Consultant for Pediatricians Vol 9 No 4

"Don’t post information about yourself online that you don’t want the whole world to know." In the 21st century, this safety rule is as important as the older “don’t talk to strangers” and “look both ways before crossing the street.” If you remember nothing else about Internet safety, remember this.

On awakening in the morning, a 2-year-old girl was noted to have left-sided facial swelling and was brought to the emergency department. The child had had no fever, trauma to the area, pain, or difficulty in swallowing. Her medical history was unremarkable. Her immunizations were up-to-date; she had received both doses of the measles, mumps, and rubella (MMR) vaccine about 6 months before presentation. There were no sick contacts.

A 16-year-old boy presented for evaluation of his worsening behavior at school. He was very hyperactive and had difficulty in paying attention. He had always required help with reading and language. Maternal pregnancy and birth history were unremarkable.

A 2-year-old girl was transferred to the pediatric ICU from a nearby community hospital because of nonremitting, generalized abdominal pain associated with fever and vomiting. Her symptoms had begun 3 days earlier and had progressively worsened despite treatment with antibiotics, pain medication, and fluids.

This 11-year-old girl has had an intensely itchy rash on her left leg for the past 10 years. It has been slowly progressing, to the point that it now extends the entire length of the leg. She has become extremely frustrated by the recurring bouts of itchiness and is desperate for relief.

Obstructive sleep apnea (OSA) has a high prevalence in the pediatric population and is associated with significant morbidity, both physical and in the realms of development, cognition, behavior, and school performance.

A 16-year-old girl presented to the emergency department (ED) with an anaphylactic reaction to a bee sting on the right side of her neck. Within 15 minutes of her arrival, swelling, numbness, and pain developed at this site. She also had headache, shortness of breath, and vague abdominal pain associated with nausea.

“Texting,” “tweeting,” “friending,” “IMing.” Many physicians have heard their teenaged patients use these terms to describe how they communicate with their peers.

A 20-month-old boy brought to the emergency department with swelling on the right side of the neck and fever (temperature, 39.3°C [102.7°F]) of 1 day’s duration. The parents reported that the child had had intermittent fevers and poor weight gain for the past 3 months but no vomiting, diarrhea, rash, drooling, or difficulty in swallowing.