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Delayed menarche with normal pubertal growthA 14-year-old female presents for a wellness visit. On history, she is noted to not have started her menstrual cycle but on physical exam has significant breast and pubic hair development since the age of 10 years.
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Persistent agitation in children with neurologic impairmentsCrying and agitation for no apparent reason in children with severe neurologic impairment is a common and frustrating problem for parents and providers alike. A methodical approach is helpful in dealing with this problem, yet sometimes the cause is not apparent, even after a thorough search. It is helpful to explain to parents and caretakers that the cause of the distress may take some time to figure out, and that diagnosis is often difficult. However, in most cases, a satisfactory treatment can be found.
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Father, son share similar blue bumpsA father brings his 8-year-old son to the office for evaluation of new, asymptomatic blue bumps that have appeared on the boy’s chest over the last several months (Figure). The dad notes that he has had similar lesions as well.
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AAP's first-ever action plan for epinephrine and anaphylaxisAnaphylaxis is a serious, life-threatening allergic reaction that can occur suddenly without warning. In children and adolescents, the leading cause of anaphylaxis is exposure to food allergens. Recently, the American Academy of Pediatrics (AAP) published 2 clinical reports that discuss guidance on appropriate epinephrine use for anaphylaxis and developing an emergency action plan for patients at risk.
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Teen vaping: Time to clear the airThe vaping culture of using non–cigarette tobacco and electronic nicotine delivery systems (ENDS) is the latest risky trend among adolescents and young adults. Vaping is the use of high-tech, advanced electronic devices such as electronic cigarettes (e-cigarettes), refillable atomizers, and other tobacco products as an alternative or in addition to regular cigarettes.
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Climate change: Challenges faced by the pediatric populationThe World Bank Group reports that as this global health emergency escalates, devastating impacts on health and well-being will also accelerate.
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Girl’s blistering rash spreads to eyes and faceA healthy 9-year-old female presents with a 1-day history of fever, progressive rash, conjunctivitis, and superficial oral ulcers.
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Nervous teenager’s hands turn blueThe father of a healthy 15-year-old girl brings her to the emergency department (ED) for evaluation of blue hands.
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Girl’s blistering rash spreads to eyes and faceA healthy 9-year-old female presents with a 1-day history of fever, progressive rash, conjunctivitis, and superficial oral ulcers.
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Full case study: Urticarial rash in a 9-hours-old maleOn exam, the patient is found to have circular, slightly raised, blanching, erythematous papules on the lower extremities and abdomen.
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Girl’s papular rash will not respond to treatmentThe mother of a healthy 5-year-old girl brings her to the office for evaluation of 2 itchy plaques on her right ankle that have worsened over the last 10 days despite treatment for possible tinea corporis with topical clotrimazole 1% ointment and hydrocortisone 2.5% ointment. A fungal culture is pending.
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Girl’s papular rash will not respond to treatmentThe mother of a healthy 5-year-old girl brings her to the office for evaluation of 2 itchy plaques on her right ankle that have worsened over the last 10 days despite treatment for possible tinea corporis with topical clotrimazole 1% ointment and hydrocortisone 2.5% ointment. A fungal culture is pending.
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The breath of life: Helping babies surviveThe first breath is the single most important moment in anyone’s life. It is when life outside the womb truly begins, the moment that makes all other moments possible.
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Infant’s seizures and skull fracture could point to child abuseA 5-month-old Hispanic male presented to the emergency department (ED) at a children’s hospital in the Northeast United States directly from his daycare after caretakers witnessed 2 shaking, seizure-like episodes. The episodes lasted 1 to 2 minutes in the setting of a fever as palpated by the parents.
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Infant’s seizures and skull fracture could point to child abuseA 5-month-old Hispanic male presented to the emergency department (ED) at a children’s hospital in the Northeast United States directly from his daycare after caretakers witnessed 2 shaking, seizure-like episodes. The episodes lasted 1 to 2 minutes in the setting of a fever as palpated by the parents.
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Stubborn ring of rash around a boy's mouthThe mother of a healthy 11-year-old boy brings him to the office for help to clear a rash that has persisted around his mouth for 3 months. Although the boy rarely licks his lips, he does not use lip products and has not changed his dental products.
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Infant’s seizures and skull fracture could point to child abuseA 5-month-old Hispanic male presented to the emergency department (ED) at a children’s hospital in the Northeast United States directly from his daycare after caretakers witnessed 2 shaking, seizure-like episodes. The episodes lasted 1 to 2 minutes in the setting of a fever as palpated by the parents.
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Pallor and swelling in an athlete’s upper armA 15-year-old female presents to the emergency department of a community hospital with acute onset of duskiness in her left arm.
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Infant girl develops bulging sacral massA 3-week-old female presented to the emergency department with a 3-day history of a progressively enlarging, erythematous, seemingly painful lump on her back.
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Infant girl develops bulging sacral massA 3-week-old female presented to the emergency department with a 3-day history of a progressively enlarging, erythematous, seemingly painful lump on her back.
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Rapidly growing nodule on infant’s posterior thighThe parents of a healthy 5-month-old boy bring him to the office for evaluation of an enlarging yellowish nodule on the back of his right thigh. It started as a pink macule several months ago and became yellow and lumpy over the last month. The infant was born at term and has grown and developed normally. His parents deny any trauma, but report occasional bleeding from the surface of the nodule. They deny any new medications or outdoor exposures. There is no history of new topical skin products.
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Child’s ear pain progresses to leg pain, arm pain, and feverAn 8-year-old girl is admitted to the hospital with complaints of right ear pain, right leg pain, left arm pain, and fever after a week of worsening symptoms.
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Child’s ear pain progresses to leg pain, arm pain, and feverAn 8-year-old girl is admitted to the hospital with complaints of right ear pain, right leg pain, left arm pain, and fever after a week of worsening symptoms.
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Elevated CPK: No short cut to muscular dystrophy diagnosisA pediatrician with special training in neuromuscular disorders cautions that nothing replaces the traditional workup-a complete history and physical-for diagnosing neuromuscular complaints.
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Protuberant blister over newborn’s lumbar spineA healthy full-term newborn presented with a prominent sacral dimple within an oval patch. Ultrasound showed no evidence of spinal anomalies, and the child was discharged home. Three days later, the patch became elevated, red, and moist appearing, and she was brought to the emergency department (ED) for further evaluation of the “growing blister.”
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Boy’s papule develops lymphangitic streakA baffled mother brings her 14-year-old son for evaluation of an asymptomatic bump that appeared on the side of his right third finger 1 week ago.
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Baby girl with right labia majora massA 26-day-old female neonate, born at 36 weeks of gestation, presents to the clinic with a visible swelling in the right labia majora.
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Baby girl with right labia majora massA 26-day-old female neonate, born at 36 weeks of gestation, presents to the clinic with a visible swelling in the right labia majora.
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Baby girl with right labia majora massA 26-day-old female neonate, born at 36 weeks of gestation, presents to the clinic with a visible swelling in the right labia majora.
