Welcome to this month’s What’s Your Diagnosis Challenge!
But before we begin, check to see if you got the previous case on Pediatric Electrolyte Emergencies: Recognition and Management in the Emergency Department right.
A 4-year-old previously healthy girl is brought into the emergency department by her mother for 6 days of vomiting and headache…
The child has woken up several times over the last week holding her head, crying, and vomiting nonbloody, nonbilious emesis. The girl’s brother is sick with viral gastroenteritis; however, the mother says the girl has not had diarrhea or fever.
The girl’s vital signs are: temperature, 37°C; heart rate, 69 beats/min; respiratory rate, 30 breaths/min; and blood pressure, 120/64 mm Hg. Your examination is notable for truncal instability when the child attempts to sit up. What is the next step in your workup?
Make your best guess, and check back next month for the case conclusion!
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