Case Presentation: A 7 year-old with hypohidrotic ectodermal dysplasia (ED) and recurrent sinusitis was admitted with diplopia, headaches, and fevers. In the preceding 2 months, he had multiple episodes of fever, nasal impetigo, and positive group A strep (GAS) throat swabs without pharyngitis. He was treated twice with azithromycin due to allergies to amoxicillin, cephalosporins, […]

Case Presentation: A previously healthy 5-year-old female was transferred to our facility for increasing respiratory distress in the setting of a COVID-19 infection with suspected secondary bacterial pneumonia. Approximately five days prior, she tested positive for COVID-19 after developing a cough. She was treated with supportive therapy until parents noticed her “breathing heavily.” At the […]

Case Presentation: A 14-year-old female with a history of hydrocephalus status-post ventriculoatrial (VA) shunt placement five years prior presented for acute lethargy characterized by difficulty waking her from sleep. Vital signs were T 36.6 C, pulse 72, respirations 20, BP 148/97, and SpO2 100% with exam notable for lethargy, spontaneous eye and limb movement, pupils […]

Case Presentation: KM is a 13-year-old woman with no past medical history who presented with 1 week of daily vomiting, epigastric abdominal pain, and body aches. On review of systems has also had fever to 100.7, decreased oral intake, shortness of breath with activity and intermittent diarrhea but no headache, sore throat, wheezing or rash. […]

Case Presentation: A 19-year-old male with history of VACTERL, end-stage kidney disease with kidney transplant 7 years prior, scoliosis with T8-L2 fusion 8 years prior, reversible posterior leukoencephalopathy syndrome (PRES), depression, and recent admission for suspected cannabinoid hyperemesis syndrome presented to the ED after a fall due to weakness, and recurrent nausea and vomiting.Physical exam […]

Case Presentation: A previously healthy, obese 15-year-old male presented to an ED in North Carolina with acute encephalopathy preceded by six days of flu-like symptoms with one day of diarrhea and cough. On presentation, he was febrile, tachycardic, tachypneic, with other vital signs normal. He was disoriented with slowed speech, inappropriate laughter, and delayed verbal […]

Case Presentation: A 14-year-old healthy male presented with throbbing, right sided abdominal pain, intermittent headache, and bilateral neck and shoulder pain in the setting of six days of fever (temperature max 103° F). He had a history of a normal endoscopy after elevated stool calprotectin that normalized without intervention. Exposure history was notable for freshwater […]

Case Presentation: A 17-year-old female with a past medical history of allergic rhinitis presents as transfer from an outside hospital for hemoptysis and chest pain. She reports three episodes of ¼ cup worth of bright red blood occurring within the last six months. No reported triggers and no history of trauma, smoking, vaping, lung or […]

Case Presentation: A 14-year-old male with autism spectrum disorder presented with history of 5 days of refusal to move and imbalance for 2 days, following diarrheal illness two weeks prior. On admission, he was tachycardic and hypertensive with dry mucous membranes. His neurologic exam was limited by agitation but demonstrated symmetric facies and 5/5 strength […]

Case Presentation: A 9 month old boy was brought to the emergency department for two day history of right arm edema and refusal to move his right arm. He began having rhinorrhea and cough earlier in the week then developed non-bloody diarrhea. During that time period he had fevers up to 102.5 that responded to […]