A 2-month-old male infant born by uncomplicated spontaneous vaginal delivery at 38 weeks presented with two days of crying and irritability. Mom stated the baby’s birth was normal and he has been growing and developing normally. Two days ago, he became fussy, and has been crying and inconsolable since…
Read MoreA three-year-old otherwise healthy male presented with rash. The patient’s mother stated she noticed large, purple/red lesions on the patient’s lower extremities over the last week. They appeared to be itchy but not painful. The patient had URI symptoms a week and a half ago that had since resolved. For the last week he had not had any fever and has been behaving like his normal self. He intermittently stated “his belly hurt” but did not have any vomiting or diarrhea. Last bowel movement was the day prior and looked normal. The patient had no history of bleeding symptoms or family history of bleeding disorders. The patient was up to date on vaccinations. He had not taken or used any new medications, foods, lotions, detergents. Vitals were normal. Exam showed non-blanching lesions along the lower extremities without oral mucosal or genital involvement (Figure 1). There were no lesions on palms/soles. The upper and lower frenulums were intact without any signs of non-accidental trauma (NAT) on full body examination…
Read MoreBy Hoi See Tsao, MD, and Alicia Genisca, MD
A 2-year-old previously healthy boy presented to the emergency department with a foreign body in his right nostril.
The patient was staying at his father’s house and the father became concerned about a foreign body when the patient suddenly began complaining of right nostril pain and dark brown nasal discharge. The father did not know what foreign body may have been inserted. On the patient’s return to his mother’s house the next day, he was found to also have right nostril swelling. His mother brought him to the emergency department for evaluation. The mother denied the patient having fever, coughing, gagging, vomiting, diarrhea, or abdominal pain.
Read MoreAn otherwise healthy 6 year-old female presented with lower abdominal pain and non-bloody, non-bilious emesis since 11:00 PM the previous night. Several hours prior to the onset of her symptoms, she was playfully thrown into a pond where she was swimming. She subsequently had take-out brown rice and vegetables with her family. Nobody else developed symptoms. Her pain was worse with ambulation and bumps in the road. She has had no diarrhea, constipation, fevers, urinary symptoms, or other acute complaints. She had similar but less severe episodes of these symptoms in the past. The patient’s father had a history of a “blood disorder” requiring abdominal surgery…
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