Contemporary Pediatrics Cases

Pearl-like mass on a girl’s tympanic membraneDuring a routine office visit for mild acute nasal congestion and possible diminished hearing, an isolated, small, pearl-like mass was noted just posterior to the umbo of the left tympanic membrane of a 5-year-old girl.
Hyperpigmentation around a teen’s eyeAn adolescent girl is referred by her pediatrician to dermatology for evaluation of a birthmark on her face.
Boy with fever, cough, and oral lesionsA previously healthy, 16-year-old Hispanic boy initially presents to the clinic with a 5-day history of tactile fevers, achy malaise, congestion, and a dry cough. He was afebrile with negative rapid strep and monospot tests, but was prescribed fluticasone, benzonatate, and ibuprofen for a presumed upper respiratory infection. He was encouraged to return if symptoms did not improve.
Hypothermia and emesis in a newbornThe patient, a 7-day-old, small-for-gestational-age female (birth weight, 2.21 kg), born by vaginal delivery at 37 weeks to a G1P0 mother, presented to the pediatric emergency department for hypothermia and emesis at the recommendation of her pediatrician.
Vesicular rash in an infant with eczemaThe parents of a healthy 6-month-old boy with eczema bring him to the office for evaluation of a rapidly progressive rash on his arms, legs, face, and back. He had a low-grade fever and loose stools for 2 days last week.
Toddler with lesions on cheeks, ears, and armsAlarmed parents bring their healthy 14-month-old son to the office for evaluation of a rash that appeared on his face and arms 3 days ago. He had a fever and runny nose at that time, but the fever has since resolved and he is behaving normally.
Neonate with acute respiratory distressAfter an otherwise normal pregnancy, a male infant was born at 37 weeks gestational age via emergency cesarean delivery for decreased or absent fetal movement with multiple late and variable heart rate decelerations.
Infant’s finger has a fast-growing noduleAnxious parents of a healthy 4-month-old boy come to the office for an urgent consultation for a pink nodule on the baby’s fifth finger that has doubled in size over the last month.
Shortness of breath in a teenaged girlA previously healthy, 16-year-old Guatemalan girl presents to the emergency department (ED) with a 1-month history of dyspnea on exertion.
Unusual skin lesion in a teenaged boyThe mother of a healthy 15-year-old boy brings him to the office for evaluation of a darkening hairy patch on his left upper chest and shoulder.