Alicia Rollin MD, Children’s National Medical Center Case: This is a 6-year-old patient who presented initially with several days of fever, vomiting and diarrhea. Found to be profoundly hyponatremic and hypoglycemic in the setting of diarrhea and poor PO intake. On arrival, he was febrile, tachycardic, and hypotensive. Labs notable for pH 7.1, Na 123, […]
Hot Seat #238: 6 year old with nausea and vomiting
Alicia Rolin MD, Children’s National Health Systemwith Haroon Shaukat MD, Children’s National Health System Patient is a 6-year-old male with autism spectrum disorder who presents with nausea and vomiting. Parents report that for the past 2-3 days he has been feeling unwell. Report tactile fevers and rigors. Has had multiple episodes of NBNB emesis. Decreased […]
Hot Seat #237: Tummy Time
A 6-year-old male fully vaccinated with no chronic medical conditions presents with abdominal pain and emesis for the past 48 hours. Over the past year, the patient has had intermittent episodes of abdominal pain and emesis, typically self-resolving within a few hours. Two days ago, after eating, he developed intense abdominal pain and non-bloody but […]
Hot Seat #236: Short of Breath, What is the right test?
18-year-old female presents with cough for the past 2 weeks now complaining of shortness of breath for the past 2 days with tactile fevers. No vomiting but feeling nauseous. Normal urine and stool output. Up to date on immunizations. Cannot lie down flat because she has trouble breathing. Endorses dizziness and denies history of wheezing. […]
Hot Seat #235: H-O-T-T-O… Go home?
Case by Nicholas Dimenstein MD MPH, CNH PEM Fellow 20-month-old female presented with fever to 101.7. Had been discharged from the hospital 6 days ago during which she had required ICU care for distributive shock and respiratory failure. She had received IVIG, ASA, Anakinra, and Infliximab for presumed KD vs MIS-C. Was discharged home on […]