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 16: Simon, a 15-Month-Old Boy with Abnormal Movements and Fever
"Simon, a 15-Month-Old Boy with Abnormal Movements and Fever", 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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A 15-month-old boy, Simon, is brought to the emergency department (ED) by ambulance after his mother witnessed him become unresponsive and have rhythmic movements of his extremities. The movements resolved by the time emergency medical services (EMS) arrived at the family’s home. EMS measured Simon’s temperature as 40 °C (104 °F) and administered a dose of rectal acetaminophen. His blood glucose level en route to the hospital was 82 mg/dL (4.55 mmol/L). Shortly after arrival at the ED, Simon has another shaking episode witnessed by his nurse. This episode lasts 90 seconds and involves unresponsiveness, rhythmic bilateral flexion and extension of his arms, and eye deviation. The episode resolves without intervention. The ED physician orders a normal saline bolus, acetaminophen, a complete blood cell count, a complete metabolic panel, and a rapid influenza test. She then calls you with an admission request because of Simon’s most recent episode.