feverA 4-week-old boy with tactile fever for the past 24 hours and fussiness of 2 weeks’ duration is referred to the emergency department (ED).
Aplasia Cutis Congenita<p><a href="/sites/default/files/images/baby%20mid%203_0.png" class="image"><img src="/sites/default/files/transfer/baby_mid_3_thumb.png" style="float: left; margin-left: 8px; margin-right: 8px; border: 1px solid black;" class="image" height="103" width="150"></a>A baby boy born after normal vaginal delivery at 36 weeks' gestation was noted to have a distinct abdominal wall lesion. Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. Weight was 2300 g. The infant appeared well-nourished and nondysmorphic.</p>
Tinea Faciei<p><img src="/sites/default/files/transfer/Tinea_Faciei.jpg" style="border: 1px solid black; margin-left: 8px; margin-right: 8px; float: left;" height="108" width="150">A 7-year-old boy was brought for evaluation of a rash on the chin that had appeared 2 weeks earlier. It was slightly itchy. The mother had applied a topical corticosteroid for a few days but then stopped because of worsening of the lesion. The erythematous, scaly lesion with a well-defined border on this boy’s face is characteristic of tinea faciei.</p>
Molluscum Contagiosum<p><img src="/sites/default/files/transfer/Molluscum_Contagiosum.jpg" style="border: 1px solid black; margin-left: 8px; margin-right: 8px; float: left;" height="114" width="150">Despite curettage several months earlier, the facial rash on this 4-year-old boy had spread across both cheeks and was now mildly pruritic. These discrete, smooth, pearly or flesh-colored, dome-shaped papules with central umbilication are characteristic of molluscum contagiosum.</p><p> </p>
Articles You Don’t Want To Miss<p>Hypercholesterolemia, atherosclerosis, and coronary artery disease are ever-growing problems in our society. While these “adult” medical issues rarely concerned pediatricians in the past, it is now well recognized that these troublesome processes begin in childhood. In 2008, the American Academy of Pediatrics (AAP) called on pediatric providers to screen for high cholesterol levels in children and teens who had a family member with coronary artery disease before age 55 years; a parent with a history of hypercholesterolemia; an unknown family history; or risk factors, such as obesity and hypertension.<sup>1</sup> However, a recent study by Ritchie and colleagues<sup>2</sup> indicates that this selective screening may be missing affected children.</p>
Sharpen Your Physical Diagnostic Skills<p><img src="/sites/default/files/transfer/CONGENITAL_FACIAL2.jpg" style="float: left; margin-left: 8px; margin-right: 8px; border: black 1px solid;" height="146" width="150">This 1-week-old baby boy was brought for his first newborn visit. The parents were concerned that when he cried, the left side of his face “does not move.” He was born at full term via normal vaginal delivery to a primigravida without complications.</p>
Uncontrollable ChildIt is estimated that about 20% of children and adolescents meet criteria for a mental health disorder, and a high percentage of these youths are impaired by disruptive behavior problems.
Phobia<p>I have a 13-month-old male patient who has been in good health. He was born at 32 weeks’ gestation but basically grew well and was discharged 10 days after birth. His development has been normal. His mother used oxycodone/acetaminophen during pregnancy for colic from recurrent kidney stones. The parents complain that their son screams very loudly when in his car seat, and they are unable to concentrate on driving. He cries so loudly that he is heard by passengers in other vehicles, despite having the windows up.</p>
Sharpen Your Physical Diagnostic Skills<P><IMG style="BORDER-BOTTOM: black 1px solid; BORDER-LEFT: black 1px solid; FLOAT: left; MARGIN-LEFT: 8px; BORDER-TOP: black 1px solid; MARGIN-RIGHT: 8px; BORDER-RIGHT: black 1px solid" src="/sites/default/files/transfer/xray10yroldgrl.jpg" width=150 height=208>A 10-year-old girl had pain in her left arm after falling off a bunk bed 4 days earlier. She denied fevers or other trauma. Since the fall, she had had difficulty in bearing weight on the arm. Her medical and family histories were unremarkable.</P>