she is a 2 year old girl. She began a week before with a sort of prurigo.

Parents did not washed her, for they believed she would get worse with water.

So they applied a corticoid cream and talcum on her body.

She did scratch herself all the time.

But they wrapped her up with more clothes, i must tell you here we are on late summer and the weather is hot and wet.

But her parents did not washed her for a whole week.

Then she got worse and they bring he

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Here are x rays and brain ct scan of an 18 months old girl.

She is in the begining of her second week of illness. She had hemolytic uremic syndrome due to invasive diarrea with e coli. At this moment she was edematous, anuric, with all blood tests positive to this known syndrome. she presente

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Hello, this is a 16 hours newborn with very critic respiratory disstress, who was born in a little town called Ilo two hours away from our city. Pediatrician refers apgar 3 and 5, does not withdraw blood, do not have arterial gases, tells us amniotic fluid is greenish. mouth and nose secretions were cleaned. Then this baby starts to breathe rapidly with retractions. So they sent him to our hospital. We receive this baby at 18 hours of life, with a first x rays it looks like meconium pneumonit

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Story
A 7-year-old male came to clinic with a 4 day history of a sore throat. His mother reports that he also had some voice changes like laryngitis and some mild croupy sounding cough. That morning he came to the kitchen for breakfast crying almost inconsolably because he was in so much pain. The past medical history was non-contributory. The review of systems revealed no fever, chills, rhinorrhea, ear pain, headache, muscle ache, abdominal pain or rash.

The

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This is a 14 months old boy. his illness begins two months ago with loss of movement in his right arm and leg. their parents take him to "curandero" in order to heal him. One month after this empirical and unknown treatment they bring him to hospital. He is worse with tumor on his scalp and his rigth ear and otorragia.

On examination he has few adenopaties, no splenomegaly, his liver edge is palpated 1 cm under ribs. No petquias, no pale skin.

platelets 697000, INR 1.1, WBC coun

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She is a 5 years 6 months old girl. Her mother brings her to ER at 4 am before sunrise with a history of 2 days of loose stools, little appetite, nausea, abdominal pain. Last night she slept but was felt hot and moaning.

As most of us here in Peru, sanitation is poor, drinking water is scarce, hygiene education is low, this family also had dogs, cats, chicken inside their house. (not a farm, but downtown)

On initial examination she was febrile, her abdomen was distended, pain on

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Story

A pediatrician was reading for pleasure and came across this passage describing Mary Queen of Scots, just before her ascension as Queen of France when she was 17 years old in 1559:
"{England's ambassdor to France} Throckmorton also noticed that Mary was unwell and she soon had to retire from court in a state of nervous collapse. He found Mary and Henri's daughter, Marguerite, 'somewhat sickly' and on 24 May, visitors said she was 'very ill, pale and green and withal shor… Continue

He is a boy 12 years old, he arrives at our emergency room at 3 am moaning and crying with abdominal pain. His mother tells it just began last nigth, she automedicated him with no avail, he did not slept well and was asking for help, afterwards he commenced with vomiting, she says yellowish-greenish, so she decided to bring him to ER.

he was afebrile, crying, could barely walk, could not sit from recumbent position. his abdomen was hugely distended, asymetric, hard to plapate, highly t

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She is a girl 7 years old. Her mother says there are 5 days of illness characterized by fever, cough, left side pain, especially on breathing, and difficult breathing. She has complete inmunizations, no previous diseases. Her stools, urine are ok, her appetite decreased. In pediatric office they take an x rays (not available) which they report as total opacification of left lung, they send her to our hospital.

She is 25 kg, temperature 37.7 celsius, respiratory rate 33, pulse 130, oxim

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A 4-year-old male came to clinic with a 1 week history of daytime enuresis. He was toilet trained for urine during the day for 9 months and used diapers at night, but over the past week often would have urinary incontinence. There was no dysuria or constipation but polyuria and polydipsia. The review of systems showed no weight loss, nausea, emesis, or fever. The family denied concerns of abuse.

The pertinent physical exam showed a well appearing male with normal vital sig

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