Case Presentation: 19 month old female with a history of unspecified T- cell immunodeficiency presented with a 10 day history of cough, fatigue, and persistent fevers. The patient had just returned from Mexico and reportedly was diagnosed with influenza there. Previously the patient had been on Bactrim prophylaxis, but ran out of it while in [...]

Case Presentation: A previously healthy 4-year-old female born in Mexico was sent to the emergency department for elevated blood pressures noted at her routine outpatient clinic visit. On arrival, her blood pressure was 161/126. The patient reported polydipsia, polyuria, and weight loss. Her initial physical exam was unremarkable and her vitals were otherwise within normal [...]

Case Presentation: A 17 y.o. female with systemic lupus erythematosus (SLE) presented with several weeks of worsening migratory polyarthralgia, as well as sporadic fevers, night sweats, and chills. Prednisone was begun 3 weeks prior for a presumed SLE flare, given elevated anti double-stranded DNA (anti-dsDNA) and erythrocyte sedimentation rate (ESR) and hematuria, but provided no [...]

Case Presentation: A 12-year-old Caucasian male with no significant medical history presented with a 6-day history of bilateral leg pain following a soccer game. As an avid soccer player, he had experienced similar episodes over the past three years, managed previously as “growing pains” with NSAIDs and acetaminophen. However, this presentation raised concern for an [...]

Case Presentation: A 57-day old ex-term, Caucasian female presented with one day of diffuse rash and fever in the setting of congestion and a sick sibling. Her rash was initially attributed to viral erythema multiforme. She was well-appearing but given vulnerable age and elevated band count, she was admitted for observation. With improvement of her [...]

Case Presentation: A 13-year-old previously healthy boy presented to the emergency department with 1 day of jaundice and scleral icterus as well as acute on chronic progressive abdominal pain. Review of systems was notable for unintentional 5 kg weight loss over the past year, fatigue, oral ulcers, Raynaud’s phenomenon, and gross hematuria. He had no [...]

Case Presentation: A 17 year-old male with a history of marijuana and nitrous oxide use presented with 4 days of paresthesia in his bilateral lower extremities, sudden onset-ataxia, gait instability, and genital numbness extending to his extremities. Comprehensive infectious and neurologic workup for Guillain-Barré syndrome, transverse myelitis, and other neuropathies all returned negative. Magnetic resonance [...]

Case Presentation: A 4-month-old unvaccinated male, presented with left-sided weakness and decreased activity. Initial physical exam demonstrated right gaze deviation, left hemineglect, decreased left-sided movements, and absent left plantar reflex. Labs showed leukocytosis 22.8 K/uL, anemia 8.6gm/dL, and thrombocytosis 661K/uL. CT brain demonstrated intracerebral edema in the distribution of the right middle cerebral artery (MCA). [...]

Case Presentation: A 6-year-old male with 4-month history of recurrent otitis media presented with one day of headache, ear pain, and left-sided facial droop. Parents claimed that he completed multiple courses of different antibiotics and steroids with incomplete resolution of symptoms. On presentation, he was afebrile. Physical exam was notable for left facial paresis House-Brackmann [...]

Case Presentation: A 3-year-old immunized male, with a history of atopic dermatitis and anaphylactic dairy allergy, was brought to the ER due to refusal to bear weight for one month. There was no trauma, fevers, or recent sick symptoms. He had a severely restricted diet of potato products and breast milk. On exam, he was [...]