Author: Brian Lee

Discussion: There was a lot of discussion regarding disclosing adverse events to patients. All participants agreed that being forthcoming with families and patients is paramount. However, the nature of this patient’s situation (a possible error occurred outside of the emergency department, but while the patient was still under the care of an ED physician), is […]

Case Review: 6-week-old female with VP shunt (placed at another institution at birth) presents with reported persistent fever despite recent inpatient hospitalization during which no source of fever was identified. Here’s how you answered: Denouement: After an extensive discussion with neurosurgery, during which our concerns were emphasized (bandemia, elevated inflammatory markers in a recently placed […]

HPI: 6-week-old, ex-full-term girl with history of VP shunt for congenital hydrocephalus, g-tube dependence presents as a transfer from outside hospital for evaluation of fever. Unfortunately, she arrives with her grandfather (patients parents preferred to drive vs fly and are about 60 minutes away). Grandfather only knows that she has had fevers and was recently […]

Case Summary: 17-year-old female presenting with 1 week of persistently worsening headache, initially with benign exam but ultimately found to have cranial nerve abnormalities. Here’s how you answered: Denouement: Patient was admitted to the neurology service for MRI/MRA and pain control. MRA completed the next morning showed an aneurysm without evidence of hemorrhage. Patient was […]

The case: 10 week old, ex-36 week boy presenting as a repeat for 4 days of fever, who had received ceftriaxone 2 days ago as part of a fever work up Here how you answered: Discussion: This case prompted a very lively discussion and highlighted the spectrum of practice patterns across the group. Almost all […]