Case Archive
Pediatric Infectious Diseases
Ref. # 96218

A 14 year old Georgia boy presented to an urgent care center with sudden convulsions, chills, body aches and fever. A screening for strep was negative. The attending family practitioner presumed tonsillitis/URI and prescribed amoxicillin, advising that the medication can take 24 hours to take full effect. At home the boy suffered diarrhea and vomiting then went into a deep sleep. When his condition did not change after 48 hours, his mother called an ambulance, which took him to a major medical center. Diagnosis was toxic shock as a result of a staph aureus originating from an ingrown toenail. The boy suffered organ failure during the next three weeks and subsequently died. A medQuest pediatric infectious disease specialist opined that the F.P. negligently performed a cursory, superficial examination. Standard of care required thoroughly evaluating tissues around the toes in light of the patient's symptoms. With timely diagnosis and treatment, the boy's death would have been avoided.

Pediatric Infectious Diseases
Ref. # 93628

A 15 year old Missouri boy presented to ER and was treated for pharyngitis and fever. Four days later he returned and was diagnosed with hepatitis and instructed to see his family physician in a few days. Three days later the patient was admitted to the ER with profuse diarrhea; he was diagnosed with fuso-bacterium necrophorum sepsis. The patient died 16 days later from ARDS and multi-system organ failure. A medQuest pediatric infectious disease specialist reported that fuso-bacterium necrophorum is a very rare pathogen with a high morality rate, consequently the treating physicians could not be faulted for not initially suspecting it. However, there was negligent failure to perform the appropriate evaluations during the initial ER visit, when the patient had abnormal lab values, and again during the second ER visit, when the patient was jaundiced. Timely and appropriate testing would have identified the pathogen and may have prevented the boy's death.

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