Pediatrics in Review
HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     


Click here for Index of Suspicion Supplemental Data Data Supplement
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Supplemental Data
Right arrow Rapid Responses: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Rapid Responses are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pingul, M.
Right arrow Articles by Hollander, M. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pingul, M.
Right arrow Articles by Hollander, M. C.

(Pediatrics in Review. 2007;28:269-275.)
© 2007 American Academy of Pediatrics

Index of Suspicion

The first 300 words of the full text of this article appear below.


   Case 1 Presentation
 
A 13-year-old boy comes to clinic having a 3-day history of swelling and redness of his eyes with discharge as well as pain with eye movement for 1 day. Acute bacterial conjunctivitis had been diagnosed elsewhere and topical antibiotic eye drops prescribed.

Now he complains of inability to see with his right eye. In addition, he has had nonprojectile vomiting for 1 week and loose stools for 2 days, but no headache. He has had no fever, trauma, sick contacts, illicit drug use, polyuria, nocturia, or recent travel. He has gained 60 lb over the last 6 months despite normal activity. His grandparents have type 2 diabetes.

Physical examination reveals a cooperative, obese teen who has a temperature of 98.7°F (37.1°C), heart rate of 110 beats/min, respiratory rate of 20 breaths/min, and blood pressure of 161/85 mm Hg. There is slight ptosis of the right upper lid, with lower lid chemosis and bilateral subconjunctival hemorrhage, more prominent on the right. The corneae and lenses are clear, and pupils are equally reactive bilaterally. Horizontal extraocular muscle movement is limited due to pain, with vertical movements intact. The optic discs appear normal. Visual acuity is 20/200 in the right eye and 20/20 in the left.

His WBC count is 10x103/mcL (10x109/L), Hgb is 13 g/dL (130 g/L), Hct is 39% (0.39), and platelet count is 424x103/mcL (424x109/L). Electrolytes are within normal range. CT scan of the orbit is ordered, and an ophthalmologist is consulted.


   Case 2 Presentation
 
A 2-month-old infant girl is admitted to the hospital following 8 days of vomiting, diarrhea, and dehydration and is rehydrated intravenously. On day 2, a nurse notes a protrusion in the infant's neck when she cries.

Physical examination reveals an alert, vigorous infant in no distress. . . . [Full Text of this Article]


Mia Pingul, MD
Lopa Shah, MD
Scott Denton, MD
 University of Nevada School of Medicine, Las Vegas, Nev

Elizabeth Walenz, MD
Michael Weisgerber, MD
Stephen Conley, MD
 Children's Hospital of Wisconsin, Milwaukee, Wisc

Su-Ting T. Li, MD, MPH
 University of California Davis, Sacramento, Calif

Matthew C. Hollander, MD
 Wright-Patterson Air Force Base, Ohio

Click here for Index of Suspicion Supplemental Data Data Supplement




HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
Pediatrics Pediatrics in Review
Copyright © 2007 by the American Academy of Pediatrics.