Case Presentation: A 5-year-old boy with autism and developmental delay presented to the emergency department with acute inability to ambulate following progressive lethargy and weakness. He was nonverbal at baseline with new developmental regression and diffuse peripheral hypotonia, limiting activities of daily living. Neuroimaging demonstrated thalamic hyperintensities consistent with thiamine- and pyridoxine-related encephalopathy. Diet history [...]

Case Presentation: A previously healthy 16-month-old girl presented to the emergency department with refusal to walk following a fall. She was lowering herself from a high bed when she fell backwards, hitting her buttocks and lower back without a head strike. Over the next couple days, the patient was fussy and less active. She refused [...]

Case Presentation: Two brothers aged 12 and 16 were referred to the ED from clinic for acute worsening of symptoms in the setting of known mercury exposure. In the preceding six months, both had experienced waxing and waning of non-specific symptoms, including musculoskeletal pain and paresthesias, urinary urgency, non-bloody diarrhea, body aches, night sweats, generalized [...]

Case Presentation: A previously healthy two-year-old male presented with six days of painless right ptosis, fever, cough, and nasal congestion. He had no ocular or head trauma. He had tried antihistamines without benefit. Non-contrast CT head showed only paranasal sinus disease. See Image 1.He was evaluated by Neurology and Ophthalmology and found to have complete [...]

Case Presentation: Six-year-old female ZT presented for evaluation of knee pain which turned into back pain after several weeks duration. ZT was initially seen in the outpatient setting for bilateral knee pain where she was sent home with supportive care. She then started developing body aches, falling, and difficulty standing despite home therapy. ZT was [...]

Case Presentation: A previously healthy 13-year-old female presented to a pediatric emergency department with 5 days of abdominal pain, emesis, headache, arthralgia, and fever. Vital signs included temperature of 100.2 F, heart rate of 122 beats/minute, normal blood pressure for age, and oxygen saturation of 99% on room air. She was ill appearing with bilateral [...]

Case Presentation: An exclusively breastfed 2-month-old male born at 31 weeks gestation presented with 10 days of progressively worsening rash over his face, genitalia, and right upper extremity. Prior to transfer, the patient had previously been treated for suspected impetigo with topical mupirocin, oral cephalexin, and IV cefazolin without improvement. Upon presentation, the patient was [...]

Case Presentation: A 9-year-old female presented with two months of hyperpigmented skin and stiffness mainly in her lower extremities. She had difficulty brushing her hair and walking accompanied by weight loss and dyspnea. On examination, diffuse hyperpigmentation and peau d’orange skin changes were observed with the “groove sign” on her right medial thigh. She also [...]

Case Presentation: Case Presentation: This is a 3 year old male who recently returned from two months traveling in Liberia. In Liberia, he contracted malaria and was treated with two days of IV antimalarial treatment (thought to be artesunate) followed by three days of oral artemether-lumefantrine with improvement in symptoms. Ten days after completing treatment, [...]

Case Presentation: A previously healthy, 7-year-old girl presented to the emergency department with intermittent episodes of achy abdominal and right-sided flank pain for one month. The patient’s mother endorsed pain severe enough to wake the patient from sleep, as well as occasional constipation, and an associated 12-lb weight loss over the previous six months. On [...]