Index of Suspicion

Abstract

Index of Suspicion| September 01 2010 Index of Suspicion Pediatr Rev (2010) 31 (9): 389–395. https://doi.org/10.1542/pir.31.9.389 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Index of Suspicion. Pediatr Rev September 2010; 31 (9): 389–395. https://doi.org/10.1542/pir.31.9.389 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsPediatrics In ReviewPediatricsHospital PediatricsNeoReviewsAAP Grand RoundsAAP NewsAll AAP Sites Search Advanced Search Subjects: Chapters Views & News, Commentary, For Your Information, In Memoriam, Seen & Heard, Washington Report Topics: bartonella henselae, blood culture, ceftriaxone, cerebrospinal fluid culture, congenital absence of spleen, dermal sinus, escherichia coli, fever, hemoptysis, magnetic resonance imaging A previously healthy 3-year-old girl presents with a 5-week history of an enlarged nodule involving the right frontal scalp area that began as a reddish-purple papule. There is no history of pain, redness, or drainage. She is afebrile and otherwise asymptomatic. However, she had experienced minor trauma 2 years ago when she accidentally struck her head on a table. Her grandmother describes her granddaughter's living conditions as “filthy,” and the girl often plays outside in the soil. Household animal contacts include frequent exposures to puppies and kittens. Physical examination reveals a 2-cm raised mass in the right frontal region of the skull, with surrounding edema and mild tenderness. Radiographs (Fig. 1) show a right frontal lytic lesion that has a small central density, possibly reflecting a sequestrum. Head CT scan shows the lesion extending from the bone into the adjacent scalp. MRI suggests an eosinophilic granuloma or osteomyelitis... You do not currently have access to this content.