This week’s case focuses on a child with decreased neck movement. The initial presentation of decreased neck movement in a 12-month-old male prompted consideration of torticollis, atlantoaxial rotary subluxation (AARS), and deep neck space infections. The distinction between subluxation, which typically presents with a fixed neck position rather than pain-limited range of motion, is helpful […]

Case by Kammeron Brissett MD, CNH PEM Fellow 12 month old male presents with 3 days of left-sided neck stiffness and increased fussiness.  Neck stiffness was first noticed after waking up from a nap 3 days ago. Mom states he appears to be reluctant to turn his neck to the left. He continues to maintain oral […]

This case highlights the complexity of managing a pediatric patient presenting with hypertensive emergency. Hypertensive emergency is characterized by stage II hypertension with signs of end-organ damage. In this case, the patient presented with signs of CNS dysfunction (seizure and altered mental status). Most learners were also concerned for some other intracranial pathology (ie abscess, […]

This week’s case focuses on a 5-year-old who presents with eye pain. The crux of the discussion centers on strategies to examine an eye in an uncooperative patient. Pediatric cooperation is a key barrier to detailed exams. Strategies such as distraction, anxiolytics, and, if needed, procedural sedation can be employed. Before considering procedural sedation, topical […]

Case by Nikki Animasaun MD, CNH Pediatric Emergency Medicine Fellow An 11-year-old female with history of recent sepsis in the setting of recent group A strep skin and soft tissue infection presents with altered mental status and possible seizure activity. Per grandma, yesterday, the patient developed a headache which continued until this morning. This morning […]