Boy With Exercise-Related Exhaustion, Hypertrophic Calf Muscles, and Thigh Muscle Wasting
August 5th 2010Otherwise healthy 9-year-old African American boy seen for first time for complaints of frequent exhaustion, particularly when climbing stairs or walking for long periods. He could no longer participate in sports because of inability to keep up with his peers. He had been toe walking and had become clumsier over the past year, tripping and falling more frequently. Besides a mild delay in walking (around 16 months), his mother had reported no outstanding gross motor delays in infancy. He was in a regular class in school, although he did receive extra help in math and reading.
Young Girl With Enlarging Tender Neck Mass
August 4th 2010A 6-year-old girl presented with tender mass on the left side of her neck that had enlarged over the past week. Her primary care doctor initially prescribed amoxicillin/clavulanate for suspected bacterial lymphadenitis. The swelling progressed, and a CT scan was ordered.
AAP issues statement on cochlear implants
August 1st 2010Children preparing for cochlear implant surgery should receive all age-appropriate doses of pneumococcal conjugate and Haemophilus influenzae type b conjugate vaccines and appropriate annual immunization against influenza at least 2 weeks before surgery, according to a recent policy statement.
Urgent care and parental satisfaction
August 1st 2010A survey of more than 1,000 parents who brought their children to either an urgent care clinic or a well care clinic during an 18-month period provided some insights into the association between parents' knowing the care provider's name and how satisfied they were with their visit.
Best practices: Kids with special healthcare needs
August 1st 2010An estimated 10.2 million children in the United States have special healthcare needs. The numbers of children with special healthcare needs are continuing to rise as medical advances foster survical of children with previously lethal congenital anomalies and conditions.
Dealing With Difficult Parents
July 26th 2010For the past several years, I’ve listed “difficult parents” on my department’s conference evaluation form as my answer to the question, “What do you consider to be the single biggest problem that you face in your practice?” At times, I have to admit that difficult parents have made me dread my decision to become a pediatrician.
Asymptomatic Papular Rash in Infant With Rhinorrhea
July 7th 2010A 10-month-old boy with an asymptomatic rash is brought to your office by his mother. The rash, which began on the legs and spread to the arms, face, and buttocks, has been present for 3 days. Other than rhinorrhea and nasal congestion for the past 3 to 5 days, the infant has been well, although fussier than usual, especially at night. His appetite is normal. The rash has persisted despite the application of bacitracin, petroleum jelly, and cortisone. He has had no sick contacts with a similar rash or illness. His immunizations are up-to-date.