Adam Garibay, MD; Kelly Winters, MSN, RN, CPNP, CNS ; Tabitha Cheng, MD,; Supriya Sharma, MD; Manpreet Singh, MD, MBE
Pediatric Emergency Department, Department of Emergency Medicine, Harbor-UCLA Medical Center
Case Presentation: Tongue Depressor
A 5-year-old male presented to the pediatric ED due to a growth on the tip of his tongue. The patient’s mother was worried as the mass had been increasing in size and was bleeding, causing decreased oral intake. Further history revealed progressive tongue swelling and increasing growth of the mass over a three-month period. Upon further questioning, it was presumed that the mass formed after a traumatic injury where he bit his tongue. Prior to this visit he presented to three other EDs and was unable to receive a referral to Otolaryngology due to insurance issues.read more
Chloe Knudsen-Robbins University of Pittsburgh Medical Center
Nelson Bansil CHOC Children’s
A 13-year-old-female with a past medical history of Crohn’s disease, presented to the Pediatric Emergency Department (PED) with 8 hours of headache, left eye pain and periorbital swelling. She denied trauma or fevers.
Exam demonstrated left periorbital swelling with ecchymosis and tenderness to palpation. Swelling prevented assessment. Intra-ocular pressure (IOP) was unobtainable.
Emergent ophthalmology consult was obtained and a lateral canthotomy with cantholysis was performed in the PED. CT of the orbits showed left periorbital swelling with diffuse enlargement of the recti muscles. Diagnosis was determined to be most consistent with orbital compartment syndrome (OCS) secondary to orbital inflammatory pseudotumor (OIP) as a complication of IBD.read more
Rob Grell, MD Division of Pediatric Emergency Medicine Department of Pediatrics Emory University School of Medicine
7-month-old male with no past medical history presented to the Pediatric Emergency Department (PED) for 4 months of rash and decreased urine output. Mom reports that she had initial sought medical care 4 months ago, but despite treatment and repeated reassurance, the rash has worsened. Over the last 24 hours prior to presentation, the rash became firm, indurated, and more edematous. The rash was initially localized to the diaper region, but recently spread inferiorly to the lower extremities and superiorly to the abdomen. Mom reports failure of treatment with topical steroids and only transient improvement when treated with oral steroids. Working diagnosis at the time of presentation was granuloma gluteale infantum.read more