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 46: Makayla, a 16-Year-Old Girl with Fever and Blurry Vision
"Makayla, a 16-Year-Old Girl with Fever and Blurry Vision", 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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Makayla is a 16-year-old girl who presents to the emergency department (ED) with fever and blurry vision. Upon presentation, she is febrile and ill appearing with concerning neurologic changes, including gait instability, difficulty starting her urine stream, and difficulty swallowing, leading the ED physician to obtain a computed tomography (CT) scan of the head, comprehensive metabolic panel, complete blood cell count, C-reactive protein (CRP) level, and a blood culture. Makayla’s head CT scan and all of her laboratory tests are within normal limits, and the ED physician orders a normal saline bolus and a dose of ibuprofen. The ED physician is concerned about Makayla’s constellation of symptoms and feels that she needs further infectious and neurologic workup, and he calls you to evaluate Makayla for admission.