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


     


Click here for Index of Suspicion Suggested Reading Lists Data Supplement
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Suggested Reading Lists
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 Absi, M. A.-A.
Right arrow Articles by Pane, L. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Absi, M. A.-A.
Right arrow Articles by Pane, L. A.

(Pediatrics in Review. 2008;29:61-66.)
© 2008 American Academy of Pediatrics

Index of Suspicion

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


   Case 1 Presentation
 
A 16-year-old boy is seen in the ED with a history of headache, blurred vision, and proptosis of his right eye. One week ago, he described his right eye as feeling "a little bigger than the left." His primary care physician prescribed antibiotic eye drops. Two days ago, the boy developed frontal headache, blurred vision, and visible prominence of his right eye. He denies any history of trauma or fever.

Physical examination shows a temperature of 99.1°F (37.3°C), a respiratory rate of 18 breaths/min, a heart rate of 86 beats/min, and a blood pressure of 110/80 mmHg. His right eye demonstrates significant proptosis and partial ptosis. Extraocular movements are limited, especially on right lateral gaze. Both conjunctivae and sclerae appear normal. The right side of his face and cheek are slightly swollen. The right pupil is approximately 5 mm and the left approximately 3 mm in diameter. No red reflex is noted in the right eye, and the afferent pupillary reflex is absent in the right eye but intact in the left eye. His visual acuity is 20/200 in the right eye (OD) and 20/25 in the left eye (OS); they were 20/40 OD and 20/25 OS 6 months ago. All other cranial nerves appear intact.

Initial laboratory results are a WBC count of 13.6x103/mcL (13.6x109/L), with 77% neutrophils and 17.3% lymphocytes, and Hgb of 14.7 g/dL (147 g/L). Urinalysis results and serum electrolyte concentrations are normal. An imaging study reveals the diagnosis.


   Case 2 Presentation
 
A 15-year-old girl comes to the ED because of erythematous and tender nodules on the soles of both feet. Stating that the pain has an intensity of 10 on a scale of 10, she is unable to walk or bear weight on either foot. Her temperature today has been 102°F (38.9°C). . . . [Full Text of this Article]


Mohammed Alsheikh-Ali Absi, MD
Lin Lin Kin, MD
Antoin Hanna, MD
 Lincoln Medical and Mental Health Center, Bronx, NY

Gretchen Matthews, MD
Chad K. Brands, MD
Kimberly Kortuem, MD
Mark Davis, MD
 Mayo Clinic College of Medicine, Rochester, Minn

Laurie A. Pane, MD
 Children's National Medical Center, Washington, DC

Click here for Index of Suspicion Suggested Reading Lists Data Supplement




HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
Pediatrics Pediatrics in Review
Copyright © 2008 by the American Academy of Pediatrics.