Author: Mary Beth Howard

The case: 6 yo presenting with a cough, with concern for possible bioterrorism exposure. Here’s how you answered the questions: Denouement: The patient subsequently developed shock, empiric antibiotics were started. Patient subsequently required intubated for respiratory failure. In PICU patient required bilateral chest tubes to drain pleural effusions. The ID attending contacted the emergency public […]

The case: a 16mo with concern for foreign body aspiration Here’s how you answered the questions: Discussion: The features that make this case interesting: 1. Multiple consulting services with differing takes on management (and which service is going to be responsible for taking this thing out?) and 2. A scary x-ray finding in a very […]

The case: 8 yo M coughing up blood with overall normal exam and normal labs. Here’s how you answered the questions: Less than 3 years PEM experience differential:-Tonsilitis-Occult Airway trauma-Infection (TB aspergillosis)-Mass-ALL-Bleeding/clotting disorder-Foreign Body-AVM-Vasculitis More than 3 years PEM experience differential:-Upper GI bleed/ulcer-Pulmonary Infection-Mass-Bleeding/clotting disorder-Foreign Body-AVM-ALL-TB-Vasculitis Discussion: The differential for this otherwise healthy child coughing […]

The case: a 13 yr old girl with a vulvar abscess requiring surgical I&D, found to be trichomonas positive. Here’s how you answered the questions: Discussion: This case raises both ethical and medical dilemmas. From an ethical stand point, we have a young post-pubertal girl presenting with a sexually transmitted infection. While concerning, most would […]

The case: a 9mo healthy boy presenting with fever and great toe redness concerning for cellulitis vs osteomyelitis. Here’s how you answered the questions:   Discussion: In a child who looks sick, most would obtain initial blood work, including blood culture, CBC ,and inflammatory markers. For imaging for this patient, most would also obtain an […]