HPI: 16-day-old ex-38 wk male who presents with erythema around the umbilicus. The umbilical stump fell off 1 day ago, and since last night parents have noticed redness along the umbilicus. This morning the erythema has worsened and child seems to be fussy upon touching the umbilicus. No drainage or pus from umbilicus. No fevers […]
Author: Walter Palmer
I grew up in Massachusetts and lived there through medical school. My favorite hobbies are pretty classic New England: traveling, skiing, taking summer trips to the beach, and watching the Patriots win Super Bowls. After med school I moved to Chicago for pediatrics residency and received my master's in public policy. I loved my time there but I'm excited to be back on the East Coast as a fellow here at Children's National! Professionally, I am interested in how public policy influences accidental injuries and toxic exposures in children and the development of clinical guidelines. Outside of work, you can find me buzzing around on an electric scooter exploring DC's monuments, parks, and restaurants.
Hot Seat #186: An 18 MO Boy with Fever
By Hannah Kotler MD, Children’s National Medical Center HPI: 18mo healthy male presenting with 3 days of fever (Tmax 101.5), associated with fatigue, decreased urine output (3-4 wet diapers daily), and non-bloody loose stools. He had a negative COVID test performed by his PMD. Referred by PMD for MISC workup. ROS: Constitutional symptoms: Fever, Diapers:: Decreased […]
Hot Seat #185: Denouement
This week we highlight the case of a child with altered mental status and unusual mixed metabolic derangements. The initial management was complicated by an incomplete clinical history and delay in obtaining Creole interpreter services. Most respondents agreed that, given the initial clinical impression of an uncomplicated child with mild dehydration, there was no further […]
Hot Seat #185: An IVF Conundrum
By Harrison Hayward, MD, Children’s National Medical Center HPI: You receive a call from an outside hospital to transfer an 8yo M with NBNB vomiting x2 days with soft stools and abdominal pain who received two boluses and failed a PO trial. No fever, respiratory symptoms, rash, sick contacts, or travel. They require transfer for […]
Hot Seat #183: 10 Year Old Girl with Fever
By Aditi Ghatak-Roy, INOVA Children’s 10-year-old female with no medical history presents to the ER with 6 days of daily fevers. Highest temperature of 104 orally and controlled with Tylenol and Motrin. Family also mentions right leg pain. Family noticed she was limping about 1 week ago and seemed to favor the right leg. It […]