If you are interested in submitting a Puzzler of your own, please see Puzzler guidelines here.
11-year-old boy with testicular pain and rash
January 19th 2024An 11-year-old boy presented to the emergency department complaining of left testicular pain for 2 days, described as intermittent and stabbing, which ranged between 5 and 8 of 10 in intensity. Read the full case to see if you can correctly diagnose the patient.
Newborn with midline neck lesion
A 4-day-old boy with a midline neck lesion was born at term by normal vaginal delivery. After birth, mid line lesion had the configuration of a linear cleft with a cephalocaudal orientation, extending from the level below the hyoid bone to the suprasternal notch with a length of 2.5 cm and a width of 0.5 cm. What's the diagnosis?
A 13-year-old girl with well-demarcated rash on back and chest
October 19th 2023A healthy 13-year-old girl presented with a 1-month history of an asymptomatic, well-demarcated rash on her back and upper chest. The eruption consisted of discrete, dark brown papules that coalesced into large, flat-topped plaques with mild superficial scale and accentuation of skin markings. What's the diagnosis?
Suspicious facial swelling in a 22-month-old girl
October 11th 2023A 22-month-old female patient with sickle cell disease on folic acid and penicillin prophylaxis with a 3-day history of nasal congestion, rhinorrhea, fever and decreased oral intake presents to the emergency department (ED) for acute facial swelling noted when she woke up from a nap. What's the diagnosis?
Friction-induced blistering on a child’s feet
July 14th 2023You are called to the hospital nursery to evaluate a healthy full-term newborn boy who developed painful flaccid blisters and erosions on the tops of his feet and ankles shortly after birth. His mother had a history of similar recurrent skin lesions that healed with scarring. She also had oral and gastrointestinal tract involvement. What's the diagnosis?
A case of late-onset group B Streptococcus infection in fraternal twins
August 18th 2022A 29-year-old White woman presented to the labor and delivery unit due to preterm premature rupture of membranes and delivered twins. The twins were transferred to the neonatal intensive care unit following delivery.
Fever and facial swelling in a neonate
April 11th 2022An 18-day-old girl whose right cheek had become increasingly red and warm over 24 hours was directly admitted to an inpatient unit. She had firmness and pain to the affected area, fussiness, increased sleeping, and poor feeding, preferring the bottle to breastfeeding. What's the diagnosis?
Persistent foot and leg swelling in a 17-year-old female
October 13th 2021A 17-year-old girl presents with a 2-year history of unilateral swelling of the left lower extremity as well as a poorly healed ankle sprain of the affected extremity 3 years prior that slowly resolved but left persistent swelling. What's the diagnosis?