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
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • 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
Index of Suspicion

Index of SuspicionCase 1: Hemoptysis, Dyspnea, and HematuriaCase 2: Rash and Headache in a WrestlerCase 3: Abdominal Distention in a Teenage Girl

Nathan D. Tofteland, Raegan Hunt, Therese L. Canares, Michelle Stuart-Hilgenfeld, Pranita Tamma, Morgen Yao-Cohen and Joanne Nazif
Pediatrics in Review November 2010, 31 (11) 477-482; DOI: https://doi.org/10.1542/pir.31-11-477
Nathan D. Tofteland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Raegan Hunt
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Therese L. Canares
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michelle Stuart-Hilgenfeld
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Pranita Tamma
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Morgen Yao-Cohen
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joanne Nazif
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • 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 previously healthy 12-year-old girl presents to the ED with a 2-week history of cough that is productive of blood-tinged sputum and dyspnea. She was admitted to the hospital 2 weeks ago, soon after her symptoms developed, and was treated with 10 days of antibiotics. After completing the course, she reported mild improvement and was discharged. However, over the past 3 days, she has felt significantly worse, with increased cough, appearance of blood in her sputum, malaise, subjective fever, chills, posttussive emesis, and intermittent brown-colored urine.

Physical examination reveals an ill-appearing girl whose axillary temperature is 37.6°C, heart rate is 120 beats/min, respiratory rate is 30 breaths/min, and oxygen saturation is 89% on 3 L oxygen per nasal cannula. She has tachypnea with coarse breath sounds bilaterally and inspiratory crackles in all lung fields. Musculoskeletal examination shows no findings of note. She does not have any oral ulcers, rash, or edema.

Laboratory results include WBC count of 17.4×103/mcL (17.4×109/L) with 93% neutrophils, Hgb of 7.8 g/dL (78 g/L), platelet count of 616×103/mcL (616×109/L), BUN of 27 mg/dL (9.6 mmol/L), and creatinine of 1.8 mg/dL (159.1 mcmol/L). Urinalysis shows trace leukocyte esterase, 2+ protein, and 3+ blood, with 5 to 10 WBCs/high power field (hpf), 10 to 20 RBCs/hpf, and granular casts. The serum concentrations of complement components 3 and 4 are normal. Chest radiograph reveals extensive, diffuse, bilateral interstitial and alveolar infiltrates (Fig. 1). Blood, urine, and sputum cultures are obtained and empiric antibiotics initiated. Additional investigations reveal the diagnosis.

Figure 1.

Chest radiograph showing extensive, diffuse, bilateral interstitial and alveolar infiltrates.

Case 2 Presentation

A 17-year-old boy presents with severe headache and progressive rash. He complains of chills, sore throat, anorexia, eye pain, and blurry vision. Before the onset of these symptoms, he was healthy 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.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics in Review: 31 (11)
Pediatrics in Review
Vol. 31, Issue 11
1 Nov 2010
  • Table of Contents
  • Table of Contents (PDF)
  • 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 SuspicionCase 1: Hemoptysis, Dyspnea, and HematuriaCase 2: Rash and Headache in a WrestlerCase 3: Abdominal Distention in a Teenage Girl
(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 SuspicionCase 1: Hemoptysis, Dyspnea, and HematuriaCase 2: Rash and Headache in a WrestlerCase 3: Abdominal Distention in a Teenage Girl
Nathan D. Tofteland, Raegan Hunt, Therese L. Canares, Michelle Stuart-Hilgenfeld, Pranita Tamma, Morgen Yao-Cohen, Joanne Nazif
Pediatrics in Review Nov 2010, 31 (11) 477-482; DOI: 10.1542/pir.31-11-477

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Index of SuspicionCase 1: Hemoptysis, Dyspnea, and HematuriaCase 2: Rash and Headache in a WrestlerCase 3: Abdominal Distention in a Teenage Girl
Nathan D. Tofteland, Raegan Hunt, Therese L. Canares, Michelle Stuart-Hilgenfeld, Pranita Tamma, Morgen Yao-Cohen, Joanne Nazif
Pediatrics in Review Nov 2010, 31 (11) 477-482; DOI: 10.1542/pir.31-11-477
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
    • Footnotes
    • Case 1 Discussion
    • Case 2 Discussion
    • References
    • 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

  • Previously Healthy 3-week-old Infant with Limited Right Arm Mobility
  • Dysphagia and Epigastric Pain in an Adolescent Boy
  • Refusal to Use an Upper Extremity in a 17-month-old with Facial Nerve Palsy
Show more Index of Suspicion

Similar Articles

Subjects

  • Nephrology
    • Nephrology
  • Pulmonology
    • Pulmonology
    • Respiratory Tract
  • Infectious Disease
    • Infectious Disease
  • Dermatology
    • Dermatology
  • 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