Case Presentation: A 39-year-old female with past medical history of multiple sclerosis and tobacco use presented to the emergency room with three days severe progressive abdominal pain and intermittent fever. She was found to be in septic shock, requiring vasopressor support. Laboratory analysis was notable for bandemia, acute kidney injury and lactic acidosis. Four days [...]

Case Presentation: A 33-year-old healthy male presented to Yale New Haven Hospital with a 3-week history of fevers up to 103°F, drenching night sweats, rigors, fatigue, mental fog, and 20lb weight loss accompanied by poor appetite. He denied recent travel or sick contacts. Recent outside hospital evaluation included negative blood cultures, Lyme Ab, EBV, hepatitis [...]

Case Presentation: A 14-year-old female with history of trisomy 21, hypothyroidism, chronic constipation, and recurrent ear infections presented for a right tympanostomy, during which she was noted to have abdominal distention. Her family reported progressive distension over the prior 2–3 months, which was attributed to constipation. Pediatric gastroenterology was consulted for suspected fecal impaction after [...]

Case Presentation: A partially vaccinated 8-year-old female presented with 1 week of recurrent spasms and choking episodes. Episodes occurred daily, and were characterized by gasping, choking, and body stiffening lasting 2-3 minutes, often waking her from sleep. Her family was unable to abort these episodes, and it was unclear whether she remained conscious during these [...]

Case Presentation: A 12-year-old female presented to the ED with 14 days of progressive forehead swelling following treatment for sinusitis and conjunctivitis. Four weeks earlier, she sought medical attention for forehead swelling and headache and completed a 10-day course of amoxicillin-clavulanate for left eye conjunctivitis and frontal sinusitis, with resolution of symptoms. 2 days prior [...]

Case Presentation: A previously healthy 8 month old unvaccinated and exclusively breastfed female presented with 24 hours of poor feeding, irritability and decreased urine output. Initial workup revealed mild leukocytosis, anion-gap metabolic acidosis, pyuria and ketonuria raising concern for dehydration and a possible urinary tract infection. Patient was admitted for intravenous hydration and empiric antibiotics. [...]

Case Presentation: Bartonella henselae classically presents in immunocompetent children as regional lymphadenopathy and fever following a cat bite or scratch. Atypical manifestations such as neuroretinitis and oculoglandular syndrome are well described, but sacral osteomyelitis is exceedingly rare. We report the case of a 4 year old male with fever, sacral pain and splenic lesions initially [...]

Case Presentation: We introduce a 17-year-old male with history of cholecystectomy two years prior, who presented to his pediatrician with transaminitis and hyperbilirubinemia. Workup revealed significant peripheral eosinophilia, along with elevated level of Immunoglobulin G (IgG). Autoimmune workup was significant for anti-smooth muscle antibodies and anti-neutrophil cytoplasmic antibodies (p-ANCA), but magnetic resonance cholangiopancreatography (MRCP) revealed [...]

Case Presentation: An 11-year-old male presented to ED with complaint of bifrontal headaches initially brief and infrequent but progressing to 12 episodes per day. Headaches were associated with photophobia, left eye twitching and redness of both eyes. Initially, the team suspected cluster headaches, and he started on supportive treatment. The workup revealed leukocytosis with normal [...]

Case Presentation: A 26-day-old girl born full term was transferred to our hospital due to persistent feeding intolerance, acute respiratory failure and hypotonia of unclear etiology. She initially presented at day-of-life (DOL) 19 with 4 days of worsening feeding difficulty, increasing lethargy, and new dyspnea. She had normal stools and no unusual exposures. CPAP support [...]