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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 […]

Hot Seat #234

A 17-day old female presents with a rash that started one week ago. The rash initially started on her back and then spread to her arms and chest. She was seen by her PCP and was given mupirocin, which has somewhat helped the rash. Two days ago, she developed an increasingly large “bump” on the […]

Hot Seat #233: Head Over Wheels

Case by Brandon Ho MD, Children’s National PEM Fellow An 11-year-old female presents with her mother with concern for wound infection. Three days ago, she was un-helmeted and fell off her bicycle and struck her head on the ground sustaining a forehead laceration. The mother states that patient initially blacked out for ~5 sec and […]