Author: Brandon Ho

Case by Steven Garbin MD, INOVA PEM Fellow An 11-month-old girl with a history of Diamond-Blackfan anemia presents with fever, a left-sided neck mass, and trouble breathing. The patient’s mother reports the child developed a fever 1-2 days ago (Tmax 101F) for which they have been giving regular antipyretics. Last night she noticed a bump […]

Case by Christina Rojas MD, Children’s National PEM Fellow A 4-year-old male with a history of ITP presents with vomiting and increased sleepiness. His mother reports that he had three days of nasal congestion, and then today had 4 episodes of NBNB emesis. This morning, he seemed more sleepy than usual, however was still responding […]

Case by Jessica Williams MD, Children’s National PEM Fellow 18 yo female presents with cough for the past 2 weeks now complaining of shortness of breath for the past 2 days. She also endorses tactile fever for the past 2 days. No vomiting but feeling nauseous. Normal urine and stool output. Up to date on […]

This week’s case focused on a child with fluctuating apnea and altered mental status ultimately found to be due to ingestion of marijuana. The diagnostic dilemmas centered on the appropriate respiratory support and decision to perform a lumbar puncture. The differential for unexplained periodic apnea and AMS is quite broad covering a range of neurological, […]

Case by Seth Gerard MD, INOVA PEM Fellow A 2-year-old previously healthy male presents to the ED with approximately 3 hours of altered mental status and twitching. Started with altered mental status at around 10:15, and was noted to also have significant jerking movements and intermittent agitation. Family adamantly denies any recreational drug use or […]