Non-accidental trauma and neglect (pediatrics) Quiz: Ace Your Exams
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A 10-month-old girl is brought to the emergency department accompanied by her older sibling for evaluation of diaper rash. The 18-year-old sibling states that the patient has been crying and inconsolable for the past two days due to the rash. They report the patient has otherwise been in her usual state of health. The patient lives with her sibling and both parents. The sibling states their parents have been out of town for the past few days. The patient was born at 37 weeks' gestation and is behind on well-child care. Temperature is 37°C (98.6°F), blood pressure is 85/42 mmHg, pulse is 118/min, respiratory rate is 30/min, and oxygen saturation is 99% on room air. On physical examination, the patient is crying in her sibling’s arms. The patient is unwashed and is wearing stained and ill-fitting clothing. The anterior fontanelle is open and flat. Pupils are equal, round, and reactive to light bilaterally. Cardiopulmonary and abdominal examinations are within normal limits. The patient has evidence of severe diaper dermatitis with denuded skin. Which of the following additional findings would be most consistent with the probable cause of this patient's presentation?
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