Consultant for Pediatricians Vol 8 No 11

A 10-month-old breast-feeding boy was taken to the emergency department (ED) with a temperature of 40°C (104°F). Because he was on day 7 of treatment with amoxicillin for a previously diagnosed ear infection, unresolved otitis media was diagnosed.

A10-year-old boy was brought to a medical mission clinic in Roaring Creek, Belize, for evaluation of bald spots on his head. The mother reported that the bald areas seemed to be worsening because of the child's uncontrollable desire to pull out his hair.

One week earlier, a 14-month-old girl with a history of eczema was evaluated because of a diffuse rash of excoriated lesions, some of them purulent. She was afebrile. Worsening eczema with secondary infection was diagnosed. Treatment with oral clindamycin was prescribed. At follow-up, the lesions had worsened. The child had multiple excoriated papules, some of which had coalesced into plaques. She also had two 5-mm vesicles on her right shoulder. Eczema herpeticum was diagnosed clinically. Culture of the vesicles later grew herpes simplex virus (HSV).

A 9-month-old girl was brought to the emergency department (ED) byher mother for abdominal distention, progressive failure to thrive, diarrhea,and occasional vomiting.

Four-year-old boy born at 35 weeks’ gestation to a gravida 2, para 1, 23-year-old mother via emergency cesarean delivery because of fetal distress. Birth weight, 1670 g (3 lb 11 oz). Apgar scores, 8 and 9 at 1 minute and 5 minutes, respectively. At birth, child found to have supravalvular aortic stenosis, peripheral pulmonary stenosis, and ventricular septal defect. Gastroesophageal reflux, laryngomalacia, bilateral inguinal hernias, hypothyroidism, hypercalcemia, growth retardation, and developmental delays noted at various times during the first 4 years of life. Family history, unremarkable.

The mother of this 4-year-old boy is concerned about a small drop of fluid that she noticed on her son’s neck at the dinner table the night before.

This thumb anomaly in a 16-month-old boy was noted within the first month of life. The mother heard an occasional popping sound when trying to straighten the thumb. The infant also had subcoronal hypospadias. He was otherwise healthy.

The clinical diagnosis of influenza is often challenging, especially in young children. Thus, pediatricians often use in-office rapid influenza diagnostic tests (RIDTs) to confirm clinical suspicions of influenza.