Crying and Fussing Child
last authored: Oct 2009, David LaPierre
This really needs to be cleaned up..
Introduction
The Case of...
Differential Diagnosis
- meningitis
- shaken baby syndrome
- thrush
- gingivostomatitis
- otitis media
- sepsis
- CHF
- mycocarditis
- pneumonia
- pain
- intussusception
- incarcerated hernia
- testicular torsion
- hair tournequet
- constipation
- diarrhea
- volvulus
- necrotizing enterocolitis
- fracture
- osteomyelitis
- syphilis
History and Physical Exam
- history
- physical exam
History
Baseline crying, sleeping, feeding
Infectious symptoms: fever, tachypnea, rhinorrhea, sick contacts
Feeding
- GERD
nausea, vomiting, diarrhea, constipation
trauma
recent immunizations
medications
maternal medications (breastmilk transmission, neonatal withdrawal syndrome)
inconsistent history, numerous emergency visits, high-risk situations suggest abuse
Physical Exam
Perform full head-to-toe exam with child completely undressed
HEENT:
- bulging fontanelle
- blepharospasm
- retinal hemorrhage
- oropharyngeal infection
cardiovascular:
- poor perfusion
- tachycardia
respiratory
- tachypnea
- grunting
abdomen
- mass
- empty RLQ
genitourinary
- scrotal swelling
- penile/clitoral swelling
rectal
- anal fissure
- FOBT
musculosketal
- point tenderness or decreased movement
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Management
Pathophysiology
Resources and References
Topic Development
created: DLP, Aug 09
authors: DLP, Aug 09
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