A 6-Year-Old Girl With Fever and Abdominal Pain

Nuzhat Ali, MD, and Kyle Smith, MDSeries Editors: Sheryl Falkos, MD, and Rosa A. Vidal, MD

Disclosures

September 21, 2005

Physical Examination

A 6-year-old girl presented to the emergency room with a 3-hour history of left-side abdominal pain and fever. Her mother reported that the patient fell asleep after having dinner, which consisted of refried shrimp rice and broccoli left over from 3 nights prior. Nobody in the house ate the same food. About an hour and a half later, the patient woke up screaming in pain and holding her left side, saying it was hurting. In addition, the mother reported that the child had a fever of 102.6º F 2 days ago, but denied any vomiting, diarrhea, or dysuria. She stated that the patient also had a mild cough and that her last bowel movement was about 2 days ago.

The past medical history was negative.

Vital Signs: Oral temperature 102.8º F, pulse 177, respiratory rate 28/min, blood pressure 132/85 mmHg
Weight: 30.2 kg
Peripheral oxygen saturation on room air: 98%

General Appearance: The patient is alert and appears to be in moderate distress, holding her left side and curled up in the fetal position

Cardiovascular: Regular heart rate and rhythm

Respiratory: Breath sounds clear on auscultation bilaterally

Abdomen: Soft, with moderate tenderness to deep palpation over the left lower quadrant; bowel sounds audible, without hepatosplenomegaly or costovertebral angle tenderness.

The remainder of the physical examination was within normal limits.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....