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Picture of the Month—Quiz Case
Melanie Pitone, MD;
Benjamin Alouf, MD
Author Affiliations: Division of Pediatric Emergency Medicine (Dr Pitone) and Department of Pediatrics (Dr Alouf), Alfred I. duPont Hospital for Children, Wilmington, Del.
Arch Pediatr Adolesc Med. 2006;160:300.
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An otherwise healthy 3-month-old male infant had umbilical erythema and watery stools. He had been slightly fussy and cried during feeding. His parents reported intermittent emesis and diarrhea over the last several weeks, with body temperature to 38.8°C. During this illness, he developed redness of the umbilicus that, after resolving spontaneously, recurred over the last 2 days.
On examination, his weight was 7.1 kg (75th percentile); temperature, 38.1°C; heart rate, 153/min; respiratory rate, 40/min; blood pressure, 62/47 mm Hg; and oxygen saturation, 98% on room air. He appeared mildly ill, pale, and quiet. His lips were dry, he had a 2/6 flow murmur heard best at the left sternal border, his skin was mottled, and his feet were cool. The abdomen was soft without apparent tenderness. Periumbilical erythema and induration extended a distance of 0.5 cm around the umbilicus.
Initial laboratory testing revealed a . . . [Full Text of this Article]
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Arch Pediatr Adolesc Med. 2006;160(3):301.
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