Case Presentation: A 13 day-old term male presented in the summer with one day of fever and irritability. Prenatal course and delivery were normal. On initial exam he was febrile and irritable but easily consoled. Blood, urine, and cerebrospinal fluid (CSF) bacterial cultures were obtained, and cefepime and ampicillin were started. CSF had no organisms [...]

Case Presentation: An 11-year-old obese male of Micronesian descent presented with a pruritic bullous rash and bilateral lower extremity pain. Scattered non-blanching purpura started on both ankles 10 days prior and spread to his legs, back and arms accompanied by bilateral leg pain and intense pruritus. Four days prior to presentation, blisters to legs and [...]

Case Presentation: A 4-year-old presented with persistent fever, headache and vomiting. History was significant for a 5 day febrile illness 1 month earlier and a family history positive for late-onset rheumatoid arthritis in a maternal grandparent. Parents reported that 4 days following resolution of the illness, his fever (up to 104F) recurred and persisted daily [...]

Case Presentation: A fifteen-year-old previously healthy male presented with one and a half months of intermittent right upper quadrant pain with one month of decreased appetite and weight loss. He was followed by his primary care physician who initiated an outpatient workup approximately two weeks into his disease course. A CT scan of the abdomen [...]

Case Presentation: 9 year old girl presented with progressively worsening severe abdominal pain, vomiting, headache, difficulty walking, and confusion for 3 weeks. At age 5 and 7 yrs, she presented with nearly identical symptoms and was diagnosed with ADEM each time. After both episodes she returned to baseline without any residual neurological deficits. CSF studies [...]

Case Presentation: A 19-year-old Hispanic man presented with 3 weeks of worsening right frontal headache associated with blurred vision and protrusion of right eye. Exam was significant for right eye proptosis with restricted upward gaze. Head CT revealed extensive sinus inflammation with erosion of the right maxillary and sphenoid sinuses and extension into the right [...]

Case Presentation: A 7-month-old former term female with congenital hypothyroidism was admitted for the third time with a diagnosis of bronchiolitis. Her first admission at 7 weeks of age involved an ICU stay requiring intubation and chest tube placement after a chest X-ray showed a right tension pneumothorax. She suffered no other major complications and [...]

Case Presentation: A 17-year-old male presented with 1 month of intractable hiccups, disturbing his sleep, and right-sided paresthesias, starting in his right upper extremity, localized to the 4th and 5th digits, then gradually spread to his bilateral lower extremities. He denied heavy lifting, fever, muscle weakness, back pain, or bladder/bowel incontinence. He first presented to [...]

Case Presentation: A 21-month-old male with failure to thrive (FTT) presents to the ED with fever and poor oral intake. On exam, he was irritable but consolable, tachycardic with clear lung fields and no murmurs. CBC was within normal limits; electrolytes showed an anion gap metabolic acidosis attributed to dehydration. He was admitted to the [...]

Case Presentation: A 3-year-old girl with history of recurrent otitis presented with 2 weeks of gait instability. Her family reported sudden onset of ataxic gait, requiring assistance with balance while ambulating. She had a preceding illness with congestion and dry cough for which she was started on a 10-day course of Amoxicillin by her primary [...]