Category: Pediatrics
Keywords: autism spectrum disorder, neurodevelopmental disorder (PubMed Search)
Posted: 5/6/2022 by Rachel Wiltjer, DO
(Updated: 5/17/2022)
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Category: Pediatrics
Keywords: inborn error of metabolism (IEM), organic acidemia (PubMed Search)
Posted: 4/1/2022 by Rachel Wiltjer, DO
(Updated: 5/17/2022)
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Laura L. Guilder, Jonathan B. Kronick; Organic Acidemias. Pediatr Rev March 2022; 43 (3): 123–134.
Category: Pediatrics
Keywords: bell's palsy, pediatric malignancy (PubMed Search)
Posted: 2/4/2022 by Rachel Wiltjer, DO
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Acute facial palsy is common in children and while bell’s palsy is significant proportion, there are other more concerning etiologies that make up a number of cases. A retrospective cohort study of pediatric patients with an ED diagnosis of Bell’s palsy was done using the Pediatric Health Information System and showed an incidence of 0.3% (0.03% in control) for new diagnosis of malignancy within the 60 days following the visit at which bell’s palsy was diagnosed. Younger age increased the risk. There was also a subset of patient’s excluded for diagnosis of bell’s palsy as well as malignancy at the index visit.
These numbers are small but may be clinically significant. They likely do not warrant laboratory or imaging workup as a rule but do make a case for detailed history taking and thorough exam. Consider avoiding steroids which are used commonly but lack high quality data and may undermine later efforts at tissue diagnosis of malignancy or even worsen prognosis.
Walsh PS, Gray JM, Ramgopal S, Lipshaw MJ. Risk of malignancy following emergency department Bell's palsy diagnosis in children. Am J Emerg Med. 2021 Dec 29;53:63-67.
Category: Pediatrics
Keywords: peds ortho, calcaneus, stress injury (PubMed Search)
Posted: 12/3/2021 by Rachel Wiltjer, DO
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Sever Disease
Smith JM, Varacallo M. Sever Disease. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441928/
Category: Pediatrics
Keywords: febrile infant, neonatal fever (PubMed Search)
Posted: 10/1/2021 by Rachel Wiltjer, DO
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What they are: Clinical practice guidelines put together by an AAP subcommittee over a span of several years based on changing bacteriology and incidence of illness, advances in testing, and evidence that has accumulated
Includes: Healthy infants 8 to 60 days of life with an episode of temperature greater than or equal to 38.0 C who at now at home after being born at home or after discharge from the newborn nursery, born between 37 and 42 weeks, without focal infection on exam (cellulitis, vesicles, etc)
Recommendations:
For the well appearing 8-21 day old:
For well appearing 22- 28 day olds:
For well appearing 29-60 day olds:
Notable changes:
Pantell, R., Roberts, K., et al. Evaluation and Managment of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics. Aug 2021, 148(2) e2021052228
Category: Pediatrics
Keywords: RSV, bronchiolitis (PubMed Search)
Posted: 8/6/2021 by Rachel Wiltjer, DO
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CDC. Increased Interseasonal Respiratory Syncytial Virus (RSV) Activity in Parts of the Southern United States. Health Alert Network. Published online June 10, 2021.
Ralston, S., Lieberthal, A., et al. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics. Nov 2014. 134(5) e1474-1502.