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Pediatric index of suspicion

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https://www.readbyqxmd.com/read/29911755/emergencies-in-the-treatment-of-wandering-spleen
#1
Osher Cohen, Arthur Baazov, Inbal Samuk, Michael Schwarz, Dragan Kravarusic, Enrique Freud
BACKGROUND: Wandering spleen is a rare entity that may pose a surgical emergency following torsion of the splenic vessels, mainly because of a delayed diagnosis. Complications after surgery for wandering spleen may necessitate emergency treatment. OBJECTIVES: To describe the clinical course and treatment for children who underwent emergency surgeries for wandering spleen at a tertiary pediatric medical center over a 21 year period and to indicate the pitfalls in diagnosis and treatment as reflected by our experience and in the literature...
June 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29887216/typhoid-fever-causing-haemophagocytic-lymphohistiocytosis-in-a-non-endemic-country-first-case-report-and-review-of-the-current-literature
#2
Paula Sánchez-Moreno, Peter Olbrich, Lola Falcón-Neyra, Jose Manuel Lucena, Javier Aznar, Olaf Neth
INTRODUCTION: Development of secondary haemophagocytic lymphohistiocytosis (sHLH) in the context of typhoid fever (TF) is a very rare but serious complication. METHODS: Description of the first pediatric case of typhoid fever acquired in a non-endemic area complicated by sHLH. A systematic literature review of sHLH in the context of TF was performed with extraction of epidemiological, clinical and laboratory data. RESULTS: The literature search revealed 17 articles (22 patients)...
June 7, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29851923/streptococcus-constellatus-tubo-ovarian-abscess-in-a-non-sexually-active-adolescent-female
#3
David Mills, Bazak Sharon, Kari Schneider
Tubo-ovarian abscess (TOA) in non-sexually active female adolescents is a rare presentation to the pediatric emergency department. In the following case, bilateral TOA secondary to Streptococcus constellatus was diagnosed in a 13-year-old virginal female. The patient was seen 4 months before presentation for interventional radiology-guided drainage and antibiotic treatment for an intra-abdominal abscess due to suspected appendiceal rupture. Exploratory laparotomy on the most recent presentation demonstrated an appendix with inflammation and serositis on pathology report, a concern for chronic appendicitis with microperforation and subsequent bacterial translocation of the bilateral ovaries...
June 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29796359/acute-appendicitis-in-young-children-a-persistent-diagnostic-challenge-for-clinicians
#4
Kewan A Hamid, Mohamed A Mohamed, Anas Salih
Acute appendicitis is a grave and life-threatening condition in children, accounting for one to two cases per 10,000 in children less than four years' old. Prompt diagnosis and management are imperative to prevent serious complications, such as abscess formation, perforation, bowel obstruction, peritonitis, and sepsis. In young children, however, the diagnosis of this condition is challenging. The delayed utilization of imaging may further delay the diagnosis due to concerns of exposure to ionizing radiation...
March 19, 2018: Curēus
https://www.readbyqxmd.com/read/29787531/blunt-traumatic-scapular-fractures-are-associated-with-great-vessel-injuries-in-children
#5
Ibrahim Abd El-Shafy, Lisa M Rosen, Jose M Prince, Robert W Letton, Nelson G Rosen
BACKGROUND: Patients with stable blunt great vessel injury (GVI) can have poor outcomes if the injury is not identified early. With current pediatric trauma radiation reduction efforts these injuries may be missed. As a known association between scapular fracture and GVI exists in adult blunt trauma patients, we examined whether that same association existed in pediatric blunt trauma patients. METHODS: Bluntly injured patients under 18 years old were identified from 2012-2014 in the National Trauma Data Bank...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29698345/presenting-signs-and-symptoms-of-pericardial-effusions-in-the-pediatric-emergency-department
#6
Matthew Cully, Jason R Buckley, Elysha Pifko, Olivia M Titus
OBJECTIVES: The primary objective of this study was to describe the frequency of the most common presenting signs and symptoms of pericardial effusions, particularly with relation to the size of the effusion. The secondary objective was to review the final etiology of the pericardial effusion in those patients who had presented to a tertiary care pediatric emergency department. METHODS: This was a retrospective chart review of patients younger than 17 years who presented and were evaluated at the pediatric emergency department and subsequently diagnosed with a pericardial effusion during a period of 10 years...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29682040/widespread-intra-abdominal-carcinomatosis-from-a-rhabdoid-meningioma-after-placement-of-a-ventriculoperitoneal-shunt-a-case-report-and-review-of-the-literature
#7
Jun Jie Ng, Kok Ann Teo, Asim Shabbir, Tseng Tsai Yeo
Intra-abdominal metastasis (IAM) of central nervous system (CNS) tumors through ventriculoperitoneal shunt (VPS) is rare but has been previously reported (e.g., germinomas and medulloblastomas). However, there has been no previous reports in literature involving meningiomas. A case of primary rhabdoid meningioma with widespread intra-abdominal carcinomatosis after placement of a VPS in a 36-year-old man is described. The patient underwent preoperative angioembolization of the tumor, craniotomy, and surgical excision, followed by postoperative gamma knife radiosurgery...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29643718/left-sided-cecal-diverticulitis-associated-with-midgut-malrotation
#8
Jia-Hui Chen
Malrotation of the midgut is generally considered as a pediatric pathology with the majority of patients presenting in childhood. The diagnosis is rare in adults, which sometimes leads to delay in diagnosis and treatment. An index of suspicion is therefore required when dealing with patients of any age group with abdominal symptoms. We present a case of a 26-year-old male who presented with left lower abdominal pain with preoperative computed tomography showing suspected left-sided appendicitis associated with midgut malrotation...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29630083/renal-microsporidiosis-in-pediatric-bone-marrow-transplant-recipients-a-case-series
#9
Saloni Shah, Sheba Sweetline Jacob, Rama Mani, Ashok Parameswaran, Sunil Kumar, Rajeev A Annigeri, Raja Mahesh, Ramya Uppuluri
Microsporidiosis is a rare, but emerging opportunistic infection in solid organ transplant and stem cell transplant recipients. Renal involvement in microsporidiosis is very rarely seen in these recipients. We describe two cases of pediatric renal microsporidiosis, diagnosed on renal biopsies, following bone marrow transplantation presenting as severe acute kidney injury. The first patient died, whereas the second survived due to early diagnosis based on high index of suspicion and prompt treatment with Albendazole...
April 9, 2018: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/29601463/conjugated-hyperbilirubinemia-in-the-neonate-and-young-infant
#10
Anna K Weiss, Parag V Vora
Cholestatic jaundice in the first few weeks of life may herald potentially life-threatening pathology. It is therefore incumbent upon the pediatric practitioner to have a high index of suspicion for severe disease when investigating jaundice in a young infant. This article outlines the epidemiology, pathophysiology, differential diagnosis, and diagnostic workup for both the most common and the most severe causes of cholestasis in the neonatal period.
April 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29596281/chikungunya-in-a-pediatric-traveler
#11
Vanessa A Thomas, Kristy O Murray, Heather L Crouse
Chikungunya is a mosquito-transmitted virus found primarily in Africa and Asia. In late 2013, chikungunya virus emerged in the Western hemisphere, spreading from the Caribbean to South, Central, and North America (MMWR Morb Mortal Wkly Rep. 2014;63:1121-1128). Symptoms can be similar to nonspecific viral presentations including fever, joint pain, joint swelling, and rash. The diagnosis of infectious tropical diseases in the emergency department often requires a high index of suspicion, given the nonspecific early findings that characterize many of these tropical diseases...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29571929/pediatric-tonsil-cancer-a-national-and-institutional-perspective
#12
Eelam A Adil, Genevieve Medina, Michael J Cunningham
OBJECTIVE: To evaluate childhood and adolescent tonsil cancer incidence and to identify the clinical characteristics indicative of those patients who would benefit from urgent operative intervention. STUDY DESIGN: The Surveillance, Epidemiology and End Results 18 database, inclusive of national cancer statistics from 1973 to 2013, provided quantitative tonsil cancer incidence data. An institutional retrospective chart review of pediatric patients diagnosed with tonsil malignancy from January 2013 to January 2017 identified supplementary qualitative clinical presentation information...
June 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29508362/staphylococcal-scalded-skin-syndrome-evaluation-diagnosis-and-management
#13
REVIEW
Alexander K C Leung, Benjamin Barankin, Kin Fon Leong
BACKGROUND: Staphylococcal-scalded skin syndrome (SSSS), also known as Ritter disease, is a potentially life-threatening disorder and a pediatric emergency. Early diagnosis and treatment is imperative to reduce the morbidity and mortality of this condition. The purpose of this article is to familiarize physicians with the evaluation, diagnosis, and treatment of SSSS. DATA SOURCES: A PubMed search was completed in Clinical Queries using the key terms "Staphylococcal scalded skin syndrome" and "Ritter disease"...
April 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29503270/diagnosis-and-management-of-gaucher-disease-in-india-consensus-guidelines-of-the-gaucher-disease-task-force-of-the-society-for-indian-academy-of-medical-genetics-and-the-indian-academy-of-pediatrics
#14
Ratna Dua Puri, Seema Kapoor, Priya S Kishnani, Ashwin Dalal, Neerja Gupta, Mamta Muranjan, Shubha R Phadke, Anupam Sachdeva, Ishwar C Verma, Pramod K Mistry
JUSTIFICATION: Gaucher disease (GD) is amongst the most frequently occurring lysosomal storage disorder in all ethnicities. The clinical manifestations and natural history of GD is highly heterogeneous with extreme geographic and ethnic variations. The literature on GD has paucity of information and optimal management guidelines for Indian patients. PROCESS: Gaucher Disease Task Force was formed under the auspices of the Society for Indian Academy of Medical Genetics...
February 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29492156/widespread-intra-abdominal-carcinomatosis-from-a-rhabdoid-meningioma-after-placement-of-a-ventriculoperitoneal-shunt-a-case-report-and-review-of-the-literature
#15
N G Jun Jie, Kok Ann Teo, Asim Shabbir, Tseng Tsai Yeo
Intra-abdominal metastasis (IAM) of central nervous system (CNS) tumors via ventriculoperitoneal shunt (VPS) is rare but has been previously reported (e.g., germinomas and medulloblastomas). However, there has been no previous report in the literature involving meningiomas. A case of primary rhabdoid meningioma with widespread intra-abdominal carcinomatosis after placement of a VPS in a 36-year-old man is described. The patient underwent preoperative angioembolization of the tumor, craniotomy, and surgical excision, followed by postoperative gamma knife radiosurgery...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29468064/the-multiple-faces-of-langerhans-cell-histiocytosis-in-childhood-a-gentle-reminder
#16
Maria Papadopoulou, Paraskevi Panagopoulou, Anastasia Papadopoulou, Emmanuel Hatzipantelis, Ioannis Efstratiou, Assimina Galli-Tsinopoulou, Efimia Papadopoulou-Alataki
Langerhans cell histiocytosis (LCH) is a rare hematologic disorder that results from the clonal multiplication and accumulation of immature dendritic Langerhans cells. Its reported incidence rate varies, but is considered to be 2.6-8.9 per million children who are <15 years of age each year. It may affect any system or organ. The present study reported 4 pediatric LCH cases in order to highlight the heterogeneity of the initial presentation, and the pitfalls that may mislead clinicians and delay diagnosis...
March 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29438165/histologic-features-of-gastrointestinal-tract-biopsies-in-iga-vasculitis-henoch-sch%C3%A3-nlein-purpura
#17
Christine Y Louie, Adam J Gomez, Richard K Sibley, Dorsey Bass, Teri A Longacre
Immunoglobulin A (IgA) vasculitis or Henoch-Schönlein purpura (HSP) typically occurs in the pediatric population, although rare cases also occur in adults. Gastrointestinal (GI) involvement is common. The "classic" histologic finding in IgA vasculitis (HSP) is leukocytoclastic vasculitis (LCV); other histologic features in biopsies of IgA vasculitis (HSP) have only been rarely described. The pathology archival files at our institution were searched for GI biopsies from patients with IgA vasculitis (HSP)...
April 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29395280/pediatric-cochlear-implant-soft-failure
#18
David Ulanovski, Joseph Attias, Meirav Sokolov, Tali Greenstein, Eyal Raveh
PURPOSE: Hard cochlear implant failures are diagnosed by objective tests whereas soft failures are suspected on the basis of clinical signs and symptoms. This study reviews our experience with children in tertiary pediatric medical center who underwent revision cochlear implantation, with emphasis on soft failures. MATERIALS AND METHODS: Children (age<18years) who underwent revision cochlear implantation from 2000 to 2012 were identified by database search. Pre- and post-explantation data were collected...
March 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29299687/the-incidence-of-brainstem-primitive-neuroectodermal-tumors-of-childhood-based-on-seer-data
#19
Omar Chamdine, Ghada Ahmad Saad Elhawary, Ahmad Samir Alfaar, Ibrahim Qaddoumi
PURPOSE: Incidence of BS primitive neuroectodermal tumors (BS-PNET) in children is not reported to date. Our main objectives were to estimate the incidence and report the outcome of BS-PNET in children. METHODS: Data were collected using the Surveillance Epidemiology and End Results cancer registry. RESULTS: From 1973 to 2013, we identified 83 pediatric patients (aged 0-21 years). Patients were divided into two age groups (0-3 years and 4-21 years)...
March 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29237543/diagnosis-and-management-of-mcfarland-fractures
#20
M Birt, B Vopat, P Schroeppel, A Tarakemeh, B Everist, S Mullen
BACKGROUND: McFarland fracture is the eponym for a rare Salter Harris III or IV fracture involving the medial distal tibia. These fractures can be difficult to diagnose without a high index suspicion and appropriate radiographic imaging. These fractures may result in significant growth disturbances to the pediatric patient. When diagnosed and treated acutely, these fractures can be managed with cast immobilization and close follow up. If diagnoses in a delayed fashion they can result in significant morbidity including prolonged casting and possible surgical treatment...
March 2018: American Journal of Emergency Medicine
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