INDEX OF SUSPICION

1993 ◽  
Vol 14 (4) ◽  
pp. 155-157
Author(s):  
Juan A. Rivera ◽  
Bruce Taubman ◽  
Christine M. Walsh-Kelly
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Cholesterol Level ◽  
Urine Culture ◽  
Blood Chemistry ◽  
Recent History ◽  
History Of ◽  
Normal Urine ◽  
Case Presentations ◽  
Soft Stool

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 12-year-old girl is brought to you by her grandmother with a variety of complaints. The child has been overweight all of her life, and she tends to be constipated. She describes recurrent, colicky mid-abdominal pain after eating fatty meals and has had recurrent bouts of vomiting associated with cough and hiccups dating back to her infancy. There is no recent history of fever, asthma, or jaundice. On examination, the girl is obese, weighing 105 kg (231 lb). Chest and abdominal examinations are normal, with no masses or organomegaly. No focal tenderness is demonstrated. Formed soft stool is noted on rectal examination; the stool is hemocultnegative. Urinalysis is normal; urine culture is negative. The results of screening blood chemistry tests are normal except for a cholesterol level of 267 mg/dL and triglycerides of 280 mg/dL.

INDEX OF SUSPICION

1995 ◽  
Vol 16 (3) ◽  
pp. 117-119
Author(s):  
Randy Cron ◽  
Laurette Ho ◽  
Bradley Bradford
Keyword(s):  
Early Diagnosis ◽  
External Genitalia ◽  
Low Grade ◽  
Palpable Mass ◽  
Pelvic Ultrasonography ◽  
Distended Bladder ◽  
Focus Of Infection ◽  
History Of ◽  
Case Presentations ◽  
Free Area

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 previously healthy 6-month-old girl is seen at the office for evaluation of fussiness and infrequent urination. The child has not voided in the past 9 hours despite her usual fluid intake. She is afebrile, with no focus of infection found on careful physical examination. A palpable mass is felt in the suprapubic area. Her external genitalia are normal. Renal and pelvic ultrasonography reveal an echo-free area superior to a normal lower renal ureteral segment on the left side, with a circular echo free area at the lower end of the ureter extending into and taking up about one quarter of the space within a distended bladder. Case 2 Presentation A 4-year-old boy is seen in your office with a 4-day history of sore throat and low-grade fever.

INDEX OF SUSPICION

1992 ◽  
Vol 13 (11) ◽  
pp. 435-437
Author(s):  
Summer Smith ◽  
John L. Green ◽  
Susan K Lynch ◽  
Mark J. Polak
Keyword(s):  
Early Diagnosis ◽  
Physical Exertion ◽  
Tanner Stage ◽  
Pubic Hair ◽  
Acting Out ◽  
History Of ◽  
Prolonged Fatigue ◽  
Axillary Hair ◽  
Case Presentations ◽  
Diagnosed Diabetes

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 17-year-old boy is admitted to the hospital for evaluation and management of recently diagnosed diabetes mellitus. His mother expresses concern about his acting-out behavior and about frequent difficulties in drinking from a glass due to tremors. On examination he is found to be 68.5 inches tall, and he has a mild scoliosis. Evaluation of sexual development reveals axillary hair at Tanner stage III, pubic hair at stage V, penile length of 8 cm, left testicular volume of 3.0 x 1.8 cm, and an undescended right testicle. No breast tissue is palpable. Case 2 Presentation A 16-year-old girl is seen at your office with a history of prolonged fatigue and weakness. She has missed school frequently over the past 4 to 5 months, having had many vague complaints of "no energy," headaches, sore throats, aching knees, and the feeling that she will almost "pass out" if she does gymnastics or physical exertion of any kind.

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

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

1996 ◽  
Vol 17 (3) ◽  
pp. 99-101
Author(s):  
Whitney C. Edwards ◽  
Rubia Khalak ◽  
Robert Gadawski ◽  
Franz E. Babl ◽  
Jeffrey S. Hyams ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Blood Cell ◽  
Community Hospital ◽  
Liver Enzymes ◽  
Blood Cell Count ◽  
Abdominal Ultrasonography ◽  
Pediatric Clinic ◽  
Case Presentations ◽  
Hands And Feet

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 boy is seen in the pediatric clinic. He has been ill for 3 weeks with fever, pharyngitis, and rash. Diagnosed as having streptococal pharyngitis and scarlet fever, he was treated with antibiotics without relief. Ten days ago, he developed vomiting, diarrhea, and right-sided abdominal pain. When given paregoric, his vomiting worsened. Six days ago he was admitted to a community hospital for treatment of dehydration. During his 3-day admission, his white blood cell count and his liver enzymes were elevated. At the time of discharge, he was no longer vomiting, but he had blisters on his hands and feet. Two days ago, the vomiting, diarrhea, and abdominal pain recurred. Findings on abdominal ultrasonography were normal.

INDEX OF SUSPICION

1996 ◽  
Vol 17 (8) ◽  
pp. 291-294
Author(s):  
J. Peter Harris ◽  
Carol J. Buzzard ◽  
Liliana D. Gutierrez ◽  
Franz E. Babl ◽  
Susan K Ratzan
Keyword(s):  
Early Diagnosis ◽  
Good Health ◽  
Left Shoulder ◽  
High School Senior ◽  
Left Chest ◽  
School Senior ◽  
History Of ◽  
Female High School ◽  
Case Presentations ◽  
The Right

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 While driving to work, a 17-year-old female high school senior who has been in good health has an abrupt syncopal episode resulting in a headon collision at 40 miles per hour. She is alert and oriented right after the accident, but complains of sternal pain as well as pain in her left chest, left shoulder, and the right side of her jaw. Evaluation in the emergency department reveals slight tachypnea of 26 breaths/min, blood pressure of 90/60 mm Hg, a midsternal abrasion, a left pneumothorax, and nondisplaced fractures of the left clavicle and right mandible. Results of her neurologic examination, including mental status, are normal. She denies the use of any medication, street drugs, or alcohol, but she does report a 9-month history of brief spells of lightheadedness, diaphoresis, nausea, and visual blackouts, with one previous episode proceeding to complete syncope.

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.

scholarly journals Perforated Appendicitis with Appendicular Abscess

2017 ◽  
Vol 8 (1) ◽  
pp. 73-75
Author(s):  
Md Tahminur Rahman ◽  
Abdus Salam Arif ◽  
Md Abdul Wohab Khan ◽  
Mumtahina Setu ◽  
Md Imam Shafique ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Acute Appendicitis ◽  
Perforated Appendicitis ◽  
Signs And Symptoms ◽  
College Hospital ◽  
Medical College ◽  
Paediatric Department ◽  
Life Threatening ◽  
History Of

Most patients with acute appendicitis can be easily diagnosed, but there are many in whom the signs and symptoms are quite variable, and a firm clinical diagnosis is often very difficult to establish. Difficulties in the early diagnosis of appendicitis, particularly in children, often lead to life threatening complications, such as gangrene or perforation of the appendix. Here we report a case where a nine-year-old boy presented to the Paediatric Department at Anwer Khan Modern Medical College Hospital in Dhaka in April 2016 with a history of abdominal pain, vomiting & fever that began nine days before admission.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 73-75

INDEX OF SUSPICION

1992 ◽  
Vol 13 (10) ◽  
pp. 391-393
Author(s):  
Geeta Berera ◽  
Robert H. Dixon ◽  
Willaim J. Koenig
Keyword(s):  
Weight Gain ◽  
Early Diagnosis ◽  
Nasal Congestion ◽  
Normal Serum ◽  
Past Medical History ◽  
Recurrent Vomiting ◽  
History Of ◽  
Case Presentations ◽  
Poor Weight Gain ◽  
Normal Serum Sodium

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 24-mo-old boy is seen with a 2-d history of cough and fever. His past medical history includes recurrent vomiting and poor weight gain since 3 mo of age, and he has been hospitalized five times for dehydration. The child sat independently at 7 mo of age but is not yet walking. On examination, he appears to be small and thin and is irritable. His temperature is 39.5°C(103.1°F), pulse is 150 beats/mm, and respiratory rate is 35 breaths/mm. The child's height, weight, and head circumference are all below the 5th percentile, but proportional. Except for nasal congestion and mild dehydration, the remainder of his examination is normal. Serum sodium is 140 mEq/L, potassium 3.5 mEq/L, chloride 117 mEq/L, and bicarbonate 11 mEq/L.

INDEX OF SUSPICION

1993 ◽  
Vol 14 (3) ◽  
pp. 117-119
Author(s):  
Vincent J. Menna ◽  
Summer Smith ◽  
Gregory S. Liptak
Keyword(s):  
Early Diagnosis ◽  
Blood Count ◽  
Complete Blood Count ◽  
Hip Pain ◽  
Physical Finding ◽  
The Past ◽  
History Of ◽  
Gag Reflex ◽  
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 and discussions. Case 1 Presentation A 2-month-old breast-fed boy is brought to the office with a 2-day history of constipation, poor feeding, lethargy, wheezing, and a temperature of 101°F (38.3°C). In the office his temperature is recorded at 98.8°F (37.1°C) rectally. The infant does not appear lethargic, and the only significant physical finding is tearing of the left eye. Because of the history of fever, a complete blood count is obtained, which is normal. The infant is discharged home with a diagnosis of conjunctivitis and possible viremia. He returns within 48 hours and is found to be hypotonic with a poor gag reflex, weak suck, and weak cry. Despite his normal temperature a septic evaluation is initiated. Case 2 Presentation A 17-year-old boy complains of bilateral hip pain that has bothered him for the past year.

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