Tight, shiny membrane encases newborn’s skinFebruary 1st 2017
After a cesarean delivery at 30 weeks, a 1430-gram premature female neonate was noted to have generalized thick, dark brown scale forming a tight membrane over her entire skin surface. Her mother was a healthy 19-year-old gravida 1 with normal prenatal screening ultrasound and laboratory studies. Family history did not reveal any congenital malformations or genetic disorders.
Small-for-age toddler is unable to walkJanuary 1st 2017
A 22-month-old African American boy born at 38 weeks by normal vaginal delivery presents to a local hospital from a private pediatric office for failure to thrive. He was seen by his pediatrician until aged 1 month but was lost to follow-up. His delay in walking prompted his mother to reestablish care at age 22 months.
Newborn with persistent hypoglycemiaDecember 1st 2016
A full-term male infant was born to a 33-year-old gravida 3, para 3 mother. The prenatal course was uncomplicated, without gestational diabetes; the mother received prenatal care at an out-of-state institution. At the delivery, however, the baby was notably macrosomic, with shoulder dystocia and perinatal distress requiring positive pressure ventilation.
Infant with facial lesions and respiratory distressNovember 1st 2016
A 2-month-old Hispanic girl is transferred by her pediatrician to the emergency department (ED) for evaluation of decreased oral intake, failure to thrive, and large bleeding facial hemangiomas.
Treat plays trick on a 3-year-old boyOctober 1st 2016
A 3-year-old boy presents to the emergency department (ED) with a 1-day history of irritability and listlessness. According to his parents, he was well until the night before when he began to behave abnormally, becoming excessively tired approximately 2 hours after eating dinner. During the night, the boy slept poorly, sporadically awakening with crying followed by brief periods of calmness. The morning of presentation, he was difficult to arouse with intermittent fussiness and reluctance to ambulate.
Peeling rash in a 4-year-old boySeptember 1st 2016
The mother of a 4-year-old boy, whose family recently emigrated from Haiti, brings him to the pediatric mobile clinic for evaluation of a rash that had begun 11 days earlier as an eruption of vesicular, pruritic papules on the bilateral lower extremities and had spread to the buttocks and medial thighs with sparing of the face. The skin eruption was followed by desquamation of the skin on his palms and soles.
Pearl-like mass on a girl’s tympanic membraneAugust 1st 2016
During a routine office visit for mild acute nasal congestion and possible diminished hearing, an isolated, small, pearl-like mass was noted just posterior to the umbo of the left tympanic membrane of a 5-year-old girl.
Boy with fever, cough, and oral lesionsJuly 1st 2016
A previously healthy, 16-year-old Hispanic boy initially presents to the clinic with a 5-day history of tactile fevers, achy malaise, congestion, and a dry cough. He was afebrile with negative rapid strep and monospot tests, but was prescribed fluticasone, benzonatate, and ibuprofen for a presumed upper respiratory infection. He was encouraged to return if symptoms did not improve.
Neonate with acute respiratory distressMay 1st 2016
After an otherwise normal pregnancy, a male infant was born at 37 weeks gestational age via emergency cesarean delivery for decreased or absent fetal movement with multiple late and variable heart rate decelerations.
Toddler with blistering acrodermal rashMarch 1st 2016
The anxious parents of a previously healthy 19-month-old boy bring the child to the emergency department for evaluation of progressive rash that began 4 months ago. The skin eruption began as small blisters on his knees, which became tense and ruptured, eventually evolving to red-pink scaly plaques. Over the next few months, the boy developed similar lesions on his hands, elbows, neck, perineal area, and face, with sparing of the mucous membranes.
Unusual abdominal pain in an 8-year-old boyJanuary 1st 2016
A previously healthy 8-year-old Hispanic boy presented to the emergency department (ED) with a 2-day history of abdominal pain and 2 episodes of nonprojectile vomiting in the last 24 hours.
Mucositis and rash in a 9-year-old boyDecember 1st 2015
The anxious parents of a 9-year-old boy bring him to clinic for the evaluation of progressive sores in his mouth for 2 days and a rash that erupted last night. Nine days earlier, he had felt warm and had a cough with wheezing and abdominal pain.
Fever, rash, and pain in the extremities of returning pediatric travelersNovember 1st 2015
Two siblings, 5-year-old Emmanuel and 3-year-old Cassandra, are brought to your emergency department (ED) in July 2014 by their parents. Both children are up to date on their immunizations and have not had significant medical problems in the past. They were referred to you by their pediatrician for 1 day of high fevers, rash, and pain in the extremities. Emmanuel had 1 episode of gum bleeding last night. His sister has been unwilling to walk since this morning.
Infant girl with progressive hypotoniaJanuary 1st 2015
A 9-month-old girl is brought to the emergency department for evaluation after 3 days of poor feeding and 1 day of decreased activity. The day prior to presentation, she was no longer crawling or pulling herself to stand. On the morning of evaluation, she is no longer able to lift her head.
A 9-Year-Old Girl With Eruptions and MalaiseJanuary 1st 2006
A 9-year-old girl presented with these lesions on her face and extremities. The lesions, which had developed within the past 24 hours, were warm to the touch and only mildly pruritic. The child feels unwell with nonspecific complaints of malaise and lack of energy. Before this eruption, she had been healthy and had not been taking any medications.