Peds

Peds – Gastro/AGE – Nontoxic

Peds

This is a *** pt presenting with abdominal pain, +fever, +myalgias, +diarrhea, and nausea most consistent with viral gastroenteritis. ***sick contacts with similar symptoms. Differential includes invasive/toxic diarrhea, sepsis, influenza, along with the far less likely surgical etiologies such as volvulus, appendicitis, malro, and SBO. No change in diet or abnormal exposures. No known stagnant water exposure, recent camping/hiking. No dietary history or bloody BM’s suggestive of B. Cereus, S. Aureus, or other invasive bacterial enteric pathogens. Pt with good capillary refill (<2 sec), MMM, and is nonseptic in appearance. Clinically is not dehydrated.  Unlikely to represent unusual manifestation of UTI, GERD, partial or complete anatomical obstruction, or other acute abdomen. Pt tolerating PO rehydration and is very well-appearing.

Plan: Presumed self-limited etiology; plan to DC home with return precautions and oral rehydration education.

Peds Cough – URI

Peds

*** year old *** presenting with cough. Patient is afebrile. Presentation consistent with uncomplicated viral URI given classic history and physical exam, positive sick contacts, and well-appearing child***. No warning signs of systemic infection (fevers, tachypnea) to suggest pneumonia, and lung sounds clear on exam. No photophobia or neck stiffness/pain to suggest meningitis. No rash. No clinical evidence of dehydration and child is taking excellent PO and making multiple wet diapers per day. Patient has attentive parents and good follow up.

Plan: Discharge to home with strict return precautions, encourage PO hydration, return to ***clinic/ER in 48 hours if no improvement