Pediatric emergency care
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Pediatric emergency care · Aug 2017
Case ReportsListeria Meningitis in an Immunocompetent Child: A Case Report.
Listeria monocytogenes is a facultative anerobic, gram-positive bacillus that is isolated from the soil, vegetables, and wild or domestic animals. Listeria infection is usually found in the older adults, immunocompromised patients, pregnant women, and newborns, whereas it is rare in healthy infants and children. ⋯ Complications such as acute hydrocephalus, brain abscess, and spine abscess can develop, and the mortality associated with listeriosis is significantly high. We present a case of a previously healthy 7-year-old boy who developed Listeria monocytogenes meningitis.
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Pediatric emergency care · Aug 2017
Ketamine Abuse Syndrome: Hepatobiliary and Urinary Pathology Among Adolescents in Flushing, NY.
Ketamine is a recreational drug widely abused in East Asia and also in certain subpopulations of the United States. Many US clinicians are unaware of abuse symptoms, leading to misdiagnosis and missed opportunities for intervention. We will discuss clinical patterns that should alert a clinician to the possibility of ketamine abuse. ⋯ Ketamine abuse is associated with a distinctive pattern of symptoms involving the urinary and hepatobiliary systems.
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Pediatric emergency care · Aug 2017
Case ReportsSevere Infant Rash Resistant to Therapy Due to Zinc Deficiency: A Case Report.
Pediatric skin diseases are a common presenting complaint to emergency medicine physicians but often pose a significant diagnostic challenge. Skin eruptions that are unusually severe for the diagnosis in question, lasting beyond the typical time of resolution, or not responding to conventional therapy should raise concern of a misdiagnosis. We present the case of a severe rash not responding to conventional atopic dermatitis therapy that led to a diagnosis of transient neonatal zinc deficiency. Clinicians caring for children should be aware of zinc deficiency and its corresponding clinical presentation, because it is readily treatable and may lead to the avoidance of unnecessary treatments and prevention of serious complications.
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Pediatric emergency care · Aug 2017
Missed Fractures in Infants Presenting to the Emergency Department With Fussiness.
The aim of this study was to evaluate incidence of prior fussy emergency visits in infants with subsequently diagnosed fractures suggestive of abuse. ⋯ Fractures concerning for child abuse are an important cause of unexplained fussiness in infants presenting to the pediatric ED. A high index of suspicion is essential for prompt diagnosis and likely prevention of other abuse.
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Pediatric emergency care · Aug 2017
Case ReportsA Curiously Rare Case of Septic Shock From Clostridium difficile Colitis.
This case provides the first report of a young healthy child presenting in septic shock from Clostridium difficile colitis. This child had no identifiable risk factors for C. difficile, raising the suspicion for a hypervirulent strain. Once infection was recognized and treated appropriately, the child made a full recovery. This case presentation highlights the need to consider C. difficile colitis in the differential diagnosis of severely ill patients, even in the absence of traditional risk factors or symptoms.