HPI: 16moF otherwise healthy, presents with fever and fussiness. Has had 4 days of upper respiratory symptoms with decreasing PO over this same time. Yesterday she had vomiting, though the parents deny and blood or bile. Today has taken only minimal formula and has gone 12 hours without a wet diaper. Presents for further evaluation. […]
Hot Seat: You’re as Cold as Ice
Case by: Masouma Mohamed, PGY4, Inova PEM fellowship HPI: 50 day old, ex FT, born to GBS negative mom, presents to the ER with low temperature. The child was doing well until 4 hours prior to presentation, when mom noticed that she felt cool to touch with forehead sweating. Mother checked a rectal temperature, and […]
Hot Seat #187: Why won’t he eat?
Case by: Dennis Ren, MD HPI: A 5-year-old boy presents to the ED refusing to eat. He had an episode 5 days ago when he choked on a meatball while eating. Parents state that spit the meatball out in its entirety. Since that time, he has been extremely anxious about eating. His parents have offered […]
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 […]