Case Presentation: A 2-year-old girl with a past medical history of hypertension and anterior mediastinal mass of unclear etiology presents to the ED with acute bruising. 2 months prior, she was admitted to PICU for fever and lethargy, AKI, hyperuricemia and electrolyte abnormalities concerning for tumor lysis syndrome (TLS), and was found to have a [...]

Case Presentation: A 19-year-old female presented to a children’s hospital with a two week history of daily fever, diffuse abdominal tenderness, vomiting, diarrhea, and body aches, starting three weeks after her immigration from Kenya. Laboratory studies revealed pancytopenia, coagulopathy, low fibrinogen, pancreatitis, hepatitis, and elevations in D-dimer and inflammatory markers. Abdominal x-ray showed air-fluid levels. [...]

Case Presentation: 12-year-old girl presented with altered mental status, hypothermia, and bradycardia following one week of abdominal pain, progressive fatigue and flattened affect. Family denied ingestion, fever, cardiorespiratory symptoms, headaches or unusual exposures. Exam significant for Temperature 33.2 C, Heart Rate 42 bpm, sluggishly reactive pupils, disconjugate gaze, able to intermittently follow commands and localize [...]

Case Presentation: A previously healthy 13-year-old male presented with a chief complaint of lower back pain and rash for the past 3 weeks. Associated symptoms included profuse sweating and 10/10 lower back pain radiating to his legs that had progressed in severity with inability to ambulate. On additional questioning, other symptoms included nausea, vomiting, diffuse [...]

Case Presentation: A healthy 11-year old female presented with 5 days of fever, headache, and progressive symptoms that included blurry vision, photophobia, lightheadedness, nausea, and intermittent vomiting. Family history was positive for migraine headaches. On exam, she had pupils measuring 10 mm, blurry vision and loss of acuity, but no visual field deficits or pain [...]

Case Presentation: 21 month old male presents to the hospital for constipation that failed outpatient therapy. Parents describe one hard difficult to pass bowel movement (BM) every other day, without pencil thin stools, blood or mucus. Constipation began at 3 months of age when they introduced formula. He passed meconium within the 24 hours of [...]

Case Presentation: A 2-month-old male, born at 32 weeks, presented with nasal congestion, fever and respiratory distress requiring supplemental oxygen. Mother reported that he was hospitalized for bronchiolitis 2 weeks ago and was discharged home on oxygen. On admission CBC, CMP, UA, CSF studies, blood and urine culture were all normal. Chest X-Ray was consistent [...]

Case Presentation: An otherwise healthy 23-month-old girl presented to her pediatrician with several days of vomiting, abdominal pain, and decreased oral intake. She was found to have a Sodium of 128 mmol/L with mild transaminitis. She was admitted, treated IV fluid, had improvement in her sodium and oral intake and discharged after two days. She [...]

Case Presentation: A 14 y.o. male with acne presented to dermatology for follow up. Having failed multiple acne treatments he was started on isotretinoin. Approximately 6 weeks later he developed fatigue, non-purulent conjunctivitis, retrosternal chest pain associated with dyspnea, joint pains, and bilateral lower extremity muscle aches. He was evaluated by cardiology with normal cardiac [...]

Case Presentation: A 9 year old male with history of astrocytoma presented to the ED with a diffuse erythematous rash for 4 days and fever for 2 days. The rash was reportedly pruritic, began on his trunk, and then progressed to his extremities. It was associated with facial edema with periorbital prominence. Of note, temozolamide [...]