title: Fever and limp: thinking outside the box.
abstract: Fever and limp is a common presentation in the pediatric emergency department. We describe a case of a 21-month-old female patient with prolonged fever and difficulty bearing weight, ultimately diagnosed with a large intracranial abscess. Intracranial abscesses are a rare cause of limp and an uncommon diagnosis in pediatric patients without underlying congenital heart disease. This case highlights the importance of differentiating the features of limp secondary to pain from limp secondary to weakness, which is particularly difficult in the preschool-aged group. It is imperative for practitioners to consider disease of the central nervous system when evaluating acutely nonambulatory children with fevers.
authors.affiliation: Division of Emergency Medicine, Children's National Medical Center, School of Medicine and Health Sciences, George Washington University, Washington, DC 20010, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Mathison
authors.forename: April
authors.initials: A
authors.lastname: Troy
authors.forename: Michael
authors.initials: M
authors.lastname: Levy
mesh_terms: D000015:Abnormalities, Multiple; D000853:Anophthalmos; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D001922:Brain Abscess / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery; D002097:C-Reactive Protein / Q000032:analysis; D002971:Cleft Lip; D002972:Cleft Palate; D060085:Coinfection; D003131:Combined Modality Therapy; D003399:Craniotomy; D003951:Diagnostic Errors; D004322:Drainage; D005260:Female; D005334:Fever / Q000209:etiology*; D005625:Frontal Lobe / Q000382:microbiology / Q000473:pathology*; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006192:Haemophilus Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D044135:Haemophilus parainfluenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D012141:Respiratory Tract Infections / Q000150:complications; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D013585:Synovitis / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein