Pediatric Journal Club // with Ghazala Sharieff, MD
Q. What are the clinical profiles of pediatric patients with acute myocarditis and dilated cardiomyopathy (DCM) before diagnosis?
A. Data suggest children with acute myocarditis and DCM most commonly present with difficulty breathing. Myocarditis and DCM may mimic other respiratory or viral illnesses, but hepatomegaly or the finding of cardiomegaly and an abnormal electrocardiogram result may help distinguish these diagnoses from other more common pediatric illnesses.
The question of oral analgesia for children is an important one and this journal club will focus on some recent articles discussing the use of ibuprofen for pain control. Many of us anecdotally realize that Tylenol with codeine is not very effective, yet we continue to write for this pain medication. Hopefully these studies will make us feel supported when we tell families that ibuprofen is superior to acetaminophen with codeine.
Is leucine-rich-2-glycoprotein the panacea for pediatric abdominal pain? Perhaps it’s time for cautious optimism.
Are you still routinely doing blood cultures to look for occult bacteremia in the healthy-looking infant with fever without a source? If you are, then read this study.
A case study from the Christiana Care Health System in Wilmington, Del.
Your next patient is a 16-year-old male with a chief complaint of “turning green”.
The “stomach flu” is making rounds in your community. All evening long you’ve seen one child after another with vomiting, diarrhea and varying degrees of dehydration.
There are a few kids out there who are prone to hypoglycemia. They may be diabetic and on insulin, or have ketotic hypoglycemia or metabolic disorders that cause them to drop their blood sugars with stress. One thing that mothers can do is stock up on cake frosting.
It’s muggy outside and the Pediatric ED is as busy as ever. Winter virus season has given way to summer virus season in the never-ending circle of hot....
...the kid has bigeminy but is completely without symptoms...Is it safe to sedate her in the ED to drain this abscess?