Pediatric emergency care
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Pediatric emergency care · Dec 2019
Case ReportsKawasaki at the Extremes of Age: Thinking Outside the Box.
Kawasaki disease is an acute vasculitis syndrome that typically occurs in children aged 1 to 4 years. Because there is no specific diagnostic test for Kawasaki disease, the diagnosis is made clinically based on specific characteristic signs and symptoms. Cases in which patients fall outside of the typical age range are uncommon and often challenging to diagnose because they have atypical presentations. ⋯ These cases illustrate the challenge of diagnosing Kawasaki disease in patients beyond the typical age range. Both patients were return visits to the emergency department after inpatient stays. When fever persists longer than 5 days, clinicians must have a high index of suspicion for Kawasaki disease in all pediatric age groups to prevent treatment delay and disease sequelae.
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A subset of testicular torsion patients report resolution of their initial severe pain that is followed by variable periods of hours to days of reduced or absent pain. Other patients report only mild pain that is described as gradual in onset. Because of delayed initial presentations or less than timely returns for secondary evaluation, these pain honeymoons may be partially responsible for poor clinical outcomes of the torsed spermatic cords and ischemic testicles.
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We report the case of a 17-year-old male football player with blunt abdominal trauma. Careful evaluation, including computed tomography and laboratory, revealed a pancreatic body laceration. Pancreatic injuries are relatively uncommon and associated with significant morbidity and mortality and require early diagnosis for optimal management and outcome.
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Pediatric emergency care · Dec 2019
Case ReportsKawasaki Disease in a 3-Month-Old Infant: How to Remain Vigilant?
Kawasaki disease is an acute vasculitis occurring between 6 months and 5 years old. Patients younger than 6 months have mostly incomplete form. This clinical symptoms lead to confusion and delayed diagnosis. ⋯ We highlight the possibilities of Kawasaki disease in infants younger than 6 months. Indeed, every diagnostic delay increases cardiovascular risk. Nonetheless, in our case, treatment was prescribed in the first 5 days, and the patient developed aneurysms.