Case Studies

Persistent birthmark grows on a toddler’s back

June 04, 2020

The parents of a healthy 20-month-old boy ask for advice about a birthmark on his lower back. The lesion is asymptomatic and has grown proportionately with their son. What's the diagnosis?

Newborn presents with jitters and tremors after delivery

May 19, 2020

A full-term male infant was born at 40.3 weeks gestational age via vaginal delivery to a 29-year-old single G6 P30204 mother with limited prenatal care (3 visits) and short interval pregnancy. The delivery was precipitous: Rupture of membranes was 3 hours in duration with clear fluid; no intrapartum medications were administered; and the infant’s Apgar scores were 9 and 9 at 1 and 5 minutes, respectively. What's the diagnosis?

Boy’s anxiety leads to hand rubbing, biting

May 15, 2020

A healthy 11-year-old boy presents for evaluation of thick skin over the metacarpal (MCP) and proximal interphalangeal (PIP) joints on his right hand. What's the diagnosis?

Toddler’s unusual oral trauma is troubling

April 16, 2020

A 17-month-old African American girl, with no significant past medical history, is brought to the Pediatric Emergency Department with acute onset of swelling in the floor of her mouth. What's the diagnosis?

Progressive plaque in a 9-year-old boy

April 07, 2020

Anxious parents present their healthy 9-year-old son for evaluation of a slowly enlarging plaque that began developing on his lower back 3 months ago. What's the diagnosis?

Girl presents with facial edema after surgery

March 18, 2020

A 9-year-old female presents to the clinic with facial edema that has progressively worsened over a period of a few weeks. What's the diagnosis?

Kiss of the spider or something more?

March 12, 2020

The parents of a healthy 8-year-old girl are worried about an asymptomatic red spot on their daughter’s left cheek that has been enlarging for more than a year. What's the diagnosis?

Boy builds a snowman, suffers swollen fingers

February 07, 2020

A 4-year-old boy presents for evaluation with painful swollen fingers on both hands that erupted after he made a snowman with his siblings following a snowstorm. He complains that they are itchy and painful. What's the diagnosis?

Rash triggers joint pain in an 8-year-old girl

January 14, 2020

An 8-year-old, previously healthy girl presents to the emergency department (ED) with a rash “that looks likes bruises” and joint pain.  The red patchy rash is not painful and not pruritic. What's the diagnosis?

Linear papules appear on a boy’s thumb, wrist

January 10, 2020

A healthy 6-year-old boy presents for evaluation with a 3-month history of an asymptomatic rash extending from his left thumb to his left wrist. What's the diagnosis?

Girl’s leg blisters after school ski trip

December 09, 2019

A 9-year-old girl presents with a painful blistering patch on her right leg noted when her mother picked her up from school following an after-school ski club trip. What's the diagnosis? 

Teenager bothered by painful bumps on toes

November 12, 2019

A healthy 15-year-old girl presents for evaluation of itchy, painful bumps on her toes that developed 3 weeks earlier. The bumps become more numerous and bothersome when she is outdoors sledding and skiing. What's the diagnosis?

Boy’s chronic lesions change with the seasons

November 08, 2019

A healthy 10-year-old male presents for evaluation with a 3-year history of an asymptomatic and progressive, mildly pruritic rash over his head and trunk. The first lesion appeared on his back 3 years ago, and numerous other lesions developed insidiously afterward. The patient’s father states that the lesions fade during the winter and become more prominent during the summer. Failed treatment included hydrocortisone. What's the diagnosis?

8-year-old girl with pain in her neck

October 17, 2019

A mildly overweight 8-year-old Hispanic female in rural Colorado is brought to her primary care provider’s office with right neck pain and right-sided neck swelling of a day’s duration. The patient’s mother also stated that her daughter had a maximum temperature (T-max) of 102°F that started that morning. The patient denied any sore throat, rash, headache, rhinorrhea, cough, nasal congestion, abdominal pain, vomiting, or diarrhea. What's the diagnosis?

Erythematous plaque on an infant’s cheek

October 10, 2019

A healthy, afebrile, 12-month-old girl presents for evaluation with an asymptomatic nodule on her left cheek that has been present for 3 weeks. She was initially seen by her pediatrician, diagnosed with cellulitis, and prescribed an oral antibiotic, which was not administered by her parents.

Segmental hemangioma on a newborn’s face

September 10, 2019

A healthy 5-week-old girl presents for evaluation of rapidly growing, flat-topped red papules on the left side of her face.

Sudden neutropenia and emesis in an SGA infant

August 21, 2019

A 24-year-old G2P1001 African American female at 38.2 weeks of gestation was induced for labor for a fetus with prenatally diagnosed intrauterine growth restriction (IUGR). She subsequently delivered via normal spontaneous delivery. The infant initially latched well at the breast, was normoglycemic and normothermic, but shortly after birth had had a significant episode of blood-tinged emesis (not deemed to be swallowed maternal blood) and was transferred to the transitional nursery for further evaluation.

Emergent itchy rash in a 5-year-old boy

August 19, 2019

A healthy 5-year-old boy with a 6-month history of asymptomatic 2-mm to 3-mm papules on his legs presents for evaluation of a red, slightly itchy rash that just developed on the back of his right knee. What's the diagnosis?

Massive splenomegaly in a 6-year-old girl

July 16, 2019

A 6-year-old female with history of previously resolved iron-deficiency anemia presents to the emergency department (ED) for numerous episodes of nonbloody, nonbilious vomiting and diffuse abdominal pain that began on the day of presentation. She had initially presented to her pediatrician who felt a large left-upper-quadrant abdominal mass and referred her to the ED for further evaluation. She has no associated diarrhea or urinary symptoms. What's the diagnosis?

Rapidly growing nodule on an infant’s finger

July 10, 2019

An otherwise healthy 5-month-old girl presents with an asymptomatic, rapidly growing, firm, smooth nodule on the side of her left fifth finger since she was 2 months of age.