Authors
Latest:
Nickel DermatitisFor the past few weeks, a 10-year-old boy had a pruritic abdominal rash that had not responded to over-the-counter topical medications. The rash had appeared around the time he started wearing a new belt (shown). The child was otherwise healthy. There was a family history of asthma.
Latest:
Blaschko Lines:Following "Lines of Evidence" to a Rash DiagnosisMany factors can be considered in attempting to establish the cause of a skin disorder. These include the color, morphology, and location of the lesions; associated symptoms, such as itching and fever; and exposure to drugs or to other children who have a rash. Linearity of the lesions may also suggest the diagnosis.
Latest:
Case in Point: Heart Block as the Presenting Symptom of Lyme DiseaseA 16-year-old girl presented to the emergency department (ED) with a 24-hour history of feeling tired and weak. The patient reported that she awoke that morning with the "worst headache of her life" and "passed out" while sitting on the edge of her bed. She did not tell her friends or family.
Latest:
Neuroblastoma in a Child With Persistent Hip PainA 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.
Latest:
Botfly InfestationFive 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.
Latest:
Müllerian Duct RemnantIn 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.
Latest:
MRSA Abscess Attributed to Spider BiteThe family of a 3-year-old girl was concerned about a painful lump in her right palm that they suspected was the result of a spider bite.
Latest:
Vesicoureteral RefluxDuring hospitalization of a 6-month-old boy for respiratory syncytial virus infection, spiking fevers led to a bacteremia workup.
Latest:
Complicated Cutaneous AnthraxA 12-year-old girl presented to the emergency department with progressing generalized inflammatory symptoms (fever and malaise), visual difficulty, severe inspiratory dyspnea, and 2 painless lesions on the right upper lip that had persisted for a few days. She had been well until 2 days before presentation, when she noticed a small pimple-like lesion above the right upper lip that was followed rapidly by facial edema, erythema, and constitutional symptoms.
Latest:
Photoclinic: Immediate Pressure UrticariaAn otherwise healthy 10-month-old boy was brought to an allergy clinic for evaluation of atopic dermatitis and chronic rhinitis. On arrival at the clinic for aeroallergen and milk prick skin testing, a rash was noted that was different from his usual atopic dermatitis. The rash had not been present 2 hours earlier when the mother dressed the child and placed him in his car seat during the ride to the clinic.
Latest:
Henoch-Schönlein Purpura in a 14-Year-Old BoyAntibiotic side effect? Diffuse abdominal pain, vomiting, and anorexia led to this initial misdiagnosis in an adolescent male. The full story, here.
Latest:
Adolescent With Syncope-Or Something Else?A 16-year-old boy presented for evaluation of asthma and exercise-induced bronchospasm. His parents recalled an episode 2 months earlier in which the patient, while jumping on a trampoline and wrestling with his brother, felt like he could not catch his breath. He took a puff of his rescue inhaler, and soon after, passed out. He remained unresponsive for 2 hours.
Latest:
Case In Point: Toxic Shock SyndromeA 12-year-old boy was brought by ambulance to the emergency department (ED) with fever and shaking of 3 days' duration. He was accompanied by his mother. The boy had spent the weekend at his father's home when he began to feel sick. Since returning to his mother's house, he has been lethargic and has had one episode of vomiting.
Latest:
Case in Point: Hypophosphatemic RicketsA 6-month-old white girl presented with a 2-day history of fever and respiratory symptoms. Initially, she was admitted with a diagnosis of respiratory syncytial virus bronchiolitis. In addition to her respiratory findings, widespread signs of rickets were found--ie, frontal bossing, rachitic rosary, widening of the wrists, and double maleoli.
Latest:
Child With "Burns" on the TongueA healthy 4-year-old girl presented to the emergency department (ED) with suspected inflicted burns on the tongue. Initially, the patient had complained of a burning mouth to school staff. On direct questioning by the principal, the child said her mother had burned her tongue with a cigarette. School staff noted the lesions.
Latest:
Streptococcus IntertrigoA 3-week-old boy was referred for evaluation of suspected herpes simplex virus (HSV) infection in the inguinal and pelvic regions. The rash had reportedly worsened since its appearance 2 days earlier and was associated with a foul smell.
Latest:
Galactorrhea of the Newborn (Witch’s Milk)The mother of a 5-week-old boy was concerned about a swelling under her infant’s right nipple. A 2-cm, movable subareolar mass was palpated on examination.
Latest:
An Active 15-Year-Old Girl With a Rash on Both FeetA15-year old girl presented with a rash on both feet that had appeared a month earlier. Initially the rash looked like bruising at the base of both large toenails.
Latest:
Young Girl With “Bumpy” Red EyeFive-year-old girl with redness and light sensitivity of the right eye of 2 days' duration. She denied any significant pain or decreased vision. She initially presented to an urgent care clinic, where application of polymyxin B/trimethoprim eye drops 4 times a day was prescribed.
Latest:
Hydrocephalus Secondary to GBS MeningitisA female infant born at 29 weeks' gestation after premature membrane rupture was admitted to the neonatal ICU in respiratory distress.
Latest:
Congenital Complete Inguinal-Scrotal HerniaThis baby was born at term via spontaneous vaginal delivery. A large left-sided inguinal hernia that completely filled the scrotum was obvious at birth (A). An ultrasonogram confirmed a complete bowel-containing inguinal-scrotal hernia. No hernia was present on the right side. Both testes were descended. The scrotum is shown after the hernia was reduced by manipulation (B).
Latest:
GastroschisisThis baby girl was born at 37 weeks' gestation via cesarean section, with the stomach, small bowel, proximal colon, and ovary outside the body
Latest:
Henoch-Schönlein purpura with gastric wall thickeningFor 3 days, a 7-year-old girl had severe, generalized abdominal pain. The patient described the pain as sharp and achy without radiation; she denied any relieving or aggravating factors. She also reported decreased appetite and energy for the past week.
Latest:
ScrofulaA 16-year-old Asian American girl presented for evaluation of a cyst on the anterior neck that had become enlarged and inflamed over the past 9 months. She also had a productive cough for 1 month. There was no history of night sweats, weight loss, or fever.
Latest:
Photoclinic: RingwormA 5-year-old boy, who lives on a farm and routinely plays with his pet dogs, presented with these scaly, inflamed macules with a central clearingon the abdomen (A) and forehead.
Latest:
ADHD: Answers to Questions Physicians Often AskThere are many exciting new studies of the biologic basis of ADHD that use neuroimaging and genetic testing. However, none of these methods can reliably diagnose this complex disorder. Someday, these technologies will be used to help subtype ADHD and improve treatment matching.
