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Hot Seat #238: 6 year old with nausea and vomiting

Alicia Rolin MD, Children’s National Health Systemwith Haroon Shaukat MD, Children’s National Health System Patient is a 6-year-old male with autism spectrum disorder who presents with nausea and vomiting. Parents report that for the past 2-3 days he has been feeling unwell. Report tactile fevers and rigors. Has had multiple episodes of NBNB emesis. Decreased […]

Hot Seat #237: Tummy Time

A 6-year-old male fully vaccinated with no chronic medical conditions presents with abdominal pain and emesis for the past 48 hours.  Over the past year, the patient has had intermittent episodes of abdominal pain and emesis, typically self-resolving within a few hours. Two days ago, after eating, he developed intense abdominal pain and non-bloody but […]

Hot Seat #236: Short of Breath, What is the right test?

18-year-old female presents with cough for the past 2 weeks now complaining of shortness of breath for the past 2 days with tactile fevers. No vomiting but feeling nauseous. Normal urine and stool output. Up to date on immunizations. Cannot lie down flat because she has trouble breathing. Endorses dizziness and denies history of wheezing. […]

Hot Seat #235: H-O-T-T-O… Go home?

Case by Nicholas Dimenstein MD MPH, CNH PEM Fellow 20-month-old female presented with fever to 101.7.  Had been discharged from the hospital 6 days ago during which she had required ICU care for distributive shock and respiratory failure. She had received IVIG, ASA, Anakinra, and Infliximab for presumed KD vs MIS-C. Was discharged home on […]

Hot Seat #234 Denouement

This week’s case involved an afebrile well-appearing infant presenting with a pustular rash and a scalp abscess. The differential for the pustular rash included benign neonatal pustular melanosis, a common and self-limiting condition in neonates, however given the scalp abscess other bacterial skin infections could not be excluded. Although the infant was afebrile, all learners […]