INDEX OF SUSPICION

Abstract

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page.We invite readers to contribute case presentations with discussions.Case 1 PresentationA 3-mo-old girl is admitted to the hospital for investigation of generalized swelling of 1 week's duration. The swelling involves her face and extremities. Her 2-y-old sister is healthy and her parents are not related.The baby was born at term following an uncomplicated pregnancy and delivery and was breast fed during the first month of life. She fed eagerly but cried a lot, usually beginning 30 to 60 min after each feeding. Suspecting that she was not providing sufficient milk, her mother weaned her to a standard prepared infant formula at 1 mo of age. Although she took the formula well, the baby continued to cry excessively and had loose, foul-smelling stools. On the advice of her physician, she was changed to a soy-based formula, which she again took eagerly.