http://www.mhprofessional.com/blogs/accessem Mystery Cases Thu, 10 Sep 2009 13:59:30 +0000 http://backend.userland.com/rss092 en By Muhammad Waseem, MD 09.10.09 A 4-year-old boy was brought to the emergency department with abdominal pain. He has a prior history of constipation and was taking stool softener. His vital signs were stable. The abdominal examination revealed a large mass in the left side of his abdomen. The mass was firm ... http://www.mhprofessional.com/blogs/accessem/?p=174 By Muhammad Waseem, MD 07.10.09 This boy visited the Emergency Department with this rash. He has been in a family picnic trip over the weekend. In the ED, he was scratching over his forearms. His parents gave him diphenhydramine, which offered no relief. What is your diagnosis? View the answer to Mystery Case #15. http://www.mhprofessional.com/blogs/accessem/?p=167 What is your diagnosis? Poison ivy causing contact dermatitis. Acute onset of pruritis, inflammation, and grouped or linear papulovesicles or bullae usually indicates the presence of contact dermatitis. Go to Mystery Case 15... http://www.mhprofessional.com/blogs/accessem/?p=170 By Muhammad Waseem, MD 06.11.09 A 2-year-old African American boy was brought to the Emergency Department because of dark colored urine and vomiting. He had fever, cough and runny nose for 2 days. In the ED he was pale and jaundiced. Spleen was palpable. Hemoglobin was 4.6 gm/dL and hematocrit 12.7% with ... http://www.mhprofessional.com/blogs/accessem/?p=164 What is your diagnosis? The presence of hematuria, jaundice and anemia suggests hemolysis. Among the causes of hemolysis in a previously healthy child, Glucose-6-phosphate dehydrogenase deficiency is one of the common. It is an X-linked recessive disease affecting exclusively males. The hemolysis is usually triggered by an infection or a medication. ... http://www.mhprofessional.com/blogs/accessem/?p=162 From Fitzpatrick's Color Atlas Case of the Week 05.15.09 A 16-year-old male presented with blistering rash in sites of sun exposure. Rash occurred the day following sun expsoure. The patient had a history of chronic granulomatous disease and was being treated with levofloxacin and voriconazole for lung infection. On examination, confluent erythematous ... http://www.mhprofessional.com/blogs/accessem/?p=160 What is your diagnosis? Bullous phototoxic drug reaction, secondary to voriconazole. Voriconazole is a new triazole antifungal agent approved for oral treatment of invasive fungal infections. It has been reported to cause severe phototoxic reactions (Vandecasteele SJ et al: Two cases of severe phototoxic reactions related to long-term outpatient treatment with voriconazole. ... http://www.mhprofessional.com/blogs/accessem/?p=159 By Muhammad Waseem, MD 04.15.09 http://www.mhprofessional.com/blogs/accessem/?p=156 What is your diagnosis? Ultrasound revealed substantially enlarged uterus with a large coarse echogenic mass occupying the endometrial canal with suggestion of multiple cysts and poor differentiation between the mass and myometrium. Surgical pathology specimens revealed chorionic villi with histologic features consistent with molar pregnancy. The diagnosis of molar pregnancy is ... http://www.mhprofessional.com/blogs/accessem/?p=155 From Fitzpatrick's Color Atlas Case of the Week 03.09.09 A 10-year-old male had swelling of toe for 5 months. The right-second toe had been red, swollen and tender for 5 months. A small traumatic break in the skin had occurred while at a beach in Florida; swelling of the toe began several ... http://www.mhprofessional.com/blogs/accessem/?p=152