The patient A 4-year-old boy presented to the hospital with fever, fatigue and weakness. He also complained of blurry vision. He had recently had nose bleeds and oral bleeding. A complete blood count showed pancytopenia, as well as blasts on his peripheral smear. A bone marrow aspiration and biopsy were performed. He was diagnosed with…
The patient A 6-year-old girl was admitted to Norton Children’s Hospital on May 11, 2020, with uncontrolled seizures that progressed to status epilepticus. The challenge After maximal medical intervention, neurosurgery was consulted on June 12, 2020. Her electroencephalogram (EEG) showed a possible seizure focus in the left central and posterior regions, but her MRI showed…
The patient A 25-year-old woman presented with recurrent left second metacarpal giant cell tumor of bone. She previously was treated with extensive curettage, bone graft substitute placement and Kirschner wire fixation. Giant cell tumor of bone is a benign aggressive tumor with a high rate of local recurrence and development of lung metastases in approximately…
The patient A female age 5 years and 11 months presented for evaluation of spinal deformity and back pain in September 2020 from a pediatrician referral. X-rays showed a 53-degree scoliosis curve in the thoracic spine and 42 degrees in the lumbar spine. An MRI was ordered to look for any other spino-neural axis abnormalities….
The patient A 33-year-old male presented with a history of a bicuspid aortic valve. He had previously undergone two aortic valve replacements. The patient first underwent aortic valve replacement in 2009 due to severe aortic insufficiency. A porcine valve was selected due to the patient’s status as a competitive football player. The patient’s recovery for…
The patient A 12-year-old boy born with double-inlet left ventricle (DILV), mitral stenosis, left-sided superior vena cava coronary sinus and pulmonary stenosis: The patient had been through surgical palliation as a baby, leaving him with Fontan circulation. The challenge Over the past decade we’ve learned that single-ventricle Fontan circulation has significant impacts on the heart…
A multidisciplinary team within Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, worked together to save the life of an infant born with structural heart defects and congenital complete atrioventricular block (CCAVB) that led to a slow heart rate. The patient was too small for the traditional path of care, driving the…
The patient A teenage male with Type 1 diabetes mellitus, who is very active in sports and physical activity: He was having extreme difficulty with blood glucose control. The challenge Patient’s blood glucose levels often were high before activity. Lows would occur during activity or after. Treatment of lows often would cause a rebound high…
The patient A 39-year-old nursing student initially presented with complaints of a two-year history of intermittent numbness in the tips of the middle and ring finger on her left hand. Over the past six months, she developed episodic numbness in the left face and twitching in the left eye. An MRI scan demonstrated a brain…
The patient A 14-month-old female presented to the emergency department with fever and refusal to bear weight. She had bilateral ear tube insertion 13 days previously and presented to her primary care provider (PCP) three days prior for a viral respiratory infection. She presented to her PCP the day before her admission for refusal to…
The patient A young adolescent male who participates in competitive football and basketball and with history of recent COVID-19 infection was admitted to the pediatric intensive care unit at Norton Children’s Hospital. The initial workup was consistent with multisystem inflammatory syndrome in children (MIS-C), and clinical presentation was consistent with severe MIS-C with respiratory, liver…
The patient Newborn with hypoplastic left heart syndrome (HLHS) with a dysplastic pulmonary valve and progressive pulmonary valve stenosis The challenge The dysplastic pulmonary valve makes it unsuitable to proceed with the typical first stage of single ventricle palliation for hypoplastic left heart syndrome (HLHS) — the Norwood procedure, which would transition the pulmonary valve…