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Test your diagnostic skills with 6 cases

Article

Challenge your diagnosing abilities with 6 of our puzzler cases.

We know you love a good challenge so we’ve collected 6 of our most puzzling cases to test your diagnostic skills. Can you properly diagnose all 6?

Toddler’s unusual oral trauma is troubling

A 17-month-old African American girl, with no significant past medical history, is brought to the pediatric emergency department with acute onset of swelling in the floor of her mouth.

Newborn presents with jitters and tremors after delivery

A full-term male infant was born at 40.3 weeks gestational age via vaginal delivery to a 29-year-old single G6 P30204 mother with limited prenatal care (3 visits) and short interval pregnancy. The delivery was precipitous: Rupture of membranes was 3 hours in duration with clear fluid; no intrapartum medications were administered; and the infant’s Apgar scores were 9 and 9 at 1 and 5 minutes, respectively.

Epidural bleeding in an infant with hemophilia

A 7-month-old male with severe hemophilia A (less than 1% factor VIII activity) presented to his pediatrician with fussiness and inability to sleep for 3 days. He had received his influenza vaccine 3 days earlier.

Newborn’s rash involves eyes and nose

A healthy 11-day-old male infant is brought to the pediatric clinic for evaluation of rash. The rash started with a 2-mm papule on the left medial epicanthal fold 4 days before the clinic visit. A day before coming to the clinic, the rash had spread to the upper left eyelid and the nasal bridge.

Subgaleal hematoma after takedown of braided hair

A previously healthy 2-year-old African American female with braids presented to our hospital with 2 days of right-sided face and head swelling.

Vesical fissure in a newborn female

During a newborn's initial examination, doctors discovered a non-erythematous, midline, suprapubic dimple located 5 cm below the level of the umbilicus. The remainder of the examination was unremarkable. On the second day of life, the newborn had a wet diaper with urine appearing to originate from 2 separate sources, including the dimple.

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Tina Tan, MD, FAAP, FIDSA, FPIDS
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