13 yo M presenting with worsening left low back pain. Two weeks ago, he was lifting a heavy tire in football practice and felt like something “pulled” in his back. 5 days ago, he presented to the ED with continued back pain and new fever, cough, and blood-tinged post-tussive emesis. CXR and UA at that time were negative. Found […]

By George Nassar, MD PGY-4 Inova Fairfax Hospital 14 yo F h/o HbSS presenting with 1.5 weeks of chest pain associated with non-bloody, occasionally bilious emesis. Chest pain (CP) is intermittent and was improving with oxycodone 5mg until today. Discharged from inpatient hospitalization for pain crisis just before this pain came on. Described as sharp […]

By Alicia Rolin, MD HPI: 20YO female with no significant past medical history presenting with new daily headache x 1 month.  She has no history of headaches but reports new headaches since coming home from college for Winter break. She reports the pain is bitemporal and throbbing. She endorses occasional blurred vision, sensitivity to light, […]

This week’s case features a baby with altered mental status, transferred to us for further workup and management. Our discussion focused mostly on the broad differential here, including toxic ingestion, seizure, arrhythmia, reflux, anaphylaxis, FPIES, and others. It highlights the difficulty in disposition for patients who are back to baseline after an extensive workup that […]

By Walter Palmer, MD; Children’s National Medical Center HPI: 7 mo previously healthy girl presents to an outside hospital with altered mental status.  She was in her usual state of health in the morning with no recent illness.  She ate cheese for the first time around 11am, which was immediately followed by many episodes of […]