Authors


Andrea Wu, MD

Latest:

Staphylococcal Scalded Skin Syndrome in a 5-Year-Old Boy

A 5-year-old boy was brought to the emergency department by his parents because of a rash that covered his entire body. The rash had started 2 days earlier, initially on the boy’s face, abdomen, and legs and had spread to his back, buttocks, and hands. There was a 1-day history of tactile fever when the child was sent home from school. He had no sick contacts and his immunizations were up-to-date. He had no significant medical history.


Andrew Herbst, MD

Latest:

Staphylococcal Scalded Skin Syndrome in a 2-Year-Old Girl

A toddler was brought to the emergency department with a 3-day history of a rash on her neck and irritability and fever (temperature, 38.3°C [101°F]) of 1 day's duration. The child's mother noticed a red, purulent bump on the girl's hand 2 days before the rash developed.


Andrew L. Wong, MD

Latest:

WHAT'S YOUR DIAGNOSIS? CLOACAL EXSTROPHY

Female infant born to a gravida II, para I, 23-year-old mother at 38 weeks' gestation. Pregnancy complicated by oligohydramnios. Cesarean delivery performed because of prolonged time after rupture of membranes and fetal distress. Apgar scores, 3 and 6 at 1 minute and 5 minutes, respectively.


Andrew S. Wong, BSc

Latest:

Teen With Progressive Depigmented Patches

This 16-year-old boy had slowly progressive hypopigmented lesions onthe lower extremities for the past 4 years. He also had atopic dermatitis,asthma, and allergic rhinitis.


Andrew Solomon

Latest:

The Transgender Conundrum

Transgendered and LGBTs are bullied and victimized at alarmingly high rates. How, then, to protect children and adolescents from physical harm?


Andy E. Shen, MD

Latest:

Eruptive Xanthoma in a Teenager

Sixteen-year-old African American girl with pruritic, painful lesions on both thighs that progressively worsened over 2 weeks and later spread to the trunk and upper and lower extremities.


Angela Kratochvil, MD

Latest:

Infant With Recurrent Omphalitis and Otitis

A baby boy, aged 14 days, presented with a temperature of 38.2°C (100.8°F), a generalized maculopapular rash, and purulent otorrhea. He was treated with oral amoxicillin for 10 days. At age 25 days, he again presented-this time with erythema and edema of the umbilicus, thrush, and fever of 24 hours’ duration.


Animesh Sharma, MD

Latest:

Eczema Herpeticum

One week earlier, a 14-month-old girl with a history of eczema was evaluated because of a diffuse rash of excoriated lesions, some of them purulent. She was afebrile. Worsening eczema with secondary infection was diagnosed. Treatment with oral clindamycin was prescribed. At follow-up, the lesions had worsened. The child had multiple excoriated papules, some of which had coalesced into plaques. She also had two 5-mm vesicles on her right shoulder. Eczema herpeticum was diagnosed clinically. Culture of the vesicles later grew herpes simplex virus (HSV).


Anisha Abraham, MD, MPH

Latest:

Botfly Infestation

Five weeks after returning from a school trip to the Amazon in Peru, a 16-year-old boy presentedwith 2 persistent “bug bites” on the lateral left calf. He had sustained multiple bug bites duringhis trip, all of which had resolved spontaneously except for the 2 on his lower leg.


Anita P. Price, MD

Latest:

Case in Point: Acute Osteomyelitis: Radiographs Versus MRI

A 10-year-old boy with no medical history was brought to his pediatrician's office with a 2-day history of intermittent fever (temperature of 38.8°C to 39.4°C [102°F to 103°F]). Physical examination results were unremarkable. There was no history of recent trauma. The child was sent home with analgesic therapy.


Anitha Malaisamy, MD

Latest:

Two Girls With Short Stature

A 14-year-old white girl whose menstrual periods have not begun presents with concerns that many of her peers are already menstruating.


Anju Sawni, MD

Latest:

Child With Bullous Lesion on Left Side of Groin

A 16-month-old Hispanic girl presented with a 2-day history of pain, redness, and swelling of the left side of her groin. Her mother first noticed the lesion after the child was seen limping and scratching the area. The mother thought her child had been bitten by an insect but did not witness any bite.


Anne Sveen, MD

Latest:

Localized Scleroderma

Scleroderma may present at any age and can be localized or systemic. Localized scleroderma affects the skin, subcutaneous fascia, and occasionally muscle and bone. Systemic scleroderma is characterized by chronic disease with both skin changes and visceral abnormalities. Rarely, localized scleroderma may progress to systemic disease; however, screening for this form is unnecessary in patients who have no systemic symptoms.1-5


Ansley Splinter, MD

Latest:

Toddler With Progressive Proptosis From Acute Myelogenous Leukemia

A few days before presentation, the mother noted some "bumps" that had developed behind the child's right ear. The child was brought to the emergency department for evaluation.


Anthony Anani, MD

Latest:

Shoulder Dislocation in a Neonate

Labor was induced at term in a 29-year-old woman who had had an uneventful pregnancy. Her baby weighed 3575 g (7 lb, 14 oz). The neonate’s left arm was internally rotated with flexion at the wrist. He had a normal grasp reflex, but Moro reflex was incomplete.


Anush S. Pillai, DO

Latest:

Eruptive Xanthoma in a Teenager

Sixteen-year-old African American girl with pruritic, painful lesions on both thighs that progressively worsened over 2 weeks and later spread to the trunk and upper and lower extremities.



Apeksha Sathyaprasad, MD

Latest:

Adenoviral Hepatitis in an Immunocompetent Child

Adenovirus infection is usually benign in healthy children, but it can be complicated by severe or fatal pneumonia, myocarditis, and hepatitis. Consider adenovirus infection in children with fulminant hepatic failure.


Ara Balkian, MD

Latest:

Toddler With Progressive Proptosis From Acute Myelogenous Leukemia

A few days before presentation, the mother noted some "bumps" that had developed behind the child's right ear. The child was brought to the emergency department for evaluation.


Archana Chatterjee, MD, PhD

Latest:

Infant With Recurrent Omphalitis and Otitis

A baby boy, aged 14 days, presented with a temperature of 38.2°C (100.8°F), a generalized maculopapular rash, and purulent otorrhea. He was treated with oral amoxicillin for 10 days. At age 25 days, he again presented-this time with erythema and edema of the umbilicus, thrush, and fever of 24 hours’ duration.


Archana Kulkarni, MD

Latest:

Newborn With Wrinkled Abdomen and Other Anomalies

Prune belly syndrome is a rare condition, classically referred to as a triad of abdominal wall musculature deficiency, bilateral cryptorchidism, and other urological abnormalities, although the clinical presentation can vary. A case history here.


Arslan Arshad, MD

Latest:

Morgagni Hernia

A 16-year-old boy with Down syndrome was referred for evaluation of nonspecific symptoms, including difficulty in breathing on standing up from a sitting position, dizziness, frequent abdominal pain, and diarrhea after ingesting fatty foods and milk. He had intermittent asthma exacerbations for which he occasionally used a β-agonist. He had no history of trauma, surgery, or allergies.


Arthur Feinberg, MD

Latest:

Müllerian Duct Remnant

In addition to syringohydromelia and meningocele, the MRI of the spine showed a fluid-filled mllerian duct remnant that extended from the base of the bladder to the posterior superior aspect of the prostate gland. The margins of the fluid collection in the remnant are smoothly bound by a hypointense structure that represents a discrete tissue wall. A mllerian duct remnant can be confused with free fluid in the cul-de-sac posterior to the bladder.


Arvind Hoskoppal, MD

Latest:

Neuroblastoma in a Child With Persistent Hip Pain

A 4-year-old boy presented for further evaluation of persistent right hip painof 2 months’ duration. Before the onset of the pain, he had been limping,favoring his right side. For several days before he was brought in forevaluation, he had had fevers and sweating in addition to the right hippain.


Arvind Vasudevan, MD

Latest:

Photoclinic: Lesch-Nyhan Syndrome

This 14-year-old boy has Lesch-Nyhan syndrome. The picture shows chronic scarring of the lip--a result of self-mutilating behavior that characterizes this syndrome. Lesch-Nyhan syndrome is also characterized by dystonia, choreoathetosis, and mental retardation--all of which are associated with hyperuricemia, write Arvind Vasudevan, MD, and Atiya Khan, MD, of Morgantown, WVa. This X-linked recessive abnormality of the long arm of the X chromosome (Xq26) causes a deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT) in the brain, liver, and red blood cells.1 In the United States, this condition may be as rare as 1 in 1.2 million.2 Because of the mode of transmission, this disorder affects males primarily; however, cases involving females have been reported.1 Partial variants of the syndrome involving decreased, but not entirely absent, levels of HGPRT also have been identified.2


Ashlea Franques, MD

Latest:

Torticollis and Fever: A Case of Grisel Syndrome From Group A Streptococcus Infection

A previously healthy 2-year-old boy was hospitalized after 2 weeks of persistent fever (temperature to a maximum of 38.9C [102F]) and a 2-day history of neck stiffness. There was no history of cough, rhinorrhea, or dysphagia. The oropharynx could not be examined because of neck stiffness. The patient had bilateral anterior cervical lymphadenopathy.


Ashley Bruns, DO

Latest:

Minocycline Hyperpigmentation

A 17-year-old girl being treated for mild acne, anxiety, and depression, presented with an ankle “bruise” related to an injury sustained 2 years earlier. Symptoms resolved with treatment, but the hyperpigmentation persisted.


Ashwin R. Sama, MD

Latest:

Tularemia in a 4-Year-Old Girl

During spring vacation, a previously healthy 4-year-old girl visited western Nebraska, where she and her family spent time along a river bank in a wooded area. After 4 days, her mother noticed 3 engorged ticks embedded in the child's scalp. The ticks were immediately removed and burned. The child also had a marble-sized swelling on the right side of her neck. Over the next few days, the child had temperatures that spiked to 39.4C (103F), with chills, generalized malaise, and weakness. There was no history of cough, myalgias, or headache.


Ashwini Lakshmanan, MD

Latest:

Infant With Persistent Fever and Fussiness

A 4-week-old boy with tactile fever for the past 24 hours and fussiness of 2 weeks' duration is referred to the emergency department (ED).


Atiya Khan, MD

Latest:

Photoclinic: Scaphocephaly

This 9-month-old infant was brought for evaluation of anteroposterior elongation of the cranium. The infant was born at term via uncomplicated vaginal delivery. His mother had noticed that his head was more elongated and narrower than his sibling's. He had achieved appropriate motor and social milestones for his age. Neither parent had a family history of abnormal head shape. The rest of the examination findings were unremarkable.

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