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Hot Seat Denouement #231

This week’s case involved a child who initially presented with presumed bronchiolitis but developed worsening neck swelling and respiratory distress. As the neck swelling and respiratory distress intensified, discussions focused on the next steps for escalating respiratory support and imaging. The team had to consider whether the patient could remain stable while lying flat for […]

Hot Seat #231: Geeze Lou-wheeze

Case by Steven Garbin MD, INOVA PEM Fellow An 11-month-old girl with a history of Diamond-Blackfan anemia presents with fever, a left-sided neck mass, and trouble breathing. The patient’s mother reports the child developed a fever 1-2 days ago (Tmax 101F) for which they have been giving regular antipyretics. Last night she noticed a bump […]

Hot Seat #230: Snooze Clues

Case by Christina Rojas MD, Children’s National PEM Fellow A 4-year-old male with a history of ITP presents with vomiting and increased sleepiness. His mother reports that he had three days of nasal congestion, and then today had 4 episodes of NBNB emesis. This morning, he seemed more sleepy than usual, however was still responding […]

Hot Seat #229: Short of Breath, What is the right test?

Case by Jessica Williams MD, Children’s National PEM Fellow 18 yo female presents with cough for the past 2 weeks now complaining of shortness of breath for the past 2 days. She also endorses tactile fever for the past 2 days. No vomiting but feeling nauseous. Normal urine and stool output. Up to date on […]

Hot Seat Denouement #228

This week’s case focused on a child with fluctuating apnea and altered mental status ultimately found to be due to ingestion of marijuana. The diagnostic dilemmas centered on the appropriate respiratory support and decision to perform a lumbar puncture. The differential for unexplained periodic apnea and AMS is quite broad covering a range of neurological, […]