Pediatric emergency care
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Pediatric emergency care · Jun 2011
Case ReportsStaphylococcal infection mimicking child abuse: what is the differential diagnosis and appropriate evaluation?
Twins with similar skin lesions are described. Although initially concerning for nonaccidental burn injury, further evaluation led to the diagnosis of bullous impetigo caused by Staphylococcus aureus. Thoughtful assessment is important in such cases to protect the child and prevent misdiagnosis.
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Pediatric emergency care · Jun 2011
Case ReportsA case of autonomically mediated pain due to spinal epidural abscess in an adolescent female.
Spinal epidural abscess (SEA) is a rare disease in children without predisposing risk factors. Atypical presentations of SEA without the classic triad of fever, back pain, and neurological signs, have previously been described. We report an atypical presentation of an acute SEA in a previously healthy adolescent female. ⋯ Our experience adds to the literature a case that demonstrates the difficulty in diagnosis of atypical presentations of SEA in previously healthy children. In addition, referred or autonomically mediated pain should be considered in unusual pain presentations. Children with significant extremity or abdominal pain should be considered for the possibility of sympathetically mediated pain syndrome due to a thoracic-level spinal cord lesion such as a SEA.
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Pediatric emergency care · Jun 2011
Case ReportsCase records of the Children's Mercy Hospital: A 12-year-old girl with a straddle injury.
Straddle injuries are common in children. At the end of this case presentation, you should be able to describe the approach to the evaluation and treatment of a straddle injury, list indications for gynecologic consultation and/or sedation, plan disposition, and discuss pitfalls to avoid in evaluating patients with straddle injuries.
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Pediatric emergency care · Jun 2011
Multicenter Study Comparative StudyIllicit drug exposure in patients evaluated for alleged child abuse and neglect.
Substantiation of drug exposure in cases with alleged maltreatment is important to provide proper treatment and services to these children and their families. A study performed at University of Iowa Hospitals and Clinics showed that 30% of pediatric patients with burn injuries, which were due to child maltreatment, were also exposed to illicit drugs. ⋯ The results of this study showed that an illicit drug screening protocol used in the assessment of children evaluated for child abuse identified almost 15% of the population of allegedly abused and neglected children who were tested according to a protocol being exposed to illicit drugs. Thus, routine drug testing of at least children assessed for neglect and nonaccidental burn and soft tissue injuries, children with a history of either parental drug use or domestic violence is recommended.