Participate in the live version of Dr. Brien’s famous “What’s Your Diagnosis” session – celebrating 25 years this fall!

In 2017, as we celebrate the 30th anniversary of the Infectious Diseases in Children Symposium, James H. Brien, DO, will lead two sessions of the popular What’s Your Diagnosis case questions and answers session this November. Join us for a weekend in New York city and see whether you can make the correct diagnoses on challenging and mysterious illnesses and infections that specialists have recently encountered in their practices.

Get a glimpse into the real case presentations for 2017:

Case #1
A healthy 11-year-old female presents with a rash about the face, that first appeared about 2 months earlier as simple, uninflamed papules, described to be mildly pruritic and occasionally inflamed. A few similar lesions soon appeared on her knee. Her past medical history reveals no other health problems, and examination reveals normal vital signs, except for the numerous discrete fleshy papular lesions, scattered on the face, including the eyelids, some of which are umbilicated, as well as some small patches of erythema.

Case #2
A 36-week gestation newborn male is delivered by emergency C-section due to decreased fetal movements. Pregnancy was complicated by mother being Group B Strep-positive and taking Zoloft (Sertraline) for depression. Mother, who is healthy, was given a dose of IV Penicillin. A blood culture was obtained on the baby per protocol, and empiric treatment was begun with Ampicillin plus Gentamicin. Examination of the baby reveals a fever of 101.5° F and the left arm having a necrotic-appearance from the mid-forearm to the hand, dark, purplish skin with an irregular sharp line of demarcation. Lab tests include a pending blood culture and culture of some fluid aspirated from under the “blistered” skin. A gram stain of the fluid was negative. A complete blood count, metabolic profile and coagulation studies were normal. A vascular ultrasound study of the left arm was normal.

Case #3
A previously healthy 2-year-old male presents with a 2-day history of progressive erythema and painful swelling of the apex of his nose. Initially, he complained of pain with the erythema, but by the second day, some epistaxis caused more alarm for concern. He has no history of significant illnesses or injuries, or foreign body in his nose. Examination revealed normal vital signs, only a healthy-appearing male with a painful, erythematous and swollen apex of his nose, with some old blood about the right nostril. The patient is admitted to prevent a severe complication.

Case #4
A previously healthy 4-year-old female presets with a rash and sore mouth. About 2 weeks earlier, she had a fever with hoarse voice. She was diagnosed with a viral illness, which lasted 4 days. She seemed to be well for a while, but a few days ago, she had the onset of a rash on her face, spreading to the trunk and extremities along with some oral sores and subjective fever. Her intake has been poor due to pain in her mouth, and she was referred for admission for dehydration, and further evaluation. Examination revealed normal vital signs, and a rash consisting of about 50 discrete, round erythematous lesions of various sizes, with many containing dark to black centers a few with small vesicles in the center. Her lips were covered with numerous discrete ulcerative lesions, with some dried blood. Her mouth had similar discrete, ulcerative lesions throughout. Her eyes and other mucous membrane surfaces were clear. HINT: She presented to her primary 8-months later with a similar episode of mouth sores without skin lesions.

Case #5
A previously healthy 5-year-old male was brought to his primary for evaluation of a painless lump in the patient’s right proximal thigh, first noted a few weeks earlier. A course of cephalexin and a subsequent course of Clindamycin were tried without benefit. There has been occasional, clear discharge and it appears to be slowly growing in size. There’s no history of significant injury; only common play-related scratches & bruises. Examination reveals normal vital signs, except for a soft mass in the right proximal, medial thigh, measuring about 2 X 2 cm, with some dark erythema about the lesion, as well as the umbilicated or puckered top.