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• W2894842439 abstract "1. Capt Dwight M. Robertson, DO*2. Tiffany M. Ohta, MD† 1. *Department of Pediatrics, US Air Force, Medical Corps, Naval Medical Center Portsmouth, Portsmouth, VA2. †Department of Pediatrics, CMC Myers Park Pediatrics/CHS-Levine Children’s, Charlotte, NCAn 18-year-old male from the Netherlands presents to the general pediatric clinic for follow-up from 2 visits to the emergency department (ED) with an approximate 1-week history of daily debilitating left-sided frontoparietotemporal headaches with associated intermittent photophobia, phonophobia, left-sided weakness, paresthesia, gait instability, bilateral hand tremors, and blurry vision. The headaches are exacerbated in intensity when supine and waking him from sleep. He denies associated nausea, vomiting, or abdominal pain. Onset occurred after his first presentation to the ED for recurrent oral aphthous stomatitis and erythema multiforme–like lesions. The headaches were poorly responsive to nonsteroidal anti-inflammatory drugs and acetaminophen; however, they would improve slightly with intravenous fluids, diphenhydramine, and prochlorperazine. Results of laboratory evaluation, including a urine drug screen and salicylate and alcohol levels, are normal. Results of noncontrast head computed tomography and magnetic resonance imaging are also reassuring.His medical history was significant for depression, anxiety, polysubstance abuse, and herpes simplex virus-1 in addition to the recurrent oral aphthous stomatitis and erythema multiforme–like lesions. His aphthous stomatitis had been severe enough to require hospital admission 3 times in the past. During his first admission 4 years earlier, he had esophageal and genitourinary tract involvement in addition to the erythema multiforme–like lesions. Extensive evaluation by multiple specialists at that time did not reveal a unifying diagnosis. His second 2 admissions were in close proximity, within 12 months of his clinic presentation. He again had extensive aphthous stomatitis, erythema multiforme–like rash, and a small genital ulceration. A mouth lesion was biopsied and revealed a nonspecific autoimmune inflammatory process and no evidence of herpes infection.His growth curve shows an approximate 5-kg …" @default.
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• W2894842439 date "2018-10-01" @default.
• W2894842439 modified "2023-09-23" @default.
• W2894842439 title "Case 2: Headaches with Recurrent Rash and Mucosal Ulcerations" @default.
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• W2894842439 doi "https://doi.org/10.1542/pir.2017-0231" @default.
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