Pediatric emergency care
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Henoch-Schönlein purpura (HSP) is the most common form of vasculitis found in the pediatric population. The most common presenting complaint for children with HSP is a purpuric rash on the lower extremities. Many other organ systems beyond the skin can be involved for children with HSP. We report a case of a 7-year-old girl with HSP who presented with status epilepticus and onset of rash 2 weeks after her initial symptoms.
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Pediatric emergency care · Aug 2009
Risk of bacterial or herpes simplex virus meningitis/encephalitis in children with complex febrile seizures.
To estimate the rates of bacterial meningitis and herpes simplex virus (HSV) encephalitis in children presenting with complex febrile seizures. ⋯ Given the low rate of bacterial meningitis and HSV encephalitis in children presenting with complex febrile seizures, routine lumbar puncture in these patients may be unnecessary.
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Pediatric emergency medicine (PEM) is more than a quarter of a century old; yet, very little is known about the career longevity of its practitioners. The purpose of our survey was to examine different aspects of career longevity in the clinical practice of PEM. ⋯ Most senior PEM physicians participating in our survey continue to carry a significant clinical load and are concerned about their career longevity in clinical practice of PEM.
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Pediatric emergency care · Aug 2009
Case ReportsStevens-Johnson syndrome and toxic epidermal necrolysis: consequence of treatment of an emerging pathogen.
We report a case of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) secondary to trimethoprim-sulfamethoxazole (TMP-Sx) therapy for presumed community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection. Although the association between SJS/TEN and the sulfonamide class of antibiotics is well established, the increasing prevalence of CA-MRSA has left practitioners with limited regimens to effectively treat skin and soft tissue infections (SSTIs) in the outpatient setting. ⋯ Future investigations evaluating the efficacy of adjunctive antibiotics for purulent SSTIs and monitoring the incidence of SJS/TEN in the era of CA-MRSA are necessary to reduce unnecessary use of sulfonamide drugs. The potential development of SJS/TEN, a severe life-threatening illness, emphasizes the need for judicious use of TMP-Sx and close monitoring and follow-up for patients who were given TMP-Sx for SSTIs.