A 4-month-old girl arrives at the clinic for a well-child visit. Her mother voices concerns about the infant’s poor weight gain, slow feeding habits, and physical delays such as head lag, poor grasp reflex, and rolling over.
A 22-month-old African American boy born at 38 weeks by normal vaginal delivery presents to a local hospital from a private pediatric office for failure to thrive. He was seen by his pediatrician until aged 1 month but was lost to follow-up. His delay in walking prompted his mother to reestablish care at age 22 months.
A 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.