Contemporary Pediatrics Cases

Boy’s lymphadenopathy leads to acute heart failureYou are the night float senior on inpatient hospital service when you receive a transfer from an outside hospital of a 5-year-old Hispanic male who presented with 2 days of fever, unilateral neck swelling with torticollis, and neck pain.
Curious yellow bumps on a baby’s heelsThe parents of a healthy 12-month-old girl are worried about yellow bumps that have been present on the baby’s heels for 7 months.
Six-year-old boy refuses to ambulateA 6-year-old boy presents to the emergency department (ED) with left hip pain and refusal to ambulate.
Infant’s growing birthmark causes blurry visionYou are asked to see a healthy 3-month-old boy with a rapidly growing lump on his left upper eyelid.
Infant’s diaper hides anogenital lesionsYou are asked to evaluate a healthy 6-month-old boy who has had 5 nonerythematous papules in the right groin area for 2 months.
Child with fever after foreign travelYou are on call as a local pediatric infectious disease physician and receive a message from a colleague at a nearby primary care clinic. A 10-year-old boy is being referred to you for persistent fever and intermittent dry cough that began 4 weeks ago after a week spent visiting family in Karachi, Pakistan.
Blistering eruptions target an 8-year-old girlThe worried parents of an 8-year-old girl bring her to your office late Friday afternoon for evaluation of a generalized, rapidly progressive, blistering eruption that started 24 hours earlier.
Unremitting rash, neck masses complicate toddler’s diagnosisA 2-year-old boy presents to the emergency department with a persistent pruritic rash and a 4-week history of enlarging, tender, bilateral anterior and posterior cervical neck masses. The patient is eating and drinking normally, and he is able to breathe comfortably. He has not developed a hoarse voice, excessive drooling, or facial swelling. The family has no pets, history of foreign travel, or exposure to tuberculosis.
Posttraumatic lesion persists on child’s forearmA worried mother brings her 2-year-old boy to your office for evaluation of an asymptomatic skin eruption that has been present for 2 months. The lesion developed 6 months after he sustained an abrasion to the same site when he fell on concrete steps.