Clinical Vignette Abstracts — Pediatric

/Tag:Clinical Vignette Abstracts — Pediatric

HM2015 Abstract Number:

The Light Is on but No One’s Home: Another Cause of Altered Mental Status Without a Fever

Case Presentation: A previously healthy 13-year-old Korean-American girl presented with acute altered mental status. She had fatigue, leg and abdominal pain, and was initially diagnosed with “the flu.” Two days later she progressed to worsening [...]

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HM2015 Abstract Number:

Double Trouble: Twins with Bulging Fontanelles and Influenza Infection

Case Presentation: 6 month old former 35 week twin Hispanic girls presented to the ED for evaluation of bulging fontanelles for almost one week.  Both twins had been fussy for 24 hours, and Twin A [...]

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HM2015 Abstract Number:

She’s Just Not That Interested

Background: Patient is a previously healthy 7-week old Hispanic female who presented to an emergency department with cough, congestion and decreased PO intake x 7 days. Baby had an unremarkable prenatal course and normal delivery. [...]

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HM2015 Abstract Number: 421

Mysterious “Myositis”: Engaging the Family in a Diagnostic Dilemma

Case Presentation: A 4 month-old female presented with decreased movement of the right lower extremity. Exam revealed a flexed, abducted right leg and pain with passive motion. CBC, inflammatory markers and CK were normal and [...]

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HM2015 Abstract Number: 422

Omental Torsion Mimicking Acute Appendicitis

Case Presentation: A 6 year old male with no past medical history presented to the emergency room (ER) with six hours of right lower quadrant (RLQ) pain. The pain was described as sharp and non [...]

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HM2015 Abstract Number: 419

Mystery Edema in an Infant During Prolonged Hospitalization

Case Presentation: A 5-week-old previously healthy male presented to an ER with 2 days of fever. He was lethargic with a sunken fontanel. Labs revealed a WBC of 13.5 with 15% bands, c-reactive protein of [...]

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HM2015 Abstract Number: 420

Occam’s Back Pain: A 6 Year Old with Leukemia

Case Presentation: A healthy 6-year-old boy with an unremarkable family history sustained a minor trampoline injury accompanied by mild back and neck pain. The neck pain resolved within several days, but back pain persisted for [...]

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HM2015 Abstract Number: 740

Mad As a Hatter

Case Presentation: Patient is a previously healthy 11-year old Hispanic female who presented to an emergency department with altered mental status, opus-myoclonus movements, aphasia, hallucinations and slurred speech. Six weeks prior to presentation, patient had [...]

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HM2015 Abstract Number: 741

Restrictive Eating in an Adolescent Girl: Is It an Eating Disorder?

Case Presentation: A 12-year-old girl presented with restrictive eating, weight loss (BMI 12.17 kg/m2; -4.10 SD), and orthostatic hypotension. She was admitted to a tertiary referral children’s hospital and placed on an eating disorder protocol [...]

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HM2015 Abstract Number: 742

The Diagnosis Has Me on Pins and Needles

Case Presentation: A 16-year-old male presented with a petechial rash and paresthesias for three weeks. Three weeks prior, he developed a petechial rash on the lateral aspects of both feet that progressively spread to the [...]

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HM2015 Abstract Number: 743

Fever, Rash, and Palatal Petechiae in a Healthy 5 Year Old

Case Presentation:             A five year old Hispanic female presented with a five day history of high grade fevers and generalized rash.  She also had bilateral anterior and posterior cervical [...]

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HM2015 Abstract Number: 744

Fulminant Cerebellitis Secondary to Viral Encepahlitis

Case Presentation: A 4 y.o. African American male presented with headache x 4 days and decreased level of consciousness.  He was very sleepy with decreased po intake, sore throat, photophobia, loss of balance, and weakness.  [...]

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HM2015 Abstract Number: 745

An Uncommon Presentation of Respiratory Distress

Case Presentation: A 21 mo old female with respiratory distress and decreased fluid intake for 3 days presented to our pediatric ED. She was previously healthy, no fever, cough, or wheeze.  Upon initial exam she [...]

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HM2015 Abstract Number: 747

Lemierre’s Syndrome: A Rare but Lethal Complication of Pharyngitis

Case Presentation: We report a 14 year old boy who presented with acute pharyngitis, complicated with multifocal pneumonia and an epidural abscess collection with bilateral frontal and sphenoidal sinus abscesses. He did not have any [...]

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HM2015 Abstract Number: 749

Paralyzed by Fear: A Confusing Case of Ascending Paralysis After a Spider Bite

Case Presentation: A 15 year-old boy presented to a referring facility with right lower extremity weakness, numbness and urinary retention following a spider bite. The weakness subsequently spread to the contralateral leg with ascending numbness [...]

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HM2015 Abstract Number: 750

When a Fever Gets Cross-Eyed

Case Presentation: A 3 year old girl with no significant past medical history presented with fever of unknown origin (FUO). Ten days prior to hospital presentation she began having daily fevers with mild URI symptoms. [...]

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HM2015 Abstract Number: 751

Malnutrition Obscures the Diagnosis in a 10 Year Old Male with Developmental Regression and Seizures

Case Presentation: A 10 year old boy presented to an outside Emergency department with increased seizure activity. The boy was a recent immigrant from Guatemala.  Additional history revealed that the boy was born in the [...]

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HM2015 Abstract Number: 752

7 Year Old Male with Fever and Neck Swelling

Case Presentation: RM is a 7-year-old African American male seen twice in 2 days in the emergency department. He had a 3 day history of fever to 39.7°C, right neck pain and swelling, vomiting, and [...]

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HM2015 Abstract Number: 753

The Great Masquerader: A Meningitis Case Report

Case Presentation: A 14yo female presented with fever, altered mental status and seizure.  Her primary care provider had seen her several times in the preceding two months with complaints of chronic cough and headaches.  In [...]

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HM2015 Abstract Number: 754

The Forgotten Disease: A Case of Lemierre’s Syndrome

Case Presentation: A 16 year old, otherwise healthy female presented with five days of intermittent fever, progressive neck pain and swelling. Prior to admission, she had been seen by her primary care physician and started [...]

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HM2015 Abstract Number: 755

Multifocal Nontuberculous Mycobacteria Infection in an Immunocompetent Adolescent

Case Presentation: A 15-year-old boy was transferred to the hospital with a 10 month history of a left cervical mass and 6 months of right calf swelling. The neck mass appeared after the patient sustained [...]

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HM2015 Abstract Number: 756

The Toxic Avenger

Case Presentation: A 13 y/o female presented with a 1 month history of painless left inguinal swelling and a 2 day history of worsening inguinal pain, diffuse pruritis, myalgias and fever.  On presentation she was [...]

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HM2015 Abstract Number: 757

A Perplexing Case of Henoch Schonlein Purpura

Case Presentation: A 17 year old female presented with 4 days of worsening epigastric pain, persistent bilious emesis, one episode of diarrhea, anorexia and fever for two days. Initial examination revealed an ill appearing, tachycardic [...]

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HM2015 Abstract Number: 758

Skin Deep: Investigations Beyond the Diaper Rash

Case Presentation: AR is a 3-week-old full term, previously healthy girl, who presented to the Emergency Department (ED) with a rash involving the perianal skin and gluteal crease. The rash began at 1 week of [...]

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HM2015 Abstract Number: 759

Avoiding Bias, a Hospitalist Headache

Case Presentation: A 12-year-old male presented with right-sided headache for 5 weeks described as constant, throbbing, and radiating to his neck, waking him from sleep.  There was a reported 11 pound weight loss and right-sided [...]

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HM2015 Abstract Number: 760

The Vanishing Boy: A Rare Cause of Progressive Weight Loss

Case Presentation: A 5-year-old previously healthy boy was referred from his new primary care provider for hospital admission after presenting with 8 months of progressive weight loss and 2 months of new-onset torticollis. He had recently [...]

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HM2015 Abstract Number: 761

Recurrent Neck Abscess: More Than Meets the Eyes

Case Presentation: An 8 year old girl with no past medical history presented to the emergency department with sore throat, fever and nonspecific neck pain that was initially diagnosed as viral pharyngitis.  Recurrent episodes of [...]

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HM2015 Abstract Number: 762

True Detective: Revealing the Uncommon Source Behind the Common Symptoms

Case Presentation: A 5 month old girl presented with 5 day history of fever and swelling of the right side of her neck.  Physical examination denoted a febrile, well appearing infant with a 3cm X [...]

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HM2015 Abstract Number: 763

Hyponatremia… Can You Smell It?

Case Presentation: A 13-year-old female was admitted for hyponatremia in the setting of unremitting bilious emesis.  Within one week, her sodium level decreased from 131 mmol/L to 116 mmol/L.  In addition to vomiting, she complained [...]

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HM2015 Abstract Number: 764

An Oddball Among Us

Case Presentation: A 3 hour old male infant born via spontaneous vaginal delivery at 39 weeks gestational age presented due to an enlarged scrotum and associated skin lesion.  Maternal medical history was significant for a [...]

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HM2015 Abstract Number: 765

Not Your Typical Case of Pharyngitis

Case Presentation: A 9 year old male presented to the emergency department (ED) with a 3 day history of fever to 103°F, sore throat, and decreased oral intake due to throat pain.  On the day [...]

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HM2015 Abstract Number: 766

Teenagers: A Pain in the Neck?

Case Presentation: A 13 year old female presents with 2 months of progressive right neck swelling, right ear pain, and fatigue.  Two months prior to presentation, she hit her right side of the neck on [...]

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HM2015 Abstract Number: 767

Incomplete Kawasaki Disease Followed by Systemic Onset Juvenile Idiopathic Arthritis: A Diagnostic Conundrum

Case Presentation: A 12 month old female was admitted with 8 days of intermittent fever and rash; she had also developed bilateral hand swelling the day of admission. She had marked elevations in her WBC [...]

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HM2015 Abstract Number: 768

Finding a Foal Amongst the Zebras: An Uncommon Presentation of Lemierres Syndrome

Case Presentation: An 8 year old previously healthy Hispanic boy was admitted with a prolonged history of fever for about 14 days with vague right upper quadrant abdominal pain. He had been seen at an [...]

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HM2015 Abstract Number: 769

Poststreptococcal Glomerulonephritis Presenting As Posterior Reversible Encephalopathy Syndrome

Case Presentation: An 11-year-old girl presented to the Emergency Department with one week history of sore throat, 3 days of abdominal pain, headache, diarrhea and increasing dizziness over the last day.  She had been seen [...]

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HM2015 Abstract Number: 770

Cytomegalovirus Cholestatsis a Cause for Prolonged Conjugated Hyperbilirubinemia

Case Presentation: A 6-day old male newborn was transferred to our institution for evaluation of conjugated hyperbilirubinemia. Examination was significant for jaundice and hepatomegaly. All anthropometric measurements plotted at the 3rd percentiles. He was born [...]

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HM2015 Abstract Number: 771

A Great New Imitator? Nonspecific Symptoms in an Adolescent

Case Presentation: A 14 year-old male with Shone Complex and a history of a pulmonary valve replacement presented with 3 months of nausea and vomiting, a 45-pound weight loss, and fatigue. He endorsed night sweats, [...]

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HM2015 Abstract Number: 772

Sticks and Stones Can Break Her Bones

Case Presentation: A 6-year-old girl with spina bifida, chiari II malformation, and shunted hydrocephalus presented with persistent discomfort of the left leg and one day of knee swelling. She has had intermittent bilateral leg pain after [...]

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HM2015 Abstract Number: 773

Kids Get Into the Darndest Things

Case Presentation: A 7-year-old boy with moderate persistent asthma presented with increased lethargy, poor oral intake, and two days of emesis with hematemesis noted on day of admission. His pediatrician recently noted pallor and started [...]

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HM2015 Abstract Number: 774

The Curious Case of a Bulging Fontanelle

Case Presentation: A 3 month old, former term male with a history of NICU admission for persistent pulmonary hypertension and SVT, presents to our emergency room with new-onset bulging fontanelle. Mother noticed this persistent “bump” [...]

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HM2015 Abstract Number: 775

A Case of Autoimmune Hepatitis Presenting As Menorrhagia and Anemia

Case Presentation: A 16 year old female with a history of bipolar disorder presented with worsening fatigue and acute on chronic menorrhagia. Over the past 4 to 6 weeks, her periods were regular, but with [...]

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HM2015 Abstract Number: 776

A Reclusive Diagnosis

Case Presentation: A 17 year-old boy presented with 5 days of left arm pain.   He was visiting relatives in Texas when symptoms began.  Pain began abruptly, waking him while he was sleeping on the floor.  [...]

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HM2015 Abstract Number: 777

Shes Just Not That Interested

SHM Clinical Abstract‘She’s Just Not That Interested’Case Presentation: Patient is a previously healthy 7-week old Hispanic female who presented to an emergency department with cough, congestion and decreased PO intake x 7 days. Baby had [...]

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HM2015 Abstract Number: 778

A Shot in the Darkfield

Case Presentation: A four month-old boy presented with abdominal distension.  His parents had noted increasing abdominal size over several weeks.  They also reported a diaper rash for two months and nasal congestion for one month. [...]

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HM2015 Abstract Number: 779

Foraging for Trouble

Case Presentation: A 13-year-old male with a history of Graves' disease was admitted with 24 hours of vomiting and diarrhea. The patient awoke at 4:30 AM on the day prior to admission with non-bloody, non-bilious [...]

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HM2015 Abstract Number: 780

Hemoglobin Hammersmith – Second Reported Male Case

Case Presentation: Unstable hemoglobins occasionally occur as de novo mutations, often causing diagnostic dilemmas[1-3]. We herein present the 18th case and only the second recorded male case of Hemoglobin Hammersmith (HbHS)[4]. A 14-year-old Caucasian male [...]

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HM2015 Abstract Number: 781

Prenatal Ultrasounds Aren’t Perfect

Case Presentation: A 3 month old male was referred to the ED by his PMD for failure to thrive (FTT), reflux and noisy breathing with feeds. He was the term product of a normal pregnancy [...]

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HM2015 Abstract Number: 782

When Eosinophils Try to Conquer All

Case Presentation: A 10-year-old male from China with prior history of a presumed parasitic infection was admitted for abdominal pain, vomiting, and diarrhea. Ten days prior to admission, he traveled to the United States and [...]

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HM2015 Abstract Number: 783

The Unexpected Culprit: A Mass with a Life of Its Own

Case Presentation: A 5 year old boy from Saudi Arabia without past medical history presented with 3 months of fevers, weight loss, and a large abdominal mass. 3 months prior to presentation, while living in [...]

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HM2015 Abstract Number: 784

The Curious Case of the Missing Thymus

Case Presentation: An 8 week old female born 33 4/7 weeks was referred by her primary care provider (PCP) for evaluation of failure to thrive (FTT).  At birth, she required a 2 week NICU stay [...]

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HM2015 Abstract Number: 785

There’s a New Ddt in Town: Pediatric Organophosphate Poisoning

Case Presentation: A 15 year old male presented to the ED after being found unresponsive in his yard. He had defecated, urinated, and had suspected seizure activity. Initial assessment revealed altered mental status, normotension, excessive [...]

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HM2015 Abstract Number: 786

A Cold Case of Pediatric Lupus

Case Presentation: A 10-year-old Hispanic girl with a history of UTIs presented to our ED with seven days of facial rash and dysuria. She had been taking cephalexin for an E. coli UTI as prescribed [...]

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