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Pediatric Management and Diagnostic Dilemma Tool
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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 #184: “Rash, Rash, Go Away!”

Case presented by Brandon Kappy, MD HPI: 14moF presents to the ED with diffusely spreading rash and itchiness. Two weeks ago, she received vaccines (MMR, VZV, Prevnar, Flu, HAV) at her well-child check. Following her vaccinations she experienced a tactile fever, but this resolved in 24 hours. Three days ago, she developed an itchy, red […]

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 […]