Day-Old Boy With Respiratory Distress After Complicated Delivery
April 2nd 2006Day-old boy born at term via vaginal delivery complicated by shoulder dystocia. He had very mild cyanosis in the extremities at birth, which resolved after 5 minutes. Referred for evaluation of respiratory distress. Birth weight, 3.3 kg (7.4 lb). Apgar scores: 7 at 1 minute, and 9 at 5 minutes.
Update on Sexually Transmitted Diseases:Herpes Simplex Virus Type 2 Infections
April 1st 2006Most cases of HSV-2 infection are spread through sexual transmission. An infected person can have virus in his or her saliva, semen, or vaginal secretions. When a seronegative partner comes in sexual contact with these secretions, the virus can enter the body through mucosal surfaces (such as the vagina, anus, or mouth) or micro-abrasions on the skin (eg, the penile shaft, scrotum, thighs, or perineum).
Guest Commentary: If I Have Herpes, Can I Still Have Children? . . .
April 1st 2006How did I get herpes? Is there a cure? What causes an outbreak-- and what can I do to prevent another one? My friend got herpes and had to stay in the hospital; will that happen to me? Can I still have children?
Photoclinic: Inflamed Keratosis Pilaris
April 1st 2006These pinpoint pustules, some with excoriations, and surrounding erythema appeared on the posterior trunk (A) and outer arms (B) of a 15-year-old boy after he had wrapped his upper body in a wool blanket. These lesions were occasionally pruritic, especially on the arms, where most of the excoriations were noted.
Case in Point: A Young Girl With Cafe au Lait Spots
April 1st 2006A 9-year-old girl presents with multiple hyperpigmented lesions, some of which have been present since birth (Figure 1). The lesions have increased in size and number. There is no history of seizures. Her 40-year-old mother has multiple skin nodules (Figure 2).
Pediatric Urology Clinics: Reddish Urine Stain in the Diaper of a 3-Week-Old Boy
April 1st 2006A mother brought in her 3-week-old son on the day she discovered a reddish urine stain in the baby's diaper. There was no stool in the diaper. The boy had been circumcised on the second day of life, and the mother was concerned that her son might have experienced a complication of the procedure.
Henoch-Schönlein Purpura and Nonpitting Edema
April 1st 2006A 10-year-old girl has had a worsening rash for 1 week. The mildly pruritic, nontender eruption initially appeared on the child's thighs and then spread to the arms and face. The child's right hand, feet, and ankles have been swollen for the past 4 days, which has made ambulation intermittently painful.
Consultations & Comments: A "New" Twist on the Technique of Umbilical Catheterization?
April 1st 2006We heard from several readers about a Photo Essay we recently published in our February issue entitled "The Butterfly Technique: A New Method of Inserting an Umbilical Vessel Catheter."1 The authors, Lisa A. Wood, MD, and Mark J. Polak, MD, described modifications of standard catheter insertion techniques that facilitated successful line placement.
Chronic Cough in Children: New Guidelines Offer New Direction
April 1st 2006Until very recently, when it came to chronic cough, children were to be treated like little adults. In its 1998 guidelines on cough, the American College of Chest Physicians (ACCP) stated that "the approach to managing chronic cough in children is similar to the approach in adults."
Acute Poisoning: Keys to Zeroing In on the Cause
April 1st 2006Poisons have been a threat to the health and well-being of humankind for millennia. Given the ubiquitous nature of potential poisons, exposure to a toxin should be included in the differential diagnosis of patients with unexplained illnesses or unusual presentations.
Photoclinic: Immediate Pressure Urticaria
April 1st 2006An 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.
Photoclinic: Congenital Aplasia of the Depressor Anguli Oris Muscle
April 1st 2006The mother of this 2-month-old boy was concerned about her son's facial asymmetry that was apparent only when he was crying. The right angle of the infant's mouth dropped substantially below the left angle of the mouth when he cried; it also deviated to the right (A). The moment the child stopped crying, his mouth became symmetric again (B).
Pediatric Urology Clinics: Red Urine in a 12-Year-Old Boy
March 1st 2006A 12-year-old boy is assessed on the same day that he passed red-colored urine. The boy had been vigorously wrestling with his older brother in the morning; he passed the abnormal-colored urine after lunch. His mother was worried that his kidneys might have been injured during the wrestling.
Pityriasis Rosea in a 7-Year-Old Girl
March 1st 2006Seven-year-old girl with generalized rash that started as a single isolated oval lesion on the lower abdomen. Six days later, diffuse papulosquamous lesions appeared mainly on the trunk, sparing the scalp, face, and extremities. Intense itching despite 3 days of diphenhydramine therapy.
Psoriasis in a 13-Year-Old Boy
May 1st 2005A 13-year-old boy presented with an explosive eruption of numerous, small, round, erythematous, itchy plaques on his lower back and lower limbs of 2 weeks' duration (A). Some of the lesions were scaly. His nails were normal. There was no evidence of arthritis or joint deformity. He had a sore throat a month before the onset of the rash but did not seek medical attention. He was not taking any medication and had no history of joint pain or family history of skin problems.
Supracondylar Process of the Humerus
April 1st 2005An otherwise healthy 16-year-old girl presented with medial arm pain after falling on her left elbow while skating. Robert P. Blereau, MD, and Timothy J. Haley, MD, of Morgan City, La, write that a radiograph of the left upper arm showed a spur projecting from the distal humerus; there was no fracture or dislocation.