On examination, he has normal vital signs. He is in no distress, comfortable appearing, but acting shy and withdrawn (appropriate for age). His eyes and conjunctiva are normal, but the eyelids are ectropic. He has moist and otherwise normal oral mucosa. The left otic canal is filled with keratinitic debris and once cleared reveals a normal tympanic membrane. The right ear is normal. The remainder of his skin examination reveals diffuse, whole-body brown plaques which are anchored at the center and peeling at the edges…
Read MoreAn ex-full term six-week old male presented to the pediatric emergency department with three weeks of forceful, non-bloody, non-bilious emesis. He was having two to four episodes of vomiting that occurred after feeding. Three weeks prior, the patient had been transitioned from breast milk to formula, and attempts to thicken the formula by adding rice had not improved his vomiting. More recently, he had poor PO intake and his parents were concerned about his weight. He had no fevers, no change in number of wet diapers or stooling, and no other acute complaints…
Read MoreStrangulation injuries are defined as any injury that results from a compressive force to the neck, leading to vascular and airway occlusion. Such forces might include hanging or strangulation (postural, ligature, or manual). Strangulation is implicated in 10% of violent deaths in the United States, while hanging is the second most common form of death by suicide…
Read MoreA 6 year-old otherwise healthy male presented to the emergency department accompanied by his parents. They note that 5 days prior to presentation, the patient developed a rash on his legs which was described as multiple “small red dots” with no other associated symptoms. On further history, they state that they just returned from a hiking vacation to Pennsylvania…
Read MoreA 4 month-old ex-full term infant presents to the ED unresponsive. He is immediately brought to the trauma room and history is gathered from his mother…
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