This educational guide provides a much-needed subspeciality-specific learning resource for pediatric hospital medicine. Featuring 50 of the most commonly presenting topics encountered by pediatric hospitalists, this book brings readers into the morning meeting and walks them through patient presentation, diagnosis, treatment, and resolution, providing realistic examples in an engaging case-based format. Available for purchase at https://shop.aap.org/pediatric-hospital-medicine-a-case-based-educational-guide-paperback/
Case 15: Liam, a 6-Week-Old Boy with Poor Weight Gain
"Liam, a 6-Week-Old Boy with Poor Weight Gain", Pediatric Hospital Medicine: A Case-Based Educational Guide, American Academy of Pediatrics, Melissa G. Cossey, MD, FAAP, Lauren K. Gambill, MD, MPA, FAAP
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Before morning rounds, you are preparing to see a 6-week-old boy named Liam who was admitted yesterday from the emergency department (ED) to the pediatric inpatient ward with dehydration and pyelonephritis. Overnight, he received intravenous (IV) fluids and IV ceftriaxone, and his vital signs demonstrate an improving fever curve and improving tachycardia. You note that Liam’s blood culture has no growth at 18 hours but find that his urine culture is growing more than 100,000 CFU/mL gram-negative rods. Renal and bladder ultrasonography was completed earlier this morning and was normal.
When you open Liam’s growth charts, you notice 2 points, one at birth and one for the current hospitalization. His birth weight was 3.6 kg (69th percentile weight for age), and his weight on the inpatient unit after rehydration is 4.1 kg (6th percentile weight for age). You are concerned about poor weight gain given this drop in his weight-for-age percentiles and realize you need to investigate further.