A 15-year-old Hispanic boy with refractory T-cell acute lymphoid leukemia was hospitalized because of fever and pain and swelling of the right knee of 3 days' duration. The patient was taking nelarabine for a recurrence of his leukemia, which was diagnosed a year earlier. He appeared nontoxic. His temperature was 39.28C (102.68F). Other vital signs were within normal limits. The right knee was warm and tender, with mild restriction of movement.
Seven days after birth, a female infant was noted to have 2 mandibular central incisor teeth. The teeth were firmly fixed in the gums, and the infant was growing well on breast milk. Neonatal teeth (which appear during the first 30 days of life) are about 3 times more common than natal teeth (which are present at birth), although both are relatively rare.
Adjunctive therapy with dexamethasone should be considered in selected cases of bacterial meningitis in infants and children. Dexamethasone has reduced hearing impairment in children with Haemophilus influenza type b meningitis when given with or before starting antimicrobial therapy.
A 23-month-old Hispanic boy was brought to an emergency department (ED) with ear pain and fever. The family had no other expressed concerns. Physical examination revealed inflammation of 1 tympanic membrane. The child had a temperature of 38.4°C (101.2°F).
An otherwise healthy female infant presented at birth with a lesion on the left side of the face that involved the frontotemporal scalp, periocular area, nose, and upper lip (A). She was born at term via spontaneous vaginal delivery after an uncomplicated gestation. The initial clinical impression was that of a port-wine stain associated with Sturge-Weber syndrome.
In addition to term infants (born after at least 37 weeks' gestation), many hospitals currently consider late-preterm infants (born between 34 and 36 weeks' gestation) mature enough to be admitted to the well-baby nursery. Several studies, including one recently published by Young and colleagues1 from Utah, have shown an increased mortality among these late-preterm (also known as near-term) infants.
ABSTRACT: Young children with suspected foreign-body aspirations are common in emergency departments and primary care offices. A "sentinel event" consisting of a sudden onset of choking, gasping, gagging, wheezing, stridor, difficulty in breathing, change in phonation, or difficulty in swallowing may indicate aspiration. In many cases, the diagnosis is missed because the child is asymptomatic on presentation. Normal physical findings can be misleading or the child may have nonspecific symptoms that are initially misdiagnosed as asthma, croup, bronchitis, or pneumonia. Except for endoscopy, most routine diagnostic studies can be falsely reassuring when results are normal. The literature is reviewed here and recommendations are made about how to evaluate and safely manage children with suspected foreign-body aspiration.
Photo A shows a red, slightly raised, 1 3 2-cm lesion on the left buttock of a 3-month-old boy. The lesion had been present since birth and had enlarged as the child grew. Photo B shows a similar lesion in the vulva of a 2-month-old girl that also had been present since birth; the mother stated that it had not enlarged.
The parents of this 12-month-old girl are concerned that their daughter “caught” psoriasis at her day-care center. The rash had been present for at least 6 months, after which it cleared significantly, only to return weeks later. The child does not seem to be bothered by it.
