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Section Head, Professor
University of Colorado/Children's Hospital Colorado
Aurora, Colorado, United States

Articles

 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.

Adolescent STIs are rising. Diane Straub, MD, MPH, stressed confidential care, routine screening, and balancing parental involvement at AAP 2025.

Diane Straub, MD, addresses STI screening and confidential care in adolescents

Professor of Clinical Pediatrics
Nationwide Children's Hospital / Ohio State University College of Medicine
Columbus, Ohio, United States

Early allergen introduction, beginning in infancy and sustained over time, can safely reduce food allergy risk, said David Stukus, MD, at AAP 2025.

David Stukus, MD, on how early allergen introduction lowers food allergy risk

University of Colorado, Anschutz
Aurora, Colorado, United States

Multidisciplinary care is key in evaluating and managing menstrual disorders in adolescents.

Melanie Cree, MD, PhD, on multidisciplinary approaches for evaluation, management of menstrual disorders in teens

. 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.

Most child health TikTok videos by non-medical eco-influencers contradicted guidelines, spreading vaccine and infant care misinformation.

Study: Eco-influencers spread pediatric health misinformation on TikTok

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

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**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

Bite injuries are a significant problem in the United States. Discriminating between human and animal bites and identifying those associated with child maltreatment is essential. Approximately 250,000 human bites and several million animal bites occur annually.

 There was also a reported increase in animal bite injuries during the COVID-19 pandemic.

 Despite their frequency, it can be challenging to distinguish between types of bites. There are also few detailed images and descriptions of cutaneous findings of human and animal bites in the literature. 

Additionally, though such injuries occur in various ways, pediatric providers must consider the possibility of child maltreatment. In the COVID-19 pandemic, there was also a documented increase in child abuse–related injuries.

 Though bite wounds are a less common cutaneous finding in child abuse,

 both human and animal bites may result from nonaccidental trauma or neglect. 

In the poll below, try to identify what caused this bite mark on the palm of a 16-year-old boy

Thank you for taking this Contemporary Pediatrics puzzler poll

Visit ContemporaryPediatrics.com on Wednesday, August 6, 2025, at 12:00 PM ET or later for many more bite examples in the pediatric population and how to distinguish between common animal bites and human bites.

"This [case] was prompted by the increases in child abuse and animal bite injuries during the COVID-19 pandemic, with the need to add to the limited descriptions of cutaneous findings of bites in the literature," wrote the authors of this case.

Bula-Rudas FJ, Olcott JL. Human and animal bites. 

. 2018;39(10):490-500. doi:10.1542/pir.2017-0212

Dixon CA, Mistry RD. Dog bites in children surge during coronavirus disease-2019: a case for enhanced prevention. 

. 2020;225:231-232. doi:10.1016/j.jpeds.2020.06.071

Kovler ML, Ziegfeld S, Ryan LM, et al. Increased proportion of physical child abuse injuries at a level I pediatric trauma center during the Covid-19 pandemic. 

. 2021;116(Pt 2):104756. doi:10.1016/j.chiabu.2020.104756

Kos L, Shwayder T. Cutaneous manifestations of child abuse. 

. 2006;23(4):311-320. doi:10.1111/j.1525-1470.2006.00266.x

Despite their frequency, it can be challenging to distinguish between types of bites. Can you identify the source of this bite mark? 

News

Case Studies

Puzzler poll: Can you identify this bite? 

 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?

 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 September 24, 2025, at 3:00 PM EST or later for the full case presentation, differential diagnosis, and correct patient diagnosis.

This case was presented by Tyler Hanna, MD; Joshua Khuvis, MD; Sara Sanders, MD; Jennifer Haile, MD

A 7-year-old female with a history of receptive-expressive speech disorder presents with her father to establish care. She complains of dull headaches that occur 3 to 4 times per month to her central forehead over the past few months that improve with acetaminophen, ibuprofen, and closing her eyes. They occur in any setting and do not have any clear trigger.

The father also described an episode of chest pain 2 days prior to presentation. She was getting ready to leave for school when she felt her heart racing and father witnessed her fall to the floor. This episode lasted 2 minutes before self-resolving. Father denied dyspnea, loss-of-consciousness, or cyanosis with this event. No previous episodes like this were reported, though father reports that she has had more anxious episodes recently that could be panic attacks. Family history was notable for hypertension in father, neuroendocrine tumor in paternal grandmother, as well as hyperlipidemia and heart disease in paternal grandfather. The initial exam was notable for an elevated automatic blood pressure of 125/88 mmHg, heart rate of 113 beats per minute (BPM), height of 125.6cm (64th percentile), and weight of 26.7kg (75th percentile).

Below, take your best guess at diagnosing this patient

 website again on Wednesday, September 24, 2025, at 3:00 PM EST or later for the full case presentation, differential diagnosis, and correct patient diagnosis.

Try to diagnose this patient with a history of receptive-expressive speech disorder and anxiety. 

Poll: Can you diagnose this 7-year-old with anxious episodes?

Thao-Ly Phan, MD, MPH, highlights how lessons from pandemic-related weight gain can guide pediatricians in addressing stress, prevention, and whole-child health.

Thao-Ly Phan, MD, MPH, stresses healthy routines to prevent weight gain during respiratory season

 has shed light on how children with a COVID-19 diagnosis experienced more rapid weight gain compared with their peers during the pandemic, adding to concerns about long-term impacts on child health. The analysis, which used data from the National COVID Cohort Collaborative, followed more than 11,000 people aged 2 to 18 years who had positive test results for COVID-19, comparing their weight trajectories to matched controls without COVID-19. Findings showed that children with COVID-19 gained more weight after diagnosis than before, with nonhospitalized children showing the greatest increases. These associations persisted even after adjusting for demographics, time, and baseline weight status. 

For Thao-Ly Phan, MD, MPH, medical director of the Healthy Weight and Wellness Clinic at Nemours Children’s Health, the significance of these findings goes beyond the pandemic itself. “The way I look at the pandemic is it was a period of extreme stress and disruption to the lives of so many children and families,” Phan explained. “Even though I hope that another pandemic doesn’t happen, I think it’s important that we keep in mind that children do experience stress and disruption from other things.”

Phan emphasized that the same lifestyle changes that fueled weight gain during the pandemic—poor sleep, irregular eating patterns, reduced activity, and stress—can also emerge during other disruptive events. “Whether it’s something that impacts a lot of children, like a pandemic or a natural disaster, or whether it’s something that impacts an individual child, things like parental separation or bullying or food insecurity…all those things can really impact lifestyle and overall health,” she said.

For pediatric providers, Phan underscored the importance of screening for social and environmental stressors that may affect health behaviors. Addressing these factors directly, she noted, is part of delivering whole-child care. At the same time, she encouraged clinicians to reinforce preventive health strategies that remain foundational.

“Really basic things—making sure children are getting plenty of sleep, eating nutritious food, drinking plenty of water, staying physically active, sticking to routines, getting vaccinations,” Phan said. “These are all things that are at the heart of what we do as pediatric providers and can really help kids as we head into the respiratory season.”

Ultimately, she added, preventive efforts not only support healthy weight trajectories but also prepare children to recover more quickly from illnesses such as influenza or COVID-19, ensuring they return sooner to school, learning, and family life.

Mottalib M, Phan TL, Bramante CT, Chute CG, Pyles LA, Beheshti R. Impact of COVID-19 diagnosis on weight trajectories of children in the US National COVID Cohort Collaborative. 

. Published online May 26, 2025. doi:10.1089/chi.2024.0256

Thao-Ly Phan, MD, MPH, highlights how lessons from pandemic-related weight gain can guide pediatricians in addressing stress, prevention, and whole-child health. 

Richard A. Bermudes, MD, underscored the need for pediatricians to integrate ongoing conversations into well visits.

Richard Bermudes, MD, on screen-related addictions and youth mental health

Richard A. Bermudes, MD, underscored the need for pediatricians to integrate ongoing conversations into well visits in this video interview.

David Stukus, MD

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