Welcome to this month’s What’s Your Diagnosis Challenge!
But before we begin, check to see if you got the previous case on Diphtheria, Pertussis, and Tetanus: An Update of Evidence-Based Management of Pediatric Patients in the Emergency Department correct.
Case Presentation: Management of Pediatric Febrile Seizures in the Emergency Department
A 12-month-old girl presents to the emergency department after 2 seizures in the last 12 hours…
- The girl’s mother explains both events were approximately 3 minutes in length and consisted of generalized full-body shaking that resolved spontaneously. She tells you the girl is fully vaccinated, with a history of a prior febrile seizure. The girl’s measured maximum temperature at home was 101.3°F
- The girl’s vital signs are: temperature, 39.1°C; heart rate, 140 beats/min; blood pressure, 80/50 mm Hg; respiratory rate, 30 breaths/min; and oxygen saturation, 100%. On examination, the child is well-appearing and at baseline neurologically. Her mucous membranes are moist, and she has normal capillary refill. She has had a history of loose watery stools and 3 days of intermittent fevers, responsive to acetaminophen and ibuprofen. She has normal urinary output.
- What type of workup is indicated in the ED? What guidance should you provide to the family?
Make your best guess, and check back next month for the case conclusion!
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