INDEX OF SUSPICION

1996 ◽  
Vol 17 (6) ◽  
pp. 221-223
Author(s):  
Linda S. Nield ◽  
Jonette E. Keri ◽  
Randall G. Fisher ◽  
Nasha't M. Khanfar
Keyword(s):  
Early Diagnosis ◽  
Late Spring ◽  
The Sun ◽  
Erythematous Rash ◽  
The Past ◽  
General Pediatrician ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 10-year-old boy is brought to your office in late spring because of an erythematous rash on his arms and legs that has been present for 4 days and because he is having joint pains. The rash first appeared after the boy had been playing outdoors for several hours in the sun. He did have a new commercial sunblock lotion applied to his skin before going outdoors. His father is concerned because even though the rash is less pronounced, his son has been experiencing stiff and painful knees and ankles upon awakening for the past 2 days. The joint discomfort improves with movement during the day. The boy has had no other symptoms and has been free of fever.

INDEX OF SUSPICION

1994 ◽  
Vol 15 (10) ◽  
pp. 391-393
Author(s):  
David M. Tejeda ◽  
Jessica Kaplan ◽  
John S. Andrews ◽  
Catherine DeAngelis ◽  
Neeru Sehgal
Keyword(s):  
Blood Pressure ◽  
Eye Movements ◽  
Early Diagnosis ◽  
Otitis Media ◽  
The Past ◽  
General Pediatrician ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation The parents of a 22-month-old boy complain that he has been increasingly clumsy and cranky for the past 7 days. He initially developed a stumbling gait and now prefers to crawl; he no longer can sit on his own. The child has been afebrile but has had a cough for several weeks. He has been on antibiotics for otitis media (with a presumed labyrinthitis) for 5 days. There have been no other recent illnesses, and he has not been ill in the past. On examination, the child appears irritable and has occasional jerking movements of his extremities. His temperature is 36.3°C, pulse is 128 beats/min, and blood pressure is 84/40 mm Hg. Chaotic, irregular eye movements are present.

INDEX OF SUSPICION

1992 ◽  
Vol 13 (1) ◽  
pp. 33-34
Author(s):  
Catherine DeAngelis ◽  
William O. Robertson ◽  
Daniel D. Chapman
Keyword(s):  
Abdominal Pain ◽  
Sickle Cell Disease ◽  
Early Diagnosis ◽  
Sickle Cell ◽  
Cell Disease ◽  
The Past ◽  
Initial Impression ◽  
General Pediatrician ◽  
Prolonged Delay ◽  
Case Presentations

Clinicians often form a diagnostic impression at the time of a patient's first presentation. Usually the initial impression is correct because commonly encountered illnesses come to mind and are, of course, most likely to be responsible. Sometimes, however, a less familiar disorder is responsible and will not be detected or will be diagnosed after a prolonged delay unless the physician maintains a suspicion of the unusual. This section reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to put in writing possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations with discussions. Case 1 Presentation A 4-year-old black boy known to have sickle cell disease is brought to your office by his mother, who is concerned because he has become listless and weak during the past 12 hours. He has been complaining of abdominal pain and is breathing "harder and faster" than usual. On examination, a greatly enlarged, tender spleen is palpated.

INDEX OF SUSPICION

1994 ◽  
Vol 15 (5) ◽  
pp. 201-203
Author(s):  
Mary D. Dvorak ◽  
Britta Mazur ◽  
A. George Pascual
Keyword(s):  
Early Diagnosis ◽  
Physical Examination ◽  
General Pediatrician ◽  
History Of ◽  
Night Awakening ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 6-day-old girl is brought into the clinic having a 12-hour history of fever to 101°F(38.3°C), irritability, and refusal to breastfeed. The child's mother is a bright, articulate woman who is very concerned about providing the best for this baby, her first, and is dedicated to breastfeeding. She notes that the child previously had been "a very good baby" - quiet, pleasant, and nondisruptive. Since birth, the child has slept for much of the day and night, awakening every 5 to 7 hours to feed. The baby usually wets her diapers after each feeding. However, her mother says that the last wet diaper was noted 6 hours ago, and it was barely wet. Upon physical examination, the child appears quiet but awake.

INDEX OF SUSPICION

1994 ◽  
Vol 15 (9) ◽  
pp. 369-371
Author(s):  
Linda S. Nield ◽  
David M. Tejeda ◽  
Lynn C. Garfunkel
Keyword(s):  
Clostridium Difficile ◽  
Early Diagnosis ◽  
Medical History ◽  
Middle Ear ◽  
The Past ◽  
Neurologic Impairment ◽  
Middle Ear Infection ◽  
Clostridium Difficile Toxin ◽  
Her 2 ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A mother is concerned because her 2-year-old son is "not as sure on his feet as he used to be." In the past 2 weeks she has noticed that he seems clumsy and is falling more than usual when playing or walking. His babysitter also has noticed this change in abilities, heightening the mother's concern. No other neurologic impairment is noted, and his play does not seem disrupted. The boy's medical history is unremarkable. Recently, he had a persistent middle ear infection that finally resolved after 1 month of treatment with three different antibiotics. He also has been having 6 to 12 loose stools a day. Clostridium difficile toxin has been isolated from his stool.

INDEX OF SUSPICION

1996 ◽  
Vol 17 (1) ◽  
pp. 32-35
Author(s):  
Arthur S. Dover ◽  
Barry A. Love ◽  
Nasha't M. Khanfar
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Gastrointestinal Illness ◽  
General Pediatrician ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 7-year-old girl is admitted to the hospital because of 9 days of gastrointestinal illness with fever. Her illness began with watery green diarrhea that has persisted. She has had several stools each day: no pus, blood, or mucus has appeared in the stool. She has been vomiting up to six times a day, with bile noted in the vomitus at times. Abdominal pain has been present almost constantly from the onset. The pain has been generalized except for intermittent periods of right-sided lower abdominal, groin, and leg discomfort. Fever in a daily spiking pattern and chills have occurred since shortly after her illness began. She has complained of a frontal headache and has had a mild cough.

INDEX OF SUSPICION

1994 ◽  
Vol 15 (12) ◽  
pp. 495-497
Author(s):  
Elliott M. Friedman ◽  
Alexandre T. Rotta ◽  
Vincent J. Menna
Keyword(s):  
Urinary Tract Infection ◽  
Early Diagnosis ◽  
Acute Urinary Retention ◽  
Positive Culture ◽  
Tanner Stage ◽  
Pubic Hair ◽  
The Past ◽  
Hair Development ◽  
Case Presentations ◽  
Similar Episode

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 13-year-old girl comes to you because it is so painful for her to urinate that she has developed acute urinary retention. Over the past 6 months she has had recurrent mild abdominal cramps; exactly 1 month ago she experienced a similar episode of dysuria. At that time she was able to urinate and was diagnosed by positive culture as having a urinary tract infection, for which she was treated. While preparing to catheterize her, you notice that this young woman is Tanner stage 5 in breast and pubic hair development, yet she states that she has never had a menstrual period. Her mother recalls her own menarche at age 11 years. Observations during the procedure allow you to determine the underlying cause of her problems.

INDEX OF SUSPICION

1993 ◽  
Vol 14 (9) ◽  
pp. 361-363
Author(s):  
Elizabeth R. Marino ◽  
Robert B. Baker ◽  
Jeffrey M. Devries ◽  
Sanjiv B. Amin
Keyword(s):  
Blood Pressure ◽  
Early Diagnosis ◽  
Physical Examination ◽  
Sleep Disturbance ◽  
Nasal Congestion ◽  
Family Members ◽  
Respiratory Difficulty ◽  
General Pediatrician ◽  
Mucous Membranes ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation You are seeing a 16-year-old male who has had nasal congestion that began a few months ago. The congestion was intermittent at first but has become constant. He denies sneezing, itchy eyes, or other respiratory difficulty. His mother is concerned because he often is awakened by his congestion. He frequently is irritable in the mornings, and she believes the sleep disturbance is responsible for the decline in his grades, which had been very good. Except for one uncle, no family members have complained of allergies. He is a slim boy whose pulse is 90 beats/min, blood pressure is 136/80 mm Hg, and temperature is 98.8°F (37.1°C). Physical examination otherwise is normal except for mildly reddened, edematous nasal mucous membranes that have a small amount of thin white mucoid discharge.

INDEX OF SUSPICION

1993 ◽  
Vol 14 (6) ◽  
pp. 215-217
Author(s):  
Neeru Sehgal
Keyword(s):  
Early Diagnosis ◽  
General Pediatrician ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 4-year-old boy is brought to the office because of bruising that his mother had noticed while bathing him 2 days previously. He has not had nosebleeds or noticeable blood in his stool or urine, and he has been well except for a bout of gastroenteritis 2 weeks earlier. His parents are separated, and his mother states that the youngster's father spanked and kicked him and his brother during a visit last weekend. An 11-year-old sister is present and says that the father grabbed the boy's arm and "kicked his rear with his boot." On examination, the child has multiple bruises—some appearing fresh, some apparently several days old—on his back, anterior torso, arms, and anterior thighs.

INDEX OF SUSPICION

1992 ◽  
Vol 13 (5) ◽  
pp. 183-184
Author(s):  
Richard B. Goldbloom ◽  
Andrea C. Bracikowski ◽  
Richard B. Goldbloom
Keyword(s):  
Early Diagnosis ◽  
Infant Formula ◽  
Uncomplicated Pregnancy ◽  
General Pediatrician ◽  
Pregnancy And Delivery ◽  
Her 2 ◽  
Case Presentations ◽  
Breast Fed

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations with discussions. Case 1 Presentation A 3-mo-old girl is admitted to the hospital for investigation of generalized swelling of 1 week's duration. The swelling involves her face and extremities. Her 2-y-old sister is healthy and her parents are not related. The baby was born at term following an uncomplicated pregnancy and delivery and was breast fed during the first month of life. She fed eagerly but cried a lot, usually beginning 30 to 60 min after each feeding. Suspecting that she was not providing sufficient milk, her mother weaned her to a standard prepared infant formula at 1 mo of age. Although she took the formula well, the baby continued to cry excessively and had loose, foul-smelling stools. On the advice of her physician, she was changed to a soy-based formula, which she again took eagerly.

INDEX OF SUSPICION

1995 ◽  
Vol 16 (9) ◽  
pp. 349-351
Author(s):  
Sanjiv B. Amin ◽  
Jeffrey M. Devries ◽  
Patricia McQuilkin ◽  
Nathalie Quion ◽  
Thomas G. DeWitt
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Chest Pain ◽  
Early Diagnosis ◽  
Physical Examination ◽  
Respiratory Rate ◽  
General Pediatrician ◽  
Difficulty Breathing ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 15-year-old girl comes to your office complaining that she has experienced intermittent, sudden episodes of chest pain, fatigue, palpitations, and sensations of difficulty breathing and lightheadedness for 2 months. These episodes occur several times daily and are unaccompanied by other symptoms such as syncope, wheezing, swelling of the extremities, or fever. She denies being worried, but reports that her parents are very frightened because a 16-year-old male cousin died recently while playing soccer, and two other relatives, a 27-year-old cousin and a 29-year-old uncle, died suddenly during exercise. The physical examination reveals a somewhat anxious girl complaining of mild precordial chest pain. Her temperature is 36.9°C(98.4°F) orally, respiratory rate is 16 breaths/min, heart rate is 110 beats/min, and blood pressure is 100/60 mm Hg; weight and height are at the 75th percentile.

Sign in / Sign up

Export Citation Format

Share Document