Authors
Latest:
Cerebral Palsy: A Multisystem ReviewABSTRACT: Most cases of cerebral palsy (CP) are the result of congenital, genetic, inflammatory, anoxic, traumatic, toxic, and metabolic disorders. A minority of cases result from asphyxia at birth. Nearly three-quarters of children with CP aged 7 years had a normal neurological evaluation at birth. Abnormal motor development usually provides the first diagnostic clue. Neuroimaging is recommended if the cause of CP has not been established with perinatal imaging. MRI is preferred to CT. Management of the multisystemic manifestations begins with a comprehensive medical evaluation by a multidisciplinary team that includes family members. Therapy is aimed at maximizing the patient's level of function. Key areas include ambulation, cognitive skills, activities of daily living, hygiene, and rehabilitation into society.
Latest:
Omental Cyst Presenting as Acute AbdomenA 2-year-old girl was transferred to the pediatric ICU from a nearby community hospital because of nonremitting, generalized abdominal pain associated with fever and vomiting. Her symptoms had begun 3 days earlier and had progressively worsened despite treatment with antibiotics, pain medication, and fluids.
Latest:
Asthma Therapy Complicated by Peters Plus SyndromeThe authors describe the case of a 2-year-old girl with severe persistent asthma whose disease management was complicated by this rare clinical diagnosis.
Latest:
Case in Point: Lead Poisoning in a Young BoyA 2-year-old African American boy was brought for evaluation of symptoms of an upper respiratory tract infection and intermittent abdominal pain.
Latest:
Infant With PurpuraA 9-week-old Caucasian infant is brought to the primary care physician for evaluation of purpura and petechiae. His parents noted the bruising the previous night, which grew progressively worse throughout the next day. The lesions seemed to appear "out of the blue" without apparent cause, including trauma.
Latest:
Newborn With Wrinkled Abdomen and Other AnomaliesPrune belly syndrome is a rare condition, classically referred to as a triad of abdominal wall musculature deficiency, bilateral cryptorchidism, and other urological abnormalities, although the clinical presentation can vary. A case history here.
Latest:
Photo Essay: Hyperpigmented MaculesThis 13-year-old boy has a Becker nevus--also called Becker melanosis, because the lesions do not contain nevus cells. This common lesion is characterized by the abrupt onset of hyperpigmentation that gradually expands; it appears at or before adolescence.
Latest:
Hypopigmented Patches in Infant With a History of SeizuresFour-month-old Hispanic boy brought for evaluation because of hypopigmented patches on his skin and a history of seizures. Infant was the product of an uncomplicated pregnancy; born at 40 weeks' gestation to a 16-year-old gravida 1, para 1 mother who received appropriate prenatal care. At birth, he had multiple hypopigmented patches on his face, torso, and extremities. At age 2 months, he was hospitalized for new-onset seizures.
Latest:
Photoclinic: MRSA Skin Abscess and OsteomyelitisThis lesion on the chest of a 6-week-old infant had developed over 2 days (A). It began as a small mass just below the right nipple. Initially, there was no tenderness or erythema; within 2 days, the lesion had begun to drain green-yellow and then white purulent exudate.
Latest:
Unusual Skin Elasticity, Joint Hypermobility, Violaceous Plaques in 3 Different Patients: What’s Your Diagnosis?Digital extension; joint hypermobility; skin elasticity with keloid scars; pectus and scoliosis from skeletal flexibility and deformation; these disparate symptoms and findings point to what diagnosis?
Latest:
Are Children with Asthma and a Single Parent at Greater Risk for Emergency Care?Children with asthma living in single-parent homes were found 50% more likely to return to the hospital within 12 months than children living with 2 parents. What's the real underlying cause?
Latest:
An Infected Finger: Child Abuse – or Mimic?A 3-year-old child was brought to her primary caregiver by her maternal grandmother who was concerned about the infected lesion shown here. The child was at the center of a heated custody dispute and abuse was strongly suspected. But could the lesion’s origin be something else?
Latest:
Concussion in Young Athletes: Heads Up on Diagnosis and ManagementThe increased incidence of sports-related concussion reported nationwide has attracted much media and public attention. Most data about sports-related concussion involve professional, college, and high school level athletes
Latest:
A Wormian Bone in a NeonateWormian bones (anterior fontanellar bones) are extra islands of bone within the calvarial sutures of the skull.
Latest:
Rib Fractures: A Case of Abuse in a 6-Month-OldRib fractures suggest abuse and are a lone finding in 29% of skeletal injury cases.
Latest:
Case in Point: Methicillin-Resistant Staphylococcal PneumoniaStaphylococcal pneumonia can be a rapidly progressive illness that is commonly associated with pneumothorax and pleural effusion. Affected patients require close monitoring. Consider staphylococcal infection in any infant with pneumonia whose health deteriorates clinically or radiographically.
Latest:
Jacquet's Dermatitis: An Unusual Type of Diaper RashJacquet’s dermatitis a rare, severe variant of irritant diaper dermatitis, presents with punched-out erosions or ulcerations with crater-like borders.
Latest:
Orbital CellulitisThis 14-month-old girl was brought for evaluation of marked swelling and erythema of the left eyelids (A) The mother had noticed a green discharge and mild swelling of the eye 2 nights earlier.
Latest:
Translocation Down (Trisomy 21) SyndromeSix-year-old East Indian boy delivered by normal spontaneous vaginal delivery to a para 3, gravida 2, 42-year-old mother following uncomplicated, full-term pregnancy. Apgar scores: 9 and 9, at 1 and 5 minutes, respectively. Birth weight, 2.5 kg. Infant hypotonic at birth with numerous dysmorphic features. Delayed developmental milestones; IQ measured at 80.
Latest:
Dyskeratosis Congenita: An Inherited Bone Marrow Failure SyndromeAbnormal pigmentation, nail dystrophy, and leukoplakia may signal dyskeratosis congenita.
Latest:
Chronic Recurrent Multifocal Osteomyelitis: REFERENCES:ABSTRACT: Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disease that occurs primarily in childhood. The clinical picture often is confused with bacterial osteomyelitis. Awareness of CRMO as a clinical entity helps avoid diagnosis and treatment delays. Our patient, an 8-year-old girl, presented with acute left hip pain. One month after presentation, a lytic lesion was seen on plain radiographs; biopsy revealed nonspecific inflammation. It was not until more than 2 years later, when multifocal bone lesions and psoriasis developed, that the diagnosis became clear. Our patient's case demonstrates several key points: not all children with CRMO present with multifocal disease, patients frequently have comorbid inflammatory conditions, and there are no diagnostic laboratory studies. The optimal treatments remain unknown.
Latest:
Osteomyelitis Associated With Cat-Scratch DiseaseA 3-year-old girl was hospitalized because of purulent drainage from a right middle finger wound (Figure 1) and a tender right axillary mass (Figure 2) of 2 days’ duration.
Latest:
When Johnny Can’t Sleep“My 8–year–old son has always had trouble falling asleep. He never falls asleep before 11 PM, even on school nights. Is there anything you can prescribe so he can get to sleep earlier?”
Latest:
Stevens-Johnson SyndromeA 13-year-old boy was brought to the emergency department (ED) with a generalized itchy rash of 2 days' duration. For the past 3 days, he had dry, itchy eyes with a purulent discharge (Figure 1) and nonbilious emesis 2 or 3 times per day, with some blood streaks in the vomitus on the third day of illness.
Latest:
PHACE SyndromeAn otherwise healthy female infant presented at birth with a lesion on the left side of the face that involved the frontotemporal scalp, periocular area, nose, and upper lip (A). She was born at term via spontaneous vaginal delivery after an uncomplicated gestation. The initial clinical impression was that of a port-wine stain associated with Sturge-Weber syndrome.
Latest:
Conflicting Recommendations for Lipid Screening and Management in Children: The Need for ConsensusIn July 2008, the American Academy of Pediatrics (AAP) updated their recommendations on lipid screening and cardiovascular health in childhood.1 The new recommendations created a media stir because of the endorsement of the use of statins in certain at-risk children as young as 8 years.
Latest:
Teen With Multiple BoilsThis 17-year-old presented with multiple boils in the perineum and under breast and skin folds. The lesions produced a malodorous discharge (which caused problems with peer acceptance at school) and were increasing in size. Oral antibiotics had not helped. The patient was admitted for intravenous antibiotic therapy.
Latest:
Repeated Episodes of Abdominal Pain Followed by Emesis in a 22-Month-OldTwenty-two-month-old girl seen in the emergency department (ED) after several hours of abdominal pain associated with non-bloody, non-bilious emesis. Over past 2 months, has had 7 or 8 similar episodes of abdominal pain followed by emesis 1 to 2 hours later.
Latest:
Pityriasis Rosea in Dark-Skinned ChildrenIn the course of studying azithromycin as a treatment for pityriasis rosea (PR) which we found does not work, we collected much data on the distribution, morphology, and course of the lesions.
Latest:
Abdominal Migraines in a 10-Year-Old BoyAbdominal migraine affects up to 4% of the pediatric population and represents 4% to 15% of patients with functional abdominal pain. Most of those affected go on to have migraine headaches.
