Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
Article

Index of Suspicion

Pediatrics in Review February 2004, 25 (2) 68-73; DOI: https://doi.org/10.1542/pir.25-2-68
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Case 1 Presentation

A 4-year-old boy has had 6 days of intermittent nausea and vomiting without diarrhea or fever. Two days into the illness, he was given promethazine suppositories for presumed viral gastroenteritis; overnight the vomiting subsided. He now experiences an unsteady gait and needs help to stand still for urination. He says that he sees “two daddies.” There has been no weight loss, headache, mental status changes, upper respiratory tract symptoms, skin lesions, or trauma.

On physical examination, his weight, height, and head circumference are appropriate for age. His vital signs are normal, and he appears comfortable, talkative, and playful, although slightly pale. His abdomen is soft and nontender with normoactive bowel sounds. He has a well-healed scar resulting from pyloromyotomy in the first postnatal month. Despite the acute history of ataxia and diplopia, a thorough neurologic evaluation reveals normal findings, as does the rest of the examination.

An imaging study reveals the cause of his vomiting, ataxia, and diplopia.

Case 2 Presentation

A 15-year-old girl who experienced menarche at age 13 years has had no menstrual periods for 7 months. Her only symptom is an occasional headache occurring at the end of the day. She denies sexual activity, medication use, and substance abuse and has had no recent weight change, heat or cold intolerance, skin or hair problems, difficulties with vision, or fainting. The patient’s family history includes a granduncle who has acromegaly.

On physical examination, she looks well. Her height is in the 50th percentile, weight is in the 75th percentile, blood pressure is 113/62 mm Hg, and pulse is 90 beats/min. Her skin is not flushed or dry, and she has no rashes or abnormalities of hair pattern or hirsutism. Extraocular movements, visual fields by confrontation, and pupils all are normal. Heart, lung, abdominal, and neurologic examinations yield normal findings. Breasts and …

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics in Review: 25 (2)
Pediatrics in Review
Vol. 25, Issue 2
1 Feb 2004
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Index of Suspicion
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Index of Suspicion
Pediatrics in Review Feb 2004, 25 (2) 68-73; DOI: 10.1542/pir.25-2-68

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Index of Suspicion
Pediatrics in Review Feb 2004, 25 (2) 68-73; DOI: 10.1542/pir.25-2-68
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Case 1 Presentation
    • Case 2 Presentation
    • Case 3 Presentation
    • Case 1 Discussion
    • Case 2 Discussion
    • Case 3 Discussion
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Review of Scabies Infestation and Selected Common Cutaneous Infections
  • Pediatric Ingestions: New High-Risk Household Hazards
  • Iron Deficiency: Implications Before Anemia
Show more Article

Similar Articles

Subjects

  • Gynecology
    • Gynecology
  • Journal Info
  • Editorial Board
  • ABP Content Specifications Map
  • Overview
  • Licensing Information
  • Authors
  • Author Guidelines
  • Submit My Manuscript
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
American Academy of Pediatrics

© 2021 American Academy of Pediatrics