Pediatric emergency care
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Pediatric emergency care · Jul 2011
Case ReportsA case of functional asplenia and pneumococcal sepsis.
Asplenia may refer to the spleen's surgical removal, functional impairment, or congenital absence. It is a risk factor for the development of severe bacterial infection. Functional asplenia is likely the most common presentation of this entity and has many etiologies. ⋯ As lifetime mortality remains exceedingly high in the asplenic population regardless of etiology, markers of hyposplenism are important to detect. The present report describes an infant with trisomy 21 and previously undiagnosed functional asplenia who ultimately experienced overwhelming pneumococcal sepsis with features of Waterhouse-Friderichsen syndrome and died within 12 hours of initial presentation. It is a poignant reminder of what features to be cognizant of on peripheral blood smear in a previously well child, who may be at risk for a devastating consequence.
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Pediatric emergency care · Jul 2011
Case ReportsPediatric button battery and small magnet coingestion: two cases with different outcomes.
Ingestion of button batteries and ingestion of 2 or more small magnets have both been increasingly recognized as having high potential for injury. Coingestion of a button battery and a small magnet has only rarely been described but has the potential for both ischemic injury due to the tight magnetic adherence and the electric current injury from the button battery. We report 2 cases of button battery and small magnet coingestion; one required surgical repair of an important bowel injury, while the other had a benign course. We discuss the management and role of radiography in these cases and the potential factors to consider when predicting which patients will have serious injury and which will do well.
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Pediatric emergency care · Jul 2011
Case ReportsInfectious aortitis: a rare cause of chest pain in a child.
Infectious aortitis (IA) is a life-threatening bacterial infection that occurs almost exclusively in adults. Only 1 case of IA had been previously reported in a child. ⋯ She underwent a thorough evaluation but died of aortic rupture before the correct diagnosis was established. The etiology, clinical presentation, diagnosis, and treatment of IA are discussed.
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Pediatric emergency care · Jul 2011
The predictive value of a normal radiographic anterior fat pad sign following elbow trauma in children.
The purposes of this study were to describe the characteristics of a normal anterior fat pad (AFP) and to determine the association between a normal AFP and the absence of fracture. ⋯ Our data suggest that a normal AFP is highly associated with absence of elbow fracture and that the determination of a normal AFP can be aided by measuring the apical angle of the AFP.
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Rhabdomyolysis and compartment syndrome are rare but a limb-threatening complication of viral myositis. Because of the potential for severe consequences of compartment syndrome, clinicians should maintain a high index of suspicion when examining children with rhabdomyolysis due to viral myositis. We report a case of recurrent bilateral thigh compartment syndrome in a patient with influenza A, subtype pandemic H1N1-2009. ⋯ This is the first reported case of recurrent rhabdomyolysis and compartment syndrome as a complication of viral myositis. This case highlights the importance of maintaining a high index of suspicion for compartment syndrome in the child with viral myositis.