Pediatric Index of Suspicion

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Dengue fever (DF) is an acute febrile illness that follows a self-limiting course. However, some patients suffer from complications, including myocarditis, due to the involvement of other organs. A child presented at the Aga Khan University Hospital in Karachi, Pakistan, in June 2013 with a high-grade fever, malaise and epigastric pain radiating to the chest. Positive DF antigen and immunoglobulin M assays confirmed the diagnosis of DF. Persistent bradycardia with low blood pressure led to further cardiac investigations which showed a decreased ejection fraction and raised serum cardiac enzymes, indicating myocardial damage...

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No abstract text is available yet for this article.

The most significant oncologic concern with finding new pulmonary nodules on imaging in a pediatric patient who has anaplastic Wilms tumor is progressive disease with new pulmonary metastases. This case emphasizes the importance of employing a creative clinical differential diagnosis, even for patients with known underlying oncologic disease.

Presentation of Case. Dr. Peggy S. Lai: A 22-year-old man was admitted to the intensive care unit of this hospital in the winter because of hypoxemia and shock. The patient had been well until 5 days before admission, when head congestion, subjective fever, chills, and a nonproductive wet cough..

Presentation of Case. Dr. Timothy P. Lax (Pediatric Allergy and Immunology): A boy who was 14 years 8 months of age and had multiple chronic illnesses was seen in the gastroenterology clinic of this hospital because he had had abnormal results on liver-function tests for approximately 1.5 years...

Presentation of Case. Dr. Patricia M. Guglietta: A 9.5-year-old girl with chronic constipation was seen in the gastroenterology clinic of this hospital because of recurrent episodes of abdominal pain with associated nonbilious vomiting. The patient had been generally well until she was 4 years of..

Presentation of Case. Dr. Emily R. Lynch (Pediatrics): An 18-year-old man was admitted to this hospital because of fever and pain in the lower abdomen, groin, and scrotum. The patient had been well until 4 days before admission, when fatigue, subjective fever, and chills developed. The next day, he..

A 6-year-old boy presented with persistent erythema and pruritus of the eyelids (Panel A), which had been previously diagnosed as atopic dermatitis and unsuccessfully treated with topical glucocorticoids and systemic antihistamines for 2 weeks. Dermatoscopy showed several crab lice (Phthirus pubis)..

• Perineal groove is described as a wet sulcus lined with mucoumembrane extending from the posterior fourchette to the anterior anus • Perineal grooves are rarely described in literature but ar likely more common in practice. • The underlying pathogenesis and embryologic origin of perineal grooves are poorly understood. • Perineal grooves generally self-resolve by 1 year of age. • Surgical intervention is rarely indicated but can be considered for rare complications (infections, mucus drainage) or for cosmetic purposes, usually after 2 years of age...

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Congenital syphilis should be considered in the differential diagnosis of common newborn rashes, especially if the palms and soles are involved. As soon as the diagnosis is confirmed, a lumbar puncture should be performed to rule out neurosyphilis and intravenous antibiotics started pending confirmatory testing.

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.