Table Of ContentI
Thieme
Pediatrics
A Case-Based Review
Michaela Kreckmann, MD
Ill
Private Practice
Saarbriicken,Gerrnany
141 illustrations
Thieme
Stuttgart · New York ·
Delhi · Rio de Janeiro
em.-
Unry of cm1ng1~1n-Pablladan nm is Impartmt Date: Medicine is an ~Di science
avallab~ from the publisher. umiergoing motinual dewlopmeot. ~ and dioial
~ are c:ontinually expanding our lcoowledge. in
This book is an authorized trmslatioo of the 2nd German particular our knawledge of proper tremnent and drug
editioo published and copyrighted 2008 by Georg Thieme tberapy. Insolilr as this book mentions any dosage or appli
Verlag. Stuttgart. Title of the Gerrrulo edition: Pallbuch Pae cation. readers may rest assured that the authors. editors,
di.atrle and pubJlshers have made every effort to ensure that such
referen<:eS are in accordance with the m2 of JmowleQe
Transktor: Gertrude Champe. Surry, MB, USA iU the time ofp rodac:doD oldie book.
Nevertheless, this does not lovolve, lmply, or express any
guarantee or responsibility on the part of the publishers In
Names: Kreckmann. Michaela, author. respect to any dosaac irutructiom and fonm ofa pplications
Title: Pedlatrlcs : a case-based review/ Mlchula stalOO io tbe book. Ewery U9el' II requesled to euadae ca
Kreckmann ; trauslator, Gertrude Clwnpc. nfull,ythe manufacturers' !Rfletsa ccumpanying each drug
Other titles: Fallbuch Phadiatrie. Eoglisb and to cbeck. if necessary in consultation with a physici
Desaiption: Stut!iart; New Yort: Thieme, (2019) I 'This an or specialist, whether the dosage schedules mentiooed
book is an authorized translation oft he 2nd GemYn therein or the contnirutialions mted by tbe manufartu·
edition published and copyrjgbted 2008 by Georg rers differ from the stall!lneoa made in the present book.
Thieme Ved~ Stuttg;lrt. Titfe oft he Gennan edition: Such exmtioatioo is particularly important with drugs that
F.JUbuchPaediatrie"-Galley. I lnd.udes llmx. I are either rarely used or have been newly rel~ on the
Identifiers: I.a:N 2019020002 (print) I LCCN 2019021658 market. Every dosage schedule or every rorm of applicati
IV (ebook) I ISBN 9783132053717 () I ISBN 9783132053618 on used is entirely at the user's own risk and responslblllty.
(alk. paper) I ISBN 9783132053717 (e-ISBN) The authors and publishers request every user m report to
Subjects: I MESH: Pediatrics I Diagnosis, Dltrerentlal I the publishen any discrepancies or inaccuracies noticed. If
DiaJMstlc Techniques and Procedures I case Reports errors In this work are round ~publication, errata will
OUs.iflcadon: LCC RJSO (ebook) I I.CC RJ50 (print) I NIM be posted at www.thleme.com on the product description
ws 100 I DOC 618.92f007S-dc23
~-
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that it is in the public donWn.
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Preface
This casebook presents 85 disease patterns observed are often frightened and uncooperative, and their
in daily pediatric practice. The intention is to make parents. The student is trained to think and act like a
the preparation for examinations easier for the stu doctor through case-and problem-oriented practice.
dents. The descriptions of the medical histories and Last but not the least, this book would also like to
situations are as close as possible to clinical events show students the joy that work in pediatrics can
as they have been encountered in the emergency bring, especially in light of the current public dis
department or reported by patients, parents, and cussion of health policy. I myself have experienced
nurses. Laboratory results, X-rays, and other diag most of these cases, or similar ones, as a resident in
nostic results are presented for analysis. This book a hospital for children and adolescents in the Saar
explains the importance of why medical histories land, Germany. Every interested student and future
v
should be taken, diagnoses established, and treat colleague is warmly invited to take a look inside this
ment planned. In addition to everyday, easily diag book and enliven all the study of theory with a taste
nosed general pediatric and neonatal diseases, this of clinical daily life.
book also presents misleading and easily misinter This book would not have been possible without
preted symptoms that are intended to illustrate the the help of many people. I owe a heartfelt thanks, first
special problems of pediatric diagnosis. Naturally, ofa ll, to the children and parents who were willing to
this book includes cases exemplifying classic emer be photo models, and to Dr. Thomas Llebner, the head
gency situations, which can be expected in every physician of the Oinic for Children and Adolescents
day pediatric practice. Special problematic cases in in the Reinhard-Nieter Hospital, Wilhelmshaven,
social pediatrics and related fields are examined and Germany, for his support and valuable advice. My
discussed, such as pediatric surgery and child and thanks also to my colleagues for their encourage
adolescent psychiatry. The diagnosis and treatment ment and to the staff at Thieme Publishers, in par
described for such cases are based on the current ticular Angelika-Marie Findgott, Joanne Stead, and
guidelines of pediatrics associations and recommen Apoorva Gaurav Prabhuzantye, without whose active
dations in the current specialized literature. participation, constructive criticism, and persistent
However, this book cannot and does not intend to inquiries, this book would not have become what it
replace a textbook. Rather, it is intended to encourage is today. A lot of thanks to Gertrude Champe for her
a critical approach to the, often dry, subject matter great translation. I also thank my family and all my
and to clarify and simplify problems by presenting friends for their patience, and especially my husband
them in a clinical context. It is also meant to help and children. who supported my work with thought
young colleagues in their first steps in clinical prac ful critiques and lovingly tolerated everything that
tice. For this purpose, it suggests simple and struc they had to go through.
tured workflows for diagnosis and treatment and
practical tips for interacting with little children, who Michaela Kreckmann, MD
Case Page Description
I. .
2 Six-year-old boy with high fever, vomiting, and headache
I. .
3 Child with barking cough and dyspnea
I. .
4 Child with high fever and seizure
I. .
5 Apathetic infant with persistent skin folds
I. .
6 Two-year-old girl with colic-like stomach pains and vomiting
I. .
7 Twelve-month-old boy comes for a health screening
I. .
8 Ten-year-old boy with painfully swollen knee
I. .
9 Girl with petechial dermatorrhagie
I. .
10 Infant with projectile vomiting
llm 11 Young girl with recurrent shortness of breath
llm
12 Fourteen-month-old toddler with "runny ear·
llEll
13 Three-year-old boy who has had contact with chicken pox
11!11
14 Five-year-old girl with a swollen jaw angle
IBll 15 Severely ill infant with cough and shortness of breath
llm 16 Young girl with difficulty swallowing and fatigue
I =D ifficult Case
llm
17 Two-year-old boy with coughing fit and cyanosis
llm
18 Twelve-month-old boy with screaming fit and swollen testicles
llill
19 Eight-year-old boy with macrohematuria
llm 20 Boy almost 1-year-old with failure to thrive
lml
21 Macrosomal newborn after obstructed labor with shoulder dystocia
IEm 22 Ten-year-old girl with fever and headache
1&11
23 Eight-year-old boy with high fever and rash
IEll
24 Five-year-old girl after fall from jungle gym
lml
25 Infant with high fever, sucking weakness, and vomiting
IEm 26 Toddler burned by boiling water
VII
IEm 27 Five-year-old girl with abdominal pain and anal itching
IE.m
28 Fourteen-year-old girl with weight loss and social withdrawal
IEill
29 Newborn whose mother has poorly controlled diabetes mellitus
llill
30 Five-year-old girl with hematuria
IE!ll 31 Three-year-old boy with numerous pigment spots
llm
32 Feverish 2-year-old girl with pustulent crusty rash
IEll 33 Hypotrophic newborn with abnormal phenotype
IEll
34 Five-year-old boy with knee pain and protective limping
lml
35 Ten-year-old boy with sderal icterus
llm
36 Fifteen-month-old child with an abrasion and no tetanus vaccination
llm
37 Fifteen-year-old girl found unconscious with hypothermia
llill
38 Two-year-old child who has ingested an unknown fluid
llill
39 Five-day-old newborn with icterus and sucking weakness
IE.m 40 Three-year-old girl refusing to eat
lml
41 Newborn with morphological abnonnalities
llm
42 Two siblings with itching and eczematous changes on the skin of the neck and head
11!11
43 Consultation regarding •sudden infant death syndrome" (SIDS)
I =D ifficult case
IEll
44 Five-year-old boy with high fever and abdominal pain
lml
45 Four-year-old boy with recurrent urinary tract infections
ll'm
46 Seven-year-old boy with pneumonia and bone pain
llm
47 Four-year-old boy with fever and exanthema
IEll
48 Four-year-old girl with facial swelling
ll'Ill
49 Five-year-old girl with pale skin and splenomegaly
llm
50 Seven-year-old girl with headaches and abnormal behavior
lml
51 Four-year-old boy with pain in right lower abdomen
llm
52 Three-year-old girl with protective posture of right arm
!IEll
53 Ten-year-old boy with tingling paresthesia, speech disorder, and headache
VIII
llm
54 Sixteen-month-old boy with undescended testis
llDI
55 Eight-year-old boy with abdominal pain and weight loss
llm
56 Premature birth in the 28th week of pregnancy with shortness of breath and abdominal pain on pressure
lml
57 Five-year-old boy with intense abdominal pain
IEll
58 Two-year-old boy with a high fever, rash, and swollen joints
IEll
59 Four-month-old screaming infant with inguinal swelling
IEll
60 Nineteen-month-old girl with bloody diarrhea, hematomas, and anuria
!lctlll
61 Newborn with persistent cyanosis
ll'm
62 Four-year-old boy with rattling breath and hypersalivation
llDI 63 Six-year-old boy with failure to thrive and recurrent pulmonary infections
llDI
64 Fourteen-year-old girl who collapsed on a school trip
11'!11
65 Three-year-old boy with deteriorating general condition and gastroenteritis
11.m
66 Healthy newborn delivered by cesarean section
llm
67 Eleven-year-old boy with high fever and joint pain
ll'm
68 Newborn boy with conspicuous genitals
II.Ill
69 Six-year-old girl with abnormal appearance
llm
70 Premature baby with acute deterioration of general condition
I =D ifficult Case
