send it to us. Please note that the differential diagnosis table should also be discussed in the body text. We’ll review your draft and let you know what you need to add or revise before we send the manuscript to peer review for evaluation.

Puzzlers vary in length, and we suggest a minimum of 1,200 words up to a maximum of 2,000 words, but that is because of the complexity of some cases and whether some patients returned for many assessments before their diagnoses were determined. Also, some authors describe the pathophysiology of the differentials in great detail. Please also note no more than 3 authors are allowed per article.

What's most important is to show us the process that you used to analyze the case, including:

Why you decided to order certain tests and why you did not order others.

Peer consultations or why you elected to contact other specialists.

Lab values including vital signs or blood tests.

Labs and values if your patient was attended to in the emergency department or other hospital departments such as radiology or neurology.

Discussion related to the possible diagnoses.

Final diagnosis, treatment, prognosis, and follow-up.

Remember to indicate numbered citations within the body of the text and include a complete list of corresponding literature/references at the end of the manuscript. (Do not use any citation management programs or unlink them.) 

Limit references to 25. No references (unless it is a seminal study) can be older than 10 years.

We prefer primary research as references, but some cases are so obscure that authors will need to pull from a variety of sources. However, 

. Be advised that peer reviewers are adamant that the disease/disorder you describe was actually diagnosed and not determined by index of suspicion on the basis of ruling out various differentials. We use AMA11 as our publication style, which uses superscript citation numbers and a corresponding numbered reference list. Please create your citations and references in this style.  Check this recent article posted online at 

https://www.contemporarypediatrics.com/view/the-rx-of-adhd

 for examples of reference style. IMPORTANT NOTE WITH AMA 11TH EDITION: PLEASE PUT DOI OR WEBSITES/URLS AT THE END OF THE REFERENCE LINE.

When you send your draft manuscript, also 

. These image files must be high-resolution jpg or tiff files (minimum of 300 dpi) and as large in size as possible. We suggest a minimum of 7 horizontal inches. The images must be original photos with clear permissions to use, not images from copyrighted sources. Send as separate attachments with your e-mail submission; do not embed images into your manuscript document.

After we receive your manuscript, our editors and peer reviewers will review your draft and let you know if we accept your submission for publication. 

Puzzler is one of the departments for which we receive the most submissions, so it may be several months after submission before you receive feedback from us.

If we do accept your submission for publication, we will contact you with further instructions.

Send your submissions in Microsoft Word format to 

, via e-mail to mpetronelli@mjhlifesciences.com

Guidelines for PUZZLER, Contemporary Pediatrics

 poll. Take a look at the following case below. After reading through the description, choose a multiple-choice answer and try to guess the correct patient diagnosis.

Then visit our website on August 20 at 12:00 PM EST or later for the full case presentation, differential diagnosis, and correct patient diagnosis.

This case was provided by Andrew Faniku, MD, pediatric hospitalist at Scott & White Healthcare.

A 21-year-old primigravida female presented to the hospital in preterm labor, with an otherwise uneventful pregnancy except for a febrile illness after exposure to family members with measles a week prior.

She reported having fever, cough, conjunctivitis, and a rash that started on her face and spread to her trunk, consistent with measles. Her fever and symptoms had mostly resolved, except for her lingering rash that began six days earlier. In the delivery room, she still had fresh excoriation marks on her arms. She had not received any MMR vaccines.

Six hours after admission, the patient delivered a female infant via spontaneous vaginal delivery at 35 weeks’ gestation. The baby weighed 2410 grams, which was approximately the 50

 percentile for her gestational age. The baby had mild respiratory distress after delivery and briefly required supplemental oxygen via blow by during transitioning. Apgar’s of 8 at 1 minute and 9 at 5 minutes was given at delivery. The baby subsequently improved and was allowed to room in with mother without the need for NICU admission. Nursing staff noticed a rash on the baby’s back. 

Below, take your best guess at diagnosing this patient

 website on Wednesday, August 20 at 12:00 PM EST or later for the full case presentation, differential diagnosis, and correct patient diagnosis.

News

Case Studies

Can you diagnose this rash in a newborn?

Richard Auchus, MD, PhD, discusses how crinecerfont is improving CAH care and easing the transition from pediatric to adult management.

Richard Auchus, MD, on how crinecerfont is changing CAH treatment

, crinecerfont (Crenessity; Neurocrine Biosciences) has brought new momentum to the management of classic congenital adrenal hyperplasia (CAH) in children and adolescents. The drug is approved for use alongside glucocorticoids in patients aged 4 years and older to reduce excessive adrenal androgen production, enabling lower steroid doses while maintaining hormonal control.

Richard Auchus, MD, PhD, professor of pharmacology and internal medicine at the University of Michigan, said the treatment offers a much-needed option for pediatric endocrinologists who struggle to control the condition without risking long-term harm from high-dose steroids.

“If they use a higher dose of glucocorticoid, not only will the patient get obese, but they’re going to suppress their growth, they’re going to interfere with their sleep and their pubertal development. They have another option now that is not going to put them at risk for these things,” he explained. 

Auchus noted the approval has sparked “a lot of excitement in the adult community” as well. By enabling a “block-and-replace” approach—suppressing androgens with crinecerfont and replacing cortisol separately—the therapy could encourage more adult endocrinologists to take on CAH care and improve transitions from pediatric to adult management. Audience polling at a recent Endocrine Society meeting revealed that at least 50% of children with CAH do not transition smoothly to adult care, a gap Auchus called “very unacceptable.”

Richard Auchus, MD: Crinecerfont's positive weight-related outcomes in children with CAH

While not every child will require crinecerfont, Auchus stressed its potential for adolescents with difficult-to-control disease. For middle school and high school students, multiple daily hydrocortisone doses can be burdensome, but the new therapy may reduce the need for late-day or bedtime doses. Pediatricians also play a key role as part of the care team.

“You’re the steward of the child’s growth and weight curve, and if something’s looking wrong, you’ve got to bring that up to the endocrinologist,” Auchus said. Even if lab results appear normal, changes in growth or weight trends may signal the need for treatment adjustments. 

The approval of crinecerfont was based on data from 2 randomized, double-blind, placebo-controlled trials involving 285 patients. Pediatric participants saw an 18% reduction in glucocorticoid doses by the study’s end, while maintaining androgen control. 

 for more on the FDA approval, as covered by 

Looking ahead, Auchus believes the drug’s success will inspire further therapeutic innovations. 

“There’s a lot of movement in this area,” he said. “Other companies are starting to develop alternative targets for treating this disease.” 

Ebert M. FDA approves Crenessity for treatment of classic congenital adrenal hyperplasia. 

. December 13, 2024. Accessed August 14, 2025. https://www.contemporarypediatrics.com/view/fda-approves-crenessity-for-treatment-of-classic-congenital-adrenal-hyperplasia

Fitch J. Richard Auchus, MD: Crinecerfont's positive weight-related outcomes in children with CAH. 

. July 31, 2025. Accessed August 14, 2025. https://www.contemporarypediatrics.com/view/richard-auchus-md-crinecerfont-s-positive-weight-related-outcomes-in-children-with-cah

® website. Take a look at some of our top stories from the week (Monday, August 11, to Friday, August 15, 2025), and click on each link to read and watch anything you may have missed.

Adolescents spend nearly 1 hour per school day on smartphones

 research letter analyzing passive smartphone activity data from over 11,000 students found that adolescents with smartphones at school spent nearly an hour per day using them, with most of that time on social media. Data from the Aura parental monitoring app, collected between September 2024 and February 2025, showed that 71% of monitored weekdays included school-hour phone use. Students aged 14 to 17 years used smartphones more than younger peers, averaging 55.9 minutes on social media compared with 42.4 minutes for those aged 10 to 13 years.

Respiratory target is linked to successful lung aeration during preterm neonate resuscitation

 found that a tidal volume of at least 4 mL/kg may be an optimal target for achieving successful lung aeration in preterm neonates during delivery room resuscitation. Researchers analyzed data from more than 240 infants born between 22 and 31 weeks’ gestation who required positive pressure ventilation (PPV). Effective lung aeration was defined as a sustained heart rate of at least 100 beats per minute within the first 10 minutes after birth. Of all respiratory parameters measured, only expiratory tidal volume (VTE) was significantly associated with this outcome.

Adolescent vaccination coverage improves for Tdap and MenACWY; HPV rates remain unchanged

CDC data from the 2024 National Immunization Survey-Teen showed year-over-year increases in adolescent vaccination rates, with Tdap coverage rising to 91.3% and MenACWY to 90.1% among teens aged 13 to 17 years. Smaller gains were also seen for MMR, hepatitis B, and meningococcal B vaccines, while HPV vaccination rates held steady at about 78% for at least 1 dose. Coverage for Tdap and MenACWY exceeded 90% in most states, reflecting ongoing public health efforts, though disparities persisted—particularly lower HPV vaccination recommendations in rural areas compared with urban ones.


FDA approves first generic iron sucrose injection for iron deficiency anemia in CKD

The FDA has approved Viatris’ iron sucrose injection, USP, as the first generic version of Venofer for treating iron deficiency anemia (IDA) in adults and children aged 2 years and older with chronic kidney disease (CKD). Available in multiple single-dose vial strengths, the intravenous therapy also received competitive generic therapy designation for certain doses, granting expedited review and potential market exclusivity.

FDA approves brensocatib to treat adolescents with non–cystic fibrosis bronchiectasis

On August 12, 2025, the FDA approved brensocatib (Brinsupri; Insmed) as the first treatment for non–cystic fibrosis bronchiectasis (NCFB) in patients aged 12 years and older. The oral DPP1 inhibitor targets neutrophilic inflammation, aiming to reduce pulmonary exacerbations—a hallmark of NCFB. Approval was based on phase 3 ASPEN trial results, where both 10-mg and 25-mg doses significantly reduced annual exacerbation rates, prolonged time to first exacerbation, and increased the proportion of patients who remained exacerbation-free over 52 weeks compared with placebo.

NCFB affects an estimated 500,000 people in the US and millions worldwide, causing chronic airway widening, mucus buildup, and recurrent infections. Experts say the approval marks a major advance in care, offering the first FDA-approved therapy to address the disease’s underlying inflammatory pathway.

Get caught up with Contemporary Pediatrics! This list helps you navigate our top stories from the week, all in 1 place.

FDA approvals for NCFB, CKD; adolescent vaccine coverage; and more

 poll. Take a look at the following case below. After reading through the description, choose a multiple choice answer and try to guess the correct patient diagnosis.

on Monday, January 6 at 12:00 PM ET for the full case presentation, differential diagnoses, and the correct patient diagnosis. 

This case was provided by Amar Davé, MD, FAAP and Pahroul Davé, APRN

A boy aged 10 years presented to the outpatient office with a history of painful nodules on the plantar surface of his bilateral feet 8 to 10 hours after spending time in a hot tub. He was unable to bear weight or put on socks and shoes due to his pain. The photos were taken soon after the painful and red papules appeared. The lesions affected the whole plantar aspect of both feet. Over the following 4 days, the nodules became less painful and red. 

Medical advice was sought on the fifth day of symptoms, and by this time, the child was improving clinically. He was stable with subcutaneous, mildly painful, fleshy nodules mostly populating the medial arch of the foot. His remaining clinical examination results were within a normal range. Further questioning of the child’s mother revealed that other children exposed to the hot tub experienced painful feet but without lesions. 

Due to the patient’s improving symptoms and the self-limiting nature of the illness, no tests or labs were ordered as the child was not acutely ill. No peer consultations or specialists were utilized.

Click here for the full case presentation, differential diagnoses, and the correct patient diagnosis, in a separate article.

The photos in this case were taken soon after the painful and red papules appeared.

Can you diagnose this boy with painful nodules on his feet?

In a new technical report and revised policy statement from the American Academy of Pediatrics (AAP), the agency described key aspects to approaching trauma care systems that provide optimal care for the child under a number of circumstances, calling for optimization across the continuum of care for injured children.

The AAP stated public health and trauma care should address "needs of injured children across the continuum of care."

Brian Chang, MD, MS

Articles

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