Differential Diagnosis in Pediatrics (Including Color Atlas) Suraj Gupte
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table
A
Abdomen, anatomical topography of 225f
Abdominal discomfort 34f
Abdominal distension 11f, 55, 56
etiology of 55, 55t
history 55
investigations 56
massive 40f
physical examination 55
Abdominal mass 225
history 225
investigations 226
parietal lump 226
physical examination 225
Abdominal pain 58, 59t
causes of 60b, 64
chronic 59b, 62
history 60
investigations 60
physical examination 60
recurrent 24f, 58
types of recurrent 58
Abetalipoproteinemia 73
Abscess 7f
appendiceal 249
fecal brown 16f
iliopsoas 232f
large 35f
liver 62
lumbodorsal 16f
lung 83, 101, 161, 248
pelvic 249
retropharyngeal 273, 273f, 277
subperiosteal 43f
subphrenic 62
Acanthocytosis 312, 312f
Acetazolamide 129, 175, 164, 194, 283
Achalasia 286
Achondroplasia 24f, 260f
Aciduria, organic 10f
Acquired immunodeficiency syndrome 116, 183, 183b, 223, 250
Acrocyanosis 103f
Acrodermatitis enteropathica 39f, 10f, 116
Acrodynia 10f
Acute abdominal pain 60
causes of 59b
Acute diarrhea
causes of 111b, 115
etiology of 111
Acute respiratory distress syndrome 119
Adenoid facies 49f
Adenoidectomy 171
Adenoma sebaceum 25f
Aerophagy 56
Air bronchogram 327
Air-fluid levels, multiple 330
Alanine aminotransferase 318
Albinism 236
Albright's hereditary osteodystrophy 20f, 238
Albright's syndrome 238
Albumin, high serum 316
Albuminocytological dissociation 320
Albuminuria 319
Alkaline phosphatase, low 318
Alkalosis 230
Alkylating agents 43f
Allergy
food 63f
history of 100
Alopecia 10f
acquired diffuse 43f
Alpha-1-antitrypsin deficiency 13f, 126
Alpha-thalassemia 134
Alveolar capillary dysplasia 122
Ambiguous genitalia 16f, 29f, 44f, 65
classification of 65b
diagnosis of 66fc
history 65
investigations 65
physical examination 65
Amebiasis, chronic 151
Amelia 35f
Aminoaciduria 319
Aminophylline 129, 194
Amitriptyline 164
Amphetamine 192, 194
Amylase, high serum 318
Anagen effluvium 43f
Anal fissure 45f, 75, 91
Anal orifice, placement of 90
Anaphylactoid purpura 62, 132, 258
Anasarca 132
Ancylostoma duodenale 58
Ancylostomiasis 151
Androgen action defect 65
Anemia 68, 69, 69b, 71
acquired hypoplastic 71
aplastic 52f, 69, 71
autoimmune hemolytic 71, 201
clinical grading of 68t
congenital
hemolytic 70
hypoplastic 71
drug-induced hemolytic 200
hemolytic 70
history 68
hypochronic 311
investigations 68
macrocytic 311
physical examination 68
severe 28f
types of 49f
unexplained 70
WHO grading of 68t
Angioma 276
Anhidrotic ectodermal dysplasia 37f, 252
Anisocytosis 70, 184
Anorectal defect, level of 28f
Anorectal stenosis 90
Anorexia 34f, 69, 183, 222
Anotia 17f
Anterior mediastinum, enlargement of 323
Antibody
antinuclear 251
blocking 197
Anticonvulsants 10f
Antidiarrheal drug 112
Antihistamines 154, 194
Antimalarials 71
Antimetabolites 43f, 71
Antimongoloid slant 39f, 298, 298f
Aorta syndrome, coarctation of 128
Aortic stenosis 128, 167
Apert syndrome 39f, 48f, 266, 298f
Aphasia 163
Apnea 278
Appendicitis
acute 60
chronic 249
diagnosis of 60
Apt's test 170
Arachnodactyly 15f, 39f
Arachnoid villi 210
Argemone mexicana 137
Arnold-Chiari malformation 36f, 210f
Arrhythmias 279
Arthralgia 203, 205, 206, 222, 223
Arthritis 203, 223, 307
juvenile idiopathic 205
pauciarticular juvenile idiopathic 17f
Arthrogryposis multiplex congenita 304f
Arthropathy, hemophiliac 13f
Ascariasis 151, 182
Ascaris lumbricoides 58, 125, 231
Ascites 55, 57, 306
massive 13f
Ascitic fluid collects 57
Ash-leaf spot 6f
Aspiration, massive 118
Aspirin 60, 175, 283
Asthma 5f, 327f
bronchial 101, 122
history of 100
severe 103
Astrocytoma 73
Ataxia 72
acute 305
causes of 73
history 72
investigations 72
physical examination 72
progressive 73f
telangiectasia 6f, 73
Atelectasis 125
Athetosis 192
Atopy 5f
Atresia
biliary 199t
extrahepatic biliary 14f, 180f, 199
Atretic obstructive lesions 276
Atrial enlargement, left 328
Atrial flutter 304
Atrial septal defect 29f, 127, 166, 168, 264
Atrial tachycardia, paroxysmal 127
Attention-seeking device 64, 164
Auerbach's plexuses 91
Aura 163
Auspitz sign 8f
Autonomic nervous system, abnormal 279
Autosomal dominant
disorder 303f
syndrome 23f
Autosomal recessive disorder 33f
Autosplenectomy 64
Azathioprine 61
Azotemia 319
B
Babinski's sign 73
Bacteremia, severe 268
Bacterial infections
generalized 249
localized 248
Bad breath 161
Bad oro-dental hygiene 161
Barium enema 61
Basilar impression syndrome 165
Basophilic stippling 311
Bassen-Kornzweig syndrome 73
B-casomorphin 279
BCG diagnostic test 249
Beckwith syndrome 175
Beef tapeworm 151
Beeturia 173
Behcet disease 247
Belladonna poisoning, sign of 87
Bile syndrome 200
Bitot spot 32f
Blastomyces dermatitidis 251
Blastomycosis 251
Bleeding diathesis 13f
Blepharitis 10f
Blindness 300
Blood
count, complete 133
dyscrasias 75
in stools 74
causes of 76
history 74
physical examination 74
loss 69
acute 43f
picture, complete 68, 254
pressure, systolic 128
urea nitrogen 278
Blue sclera 299
Bluish purple gums 81
Body mass index 237
Bone
age
interpretation of 262b
through radiology 261t
density, increased 332
Bordet-Gengou medium 178
Boric acid 43f
Bornholm's disease 62, 78
Bottle baby disease 25f, 157
Bowleg deformity 26f, 302
Brain
damage 108
development 265
tumor 36f, 73, 252
Brainstem 279
Brandt's syndrome 116
Breastfeeding 39f
Bronchial foreign body 188
Bronchiectasis 83, 101, 328f
Bronchiolitis, acute 123, 123f
Bronchitis
acute 100
asthmatic 124
Bronchomalacia 279
Bronchopneumonia 34f, 123f
hospital-acquired 30f
Brucellosis 249
acute 221
chronic 222
Brudzinski signs 218, 273
Bruises, aging of 242t
Brushfield spots 5f
Buffalo hump 3f
Bulging anterior fontanel 296
Bull-neck appearance 21f
Bullous dermatosis, chronic 9f
Burkitt lymphoma 51f
Butterfly rash 305
C
Café-au-lait spots 6f, 305
Caffey disease 81, 253
Calcium, high serum 318
Calf hypertrophy 306
Campomelic syndrome 66
Campylobacter 114
jejuni 111
Cancer chemotherapy 43f
Cancrum oris 159
Candida albicans 114
Candidiasis 5f
Canker sores 160
Caput succedaneum 136
Carbamazepine 154, 164, 283
Carbohydrate malabsorption 115
Cardiac disease origin, cyanosis of 104
Cardiac failure, congestive 30f, 57, 101, 103, 125, 127, 128f, 132, 134, 174, 238, 289
Cardiac murmur, innocent 304
Cardiomyopathy 128, 327f
hypertrophic 129f
Cardiorespiratory distress, severe 126
Cardiovascular disorders 83, 135
Cardiovascular system 73
Carotid body defects 279
Carpal bones 261
Carpenter syndrome 31f, 266
Cataract 299
congenital 236
Cavernous sinus thrombosis 43f
Celecoxib 60
Celiac disease 18f, 30f, 39f, 57, 57f, 109, 113, 115, 151, 194
Cellulitis 7f
Central nervous system 93, 106, 147, 171, 190, 193, 209, 268, 272, 278, 283, 285
congenital malformation of 95
diagnosis of 249
Cephalhematoma 197
large 199
Cephaloridine 71
Cephalosporins 71
Cerebellar
ataxia
acute 72
congenital 146
disease 236
Cerebral
abscess 95
diplegia 269
gigantism 21f, 298f
hemorrhage 119
malaria 95, 273
palsy 26f, 49f, 146
perfusion pressure 248
Cerebrospinal fluid 94, 164, 185, 193, 194f, 245, 249, 273
Cervical
lymphadenitis 35f, 272
tumor-bearing 24f
lymphadenopathy 222, 272
Chancre 222
Chassaignac's paralysis 203
Cheilosis 159
Chest
deformity 126
dull percussion note 306
pain 77, 77b
benign 77
causes of 78
history 77
investigations 77
organic 78
physical examination 77
wall compliance 30f
X-ray 328
findings, grading of 118t
Chickenpox 256, 325f
rash 257f
Child abuse 41f
and neglect 79, 79f, 80f
history 79
investigations 80
nonorganic failure to thrive 80
physical abuse 80
physical examination 79
sexual abuse 80
physical indicators of 80b
Childhood disability, causes of 35f
Chlamydia 207
trachomatis 223, 251
Chlamydial infection 251
Chloramphenicol 71
Chlorpromazine 164, 272
Choanal atresia 121
Cholecystitis 62
Chondroitin sulfate 185
Choreoathetosis 192
Chromosomal syndromes 300
Chronic ataxia
progressive 306
static 306
Chronic obstructive pulmonary disease 290f
Cirrhosis 37f
biliary 13f, 57f
childhood 186f
clinical diagnosis of 13f
Cleft
lip 12f
palate 12f, 29f, 279
Clinodactyly 302, 302f
Clitoris, hypertrophied 44f
Clonazepam 194, 237
Clostridium difficile 75, 114
Club foot 304
Clubbing 42f, 82
causes of 84
history 82
physical examination 82
Coarctation of aorta 29f, 168
Cobbler-stone 231
Cold
agglutinin disease 202
injury 134
Collodion baby 7f
Coloboma 14f
Color blindness, total 236
Coma 85
central nervous system infections 88
dehydration and electrolyte imbalance 88
diabetic ketoacidosis 87
drugs and poisons 87
head injury 87
hepatic 181
history 85
hypoglycemic shock 87
hysteria 88
liver disease 88
nonketotic hyperosmolar 87
physical examination 86
fever 86
fundoscopy 86
head and body 86
limbs 86
neck rigidity 86
reflexes 86
remaining causes of 88
seizure disorder 87
syncopal attacks 88
uremic 88
Conjunctiva, palpebral 24f
Conjunctivitis 13f
Consciousness, stages of depressed 85
Conservative hydrostatic reduction 61, 75
Constipation 63, 89, 157
childhood 91
chronic 18f, 138
history 89
investigations 90
later infancy 91
benign 91
organic 91
neonatal 90
and early infancy 90
benign 90
early infancy 90
organic 90
physical examination 90
severe chronic 138
Cooley anemia 70
Coombs’ test 71
Copper-beaten appearance 332
Cor pulmonale 126
Corpora cavernosa 38f
Cortical hyperostosis, infantile 81
Corticosteroids 61
Costochondral beading 301
Costochondral prominence 301f
Costochondritis 78
Cough 100
causes of 102
chronic 100
history 100
investigations 100
physical examination 100
severe 22f, 62
uninterrupted 23f
Coumarins 43f
Cow's milk 69
allergy 60, 63, 69, 76, 134
protein intolerance 156
Coxa vara, congenital 214
Coxsackie stomatitis 159
Craniofacial dysmorphism 33f
Craniopharyngioma 154, 332f
Craniosynostosis 20f, 42f, 265, 331
microcephaly secondary to 266f
Craniotabes 296
C-reactive protein 248
high 317
Crohn's disease 63, 76, 116, 231, 253
Croupy cough 275
Crouzon's syndrome 48f
Cryptophthalmos, bilateral 15f
Cryptosporidiosis 116
Cubitus valgus 33f
Curling's ulcer 171
Curth's modified profile sign 83
Cushing's syndrome 3f, 241, 263
Cushing's ulcer 171
Cyanosis 42f, 45f, 103, 105, 177
central 103, 104f
congenital heart
disease 104
failure 105
defect 104
history 103
investigations 103
peripheral 103
physical examination 103
upper airway obstruction 104
Cyclopentolate 194
Cyclophosphamide 71, 129, 175
Cycloserine 194
Cystic fibrosis 10f, 18f, 42f, 57, 82, 83, 103, 109, 115, 152, 289, 291f
Cysticercosis 93
Cysts
congenital 187
intra-abdominal 329
Cytomegalic inclusion disease 250
Cytomegalovirus 14f, 107, 247
infection 221, 243
D
Da Costa syndrome 77
Dandy-Walker
anomaly 210
cyst 210f
de Lange syndrome 39f
Deafness 106, 300
congenital 107
genetic 107
nongenetic 107
history 107
physical examination 107
postnatal 108
genetic 108
nongenetic 108
special tests 107
Defective feeding, types of 287
Degenerative diseases 138
Dehydration 56
fever 156
severe 35f
Demeclocycline 154
Dengue
fever 253
hemorrhagic fever 245
grading of 245b
shock syndrome 245
Dental
caries 15f
eruption 37f
Depression 316
Dermatitis
atopic 5f
herpetiformis 257, 257f
Dermatomyositis 251
Dermatophytosis 5f
Dermoid cyst 227
Devil's grip 78
Dextrocardia 328f
Diabetes
insipidus 153, 253
maternal 134
mellitus 153, 159, 263, 288
Diamond sign 82
Diaper rash 11f
Diaphragm, paralysis of 121
Diarrhea 60, 69, 111, 157
acute 111, 112
chronic 10f, 18f, 42f, 57f, 109, 112, 112b, 113, 115, 194
anemia 115
intestinal parasitic infestations 115
iron-deficiency 115
protein-energy malnutrition 115
cow's milk allergy 116
history 112
infective 114
noninfective 114
persistent 111, 113
physical examination 113
acute 113
chronic 113
persistent 113
relevant investigations 113
acute 113
chronic 113
persistent 113
Diarrheal disease 111f
Diastolic murmur 166, 168
aortic incompetence 168
mitral stenosis 169
pulmonary incompetence 168
tricuspid stenosis 169
Diazepam 137, 164, 283
Diclofenac 60
Dietary intake, poor 91
DiGeorge syndrome 39f
Digestive function, altered 112
Digital clubbing 82f
Diphenhydramine 71
Diphenoxylate HCl 57
Diphenylhydantoin sodium 160
Diphtheria 276
Disseminated intravascular coagulation 46f, 47f
Diverticulitis 232
Doll's eye phenomenon 86
Doll's head maneuver 86
Dorsal meningocele 16f
Double bubble appearance 329
Down's syndrome 3f-5f, 26f, 39f, 56, 146, 146f, 166, 331f
Dropsy, treatment of 137
Drowsiness, progressive 22f, 35f
Drug toxicity 72
Duchenne muscular dystrophy 216f
Duodenal atresia 330f
double bubble sign in 329f
Duodenal ulcer disease 63
D-xylose malabsorption 194
Dysentery 75
Dysmorphic facial features 12f
Dysphagia 272
Dysplasia 216f
developmental 213
Dyspnea 117, 118, 122, 190, 275, 290
history 117
investigations 117
physical examination 117
Dystonia 36f
Dysuria 60, 130
acute glomerulonephritis 130
drugs 131
history 130
investigations 130
physical examination 130
physiologic 130
urinary
lithiasis 130
tract infection 130
E
Ebstein-Barr syndrome 219
Ectopic anus 90
Eczema 5f
infantile 288
Edema 132
after neonatal period, localized 136
angioneurotic 136, 288
cardiac cause 133
etiology of 132b
generalized 134
history 132
in newborn, localized 136
abdominal wall 136
face 136
genitalia 136
head 136
limbs 136
non-pitting 136
nutritional 134
physical examination 132
pitting 136
renal 134
Edwards’ syndrome 48f
Effort syndrome 77
Ehler-Danlos syndrome 18f, 245
Eisenmenger complex 105
Ejection systolic murmur 167, 168
Elbow 261
Electrolyte imbalance 134
Elliptocyte 312f
Elliptocytosis 312
Ellis-Van-Creveld syndrome 29f, 31f
Embryonic testicular regression syndrome 66
Emotional disturbance 138
Emphysema 125, 179
Empyema 83, 124, 326f
Encephalitis 72, 95, 273
Encephalocele, cranial 16f
Encephalopathy, hypoxic ischemic 119
Encopresis 45f, 138
history 138
investigations 138
local defects 139
physical examination 138
types of 138
Endemic tropical sprue 152
Endocarditis, infective 83, 249
Endogenous obesity 238
Cushing's syndrome 238
genetic syndromes 238
hypothalamic dysfunction 238
hypothyroidism 238
polycystic ovaries 238
Prader-Willi syndrome 238
Entamoeba histolytica 62, 112, 114, 115, 182, 231
Enteric bacteria, gram-negative 204
Enteric infections 111
Enterobius vermicularis 130, 131
Enterocolitis, necrotizing 61, 75
Enteroteratoma 227
Enuresis 140
anatomical defects 141
emotional deprivation 141
enuresis 140
familial 141
history 140
investigations 140
mental retardation 141
neurogenic bladder 141
physical examination 140
primary 140
poor toilet training 140
regressive 140
secondary 140, 141
metabolic disorders 141
psychological 141
worm infestation 141
types of 140
urinary tract infection 141
Enzyme 198
Eosinopenia 314, 314f
Eosinophilia 313, 314f
tropical 124, 325f
Ephedrine 164, 194
Epicanthal fold 298, 298f
Epidemic dropsy 136
Epidermolysis bullosa simplex 9f
Epigastrium 226
Epiglottitis, acute 189, 276
Epilepsy 97, 284
abdominal 63
classification of 97, 97b
evidence of 63
focal 98
grand mal 97
idiopathic 97
organic 97
simulating states 98
Epistaxis 142, 171
allergy 143
bleeding disorders 143
causes of 143
congenital vascular defect 143
foreign body 143
history 142
investigations 142
nasal polyposis 143
physical
and emotional stress and strain 143
examination 142
recurrent 143
remaining causes of 143
solar radiation 143
systemic diseases 143
trauma 143
upper respiratory infection 143
Epstein-Barr virus 221, 256
Erysipelas 7f
Erythema
infectiosum 256
multiforme 10f
toxicum 255f
Erythrocyte sedimentation rate 248, 291
Erythroid
hyperplasia 316
hypoplasia 316
Escherichia coli 61, 75, 111, 198, 269
Esophageal atresia 286
Esophageal sphincter, lower 286
Esophageal varices 171f
Esophagus 286
chalasia of 286
foreign body in 171
Ethambutol 164
Ethionamide 194
Ethosuximide 164
Eunuchoid stature 109
Evening colic 63
Exomphalos major 227f
Exomphalos minor 227f
Exophthalmos 299
Extracorporeal membrane oxygenation 122
Extremity, lower 35f
Eyebrows, absence of 37f
Eyelid, left upper 14f
Eyes
antimongoloid slant of 298
bulge 23f
downslanting 282
mongoloid slant of 297
movements 43f
limitation of 24f
F
Face edema 136
Facial palsy 31f
Facies, hemolytic 42f
Fahr syndrome 331f
Failure to thrive 148
environmental deprivation 150
history 148
investigations 149
maternal 150
nutritional deprivation 149
physical examination 149
remaining causes of 152
social 150
tuberculosis 152
False penile urethra, development of 67
Fanconi anemia 6f
Fatty acid deficiency 10f
Febrile seizures 95
Fecal pellets 90f
Fecal soiling 138
Fecolith 45f, 55, 90, 91f
Feeding problems 155
bottle addiction 157
change in bowel habit 157
choking 157
colic 156
dehydration fever 156
excessive crying 156
history 155
investigations 155
overfeeding 157
physical examination 155
poor mothering 157
regurgitation 155
sucking difficulties 156
swallowing difficulties 156
underfeeding 157
vomiting 156
Femoral epiphysis, slipped capital 214
Fenfluramine 154, 194
Fertile eunuch 109
Fetal
alcohol syndrome 46f, 166, 191
part of 14f
hemoglobin level 68
transfusion syndrome 28f
Fetoprotein, high alpha-1 317
Fetor hepaticus 88
Fetor oris 161
Fever
blisters 248
enteric 249, 268f
glandular 221
high 223
recurrence of 305
Fever of unknown origin 246
collagen disorders 251
dehydration fever 252
drug fever 252
factitious fever 252
history 246
infections 248
investigations 248
malignancies 251
malingering 252
miscellaneous causes of 253
normal high temperature 253
physical examination 247
Fibrillation 304
Fibrin-split products 243
Fibrocystic disease 152
Fibrous tissue 298f
Finger-nose test 191
Flaccid paralysis, acute 21f
Flaky-paint dermatosis 35f
Flat foot 304
Flexible flat feet 20f
Floppy baby syndrome 144, 144f
causes of 144b
central etiology 145
drugs 147
investigations 144
peripheral etiology 145
physical examination 144
remaining causes of 147
Fluctuation sign 83
Follicle stimulating hormone 262
Francisella tularensis 222
Friedreich ataxia 73
Frohlich's syndrome 238
Fructose intolerance 95
Full-blown disease 221
Fungal infection 143, 251
Funnel chest 41f, 301, 301f
Furazolidone 71
G
Galactorrhea 240
Galactosemia 95, 185, 200
Gallop rhythm 167
Gamma globulin
high 317
low 317
Gastric aspirate cytology 120
Gastritis 75
acute 61
chronic 63
Gastroenteritis 35f, 156, 307
Gastroesophageal junction, anatomy of normal 287f
Gastroesophageal reflux 156, 279, 286
Gastrointestinal bleeding 307
Gastrointestinal disorders 84
Crohn's disease 84
multiple polyposis 84
regional ileitis 84
steatorrhea 84
ulcerative colitis 84
Gastrointestinal tract 122, 171, 285
Gastroschisis 227f
Gaucher's cells 51f, 185
Gaucher's disease 6f, 57, 71, 185
Genetic disorders 5f
Genitalia
external 173
female 66
infantile 109
normal 109
Gentamicin 283
Genu valgum 30f, 211, 302
Genu valgus 15f
Genu varum 15f, 211
Genu varus 302
German measles 221
Giardia lamblia 58, 75, 112, 115
Giardiasis, chronic 151
Gingival hyperplasia 300
Gingivostomatitis
aphthous ulcers 160
avitaminosis 159
chronic mouth breathing 160
dental defects 160
drugs 160
fibromatosis gingivae 160
history 159
hypovitaminosis 159
infections 159
investigations 159
physical examination 159
Glasgow coma scale, modified 85t
Glaucoma, primary congenital 43f
Globulin
high alpha-1 316
high alpha-2 317
low alpha-1 316
low alpha-2 316
Glomerulonephritis, acute 27f, 57, 62
Glucose-6-phosphate dehydrogenase 71
deficiency 197
Glucuronyl transferase 198
Glutamic-pyruvic transaminase, high serum 318
Gluten
hypersensitivity 134
sensitivity 194
Glycogen storage disease 21f, 34f, 37f
Goiter 41f
congenital 304
Goldenhar syndrome 39f
Gonadal failure, primary 110
Gonadal intersex, true 65
Gonadotropin-releasing hormone 109
Gower's sign 216
Granuloma, eosinophilic 252
Granulomatous disease, chronic 16f, 223
Graves’ disease 190
Great arteries, transposition of 30f, 103
Great vessels, transposition of 29f, 128
Griseofulvin 283
Group B streptococcal infection 120
Growth
chart 148f, 149f
constitutional delay of 109
hormone deficiency 263
Guillain-Barré syndrome 21f, 26f
Gut-brain intersection 58f
Gynecomastia 36f, 305
H
Haemophilus influenzae 204, 258, 276
Hair
light-colored 10f
on-end appearance 331f
premature graying of 307
Hairy cell leukemia 50f
Hairy pinna 36f
Halitosis 161
bronchiectasis 162
chronic rhinitis 161
foreign body in nose 161
history 161
infections 162
investigations 161
lung abscess 162
physical examination 161
remaining causes of 162
Hallermann-Stroff syndrome 29f
Haloperidol 87
Halstrea's antibody-dependent immune 245
Hamartoma, pathologically 23f
Hamman-Rich syndrome 126
Hand-Schuller-Christian disease 252
Harrison sulcus 211, 301
Hay fever 5f
Head injury, severe 36f
Headache 163
causes of 165
drugs 164
history 163
investigations 163
physical examination 163
related to
epilepsy 164
eye problems 164
psychiatric disease 164
psychological problems 164
sinusitis 164
severe 22f
tension 164
vascular 163
Hearing
loss 300
phases of 106b
Heart
disease 103
congenital 82, 103, 127
cyanotic congenital 83
history of 100
failure 121
murmurs 166
history 166
investigations 167
physical examination 167
rate viability 279
right-sided 328
Heat rash 256
Helicobacter pylori infection 57, 63
Hemangioma 179, 187, 276
capillary 9f
Hematemesis 170, 267
causes of 172
pediatric 170, 170b
drugs 171
hemorrhagic disease 171
history 170
in later infancy
and childhood 171
blood dyscrasias 172
chalasia 171
corrosive esophagitis 172
drugs 172
esophageal varices 171
hiatal hernia 171
peptic ulceration 171
swallowed blood 171
violent retching 172
in newborn 170
investigations 170
physical examination 170
remaining causes of 171
swallowed maternal blood 170
Hematogenous diseases 183, 231
anemias 270
hypersplenism 270
thrombocytopenic purpura 270
Hematoma 27f, 242f
Hematuria 11f, 69, 173, 174, 229, 230
bleeding diathesis 175
drugs 175
factitious hematuria 175
foreign body 175
hemolytic uremic syndrome 174
hemorrhagic cystitis 175
Henoch-Schönlein purpura 174
history 173
investigations 173
meatal ulceration 175
nephropathy 173
nephrotic syndrome 174
physical examination 173
remaining causes of 176
renal
calculus 175
tuberculosis 175
vein thrombosis 175
trauma to perineum 175
urethral carbuncle 175
urethritis 175
urinary tract infection 174
Wilms’ tumor 175
Hemichorea 191
Hemicrania 163
Hemihypertrophy 215, 215f, 306
Hemiparesis 163
Hemiplegia 215
Hemoglobin
abnormal 103, 105
physiologic reduction of 69
Hemoglobinuria 173
Hemolysis 201
Hemolytic disease 70, 132, 134, 197
Hemolytic uremic syndrome 71, 244
Hemophilia 18f
diagnosis of 206
Hemoptysis 177
bronchiectasis 177
foreign body 177
history 177
investigations 177
physical examination 177
remaining causes of 178
whooping cough 178
Hemorrhage
adrenal 57
gastric 230
subarachnoid 36f
subconjunctival 13f, 299
subperiosteal 302f
Hemorrhagic disease 74
Hemosiderosis 185
Henoch-Schönlein purpura 62, 69, 174, 203, 244, 258f
Heparin 43f
Hepatic disorders 84
Hepatitis
Hepatitis
amebic 182
chronic
active 182, 182f
persistent 182
idiopathic neonatal 199
neonatal 199, 199t
Hepatoblastoma 11f, 186f
Hepatoma 11f
Hepatomegaly 179
in later infancy 181
and childhood 181
congestive hepatomegaly 184
infections 181
inflammations 181
malignant diseases 186
nutritional problems 184
storage diseases 184
in newborn 179
alpha-1-antitrypsin deficiency 180
cholesterol storage disease 181
congestive cardiac failure 179
erythroblastosis fetalis 180
extrahepatic biliary atresia 180
galactosemia 180
gangliosidoses 181
intrauterine infections 180
neonatal hepatitis 180
septicemia 180
Wolman disease 181
investigations 179
physical examination 179
Hepatotoxic drugs 187
Hereditary hemorrhagic telangiectasia 245
Hermaphroditism 65
female 65
male 65
true 66
Hernia
congenital inguinal 26f
diaphragmatic 121, 121f, 125
hiatal 62, 286
Herpes gingivostomatitis 159
Herpes labialis 10f
Herpes simplex 257f
virus 14f
Herpes zoster 10f, 78, 257f
High alkaline phosphatase 318
High arched palate 37f
High sweat chloride 320
Hilar enlargement 323
bilateral 323f
Hip
and knee 261
congenital dislocation of 213, 216f
developmental dysplasia of 213
tuberculosis of 214
Hirschsprung's disease 89, 90, 91, 286
Histiocytosis 252
Histoplasmin skin test 270
Histoplasmosis 251
Hoarseness 144, 188, 275
acute laryngitis 189
congenital laryngeal anomalies 189
foreign body 188
history 188
investigations 188
physical examination 188
remaining causes of 189
trauma to larynx 188
weakness of laryngeal muscles 189
Hodgkin's lymphoma 22f, 57, 84, 223, 231, 251, 271
Homocystinuria 281t
Hookworm 112
infestation 69
Horseshoe kidney 175
Howell-Jolly bodies 311, 312f
Human chorionic gonadotropin 109
Human immunodeficiency virus 16f, 107, 183, 250, 300f
Human placental lactogen 19f
Huntington's chorea 191
Hurler's disease 26f
Hurler's syndrome 38f, 211, 331f
Hyaline membrane disease 118, 119
Hydatid
cysts, multiple 325f
disease 182
Hydrocephalus 209b, 211f, 332f
acquired 25f
congenital 22f, 34f, 44f, 210, 210f, 295f
Hydrochloric acid 172
Hydropneumothorax 125f, 326f
Hydrops fetalis 26f
Hydrops gallbladder 232
Hygroma, cystic 35f, 42f
Hymenolepis nana 75, 114, 151
Hyoscine 194
Hyperbilirubinemia
severe neonatal 108
unconjugated 197b
Hypercellular bone marrow 315, 316f
Hyperesthesia 10f
Hyperkinetic syndrome 331f
Hyperlipemia 21f
Hyperlipidemia 34f
Hyperplasia, congenital adrenal 19f, 44f, 67
Hyperprolactinemia 110
Hyperreactive airway 279
Hypertelorism 3f, 17f, 297
Hypertension 27f, 163
benign intracranial 164
extrahepatic portal 13f
portal 57
Hyperthermia 279
Hyperthyroidism 41f
Hypertrophic pyloric stenosis, congenital 286
Hyperuricemia 21f
Hyperventilation 126
Hypervitaminosis
A 43f, 81
D 154
Hypoalbuminemia 57
Hypocalcemic tetany 94
Hypocellular bone marrow 315, 316f
Hypochondria
left 226
right 226
Hypochondrium
left 231
gallbladder 232
gut 231
hypogastrium 232
iliopsoas sheath 232
kidney 232
lymph nodes 231
right and left lumbar regions 231
right iliac fossa 231
testis 232
umbilical region 231
urinary bladder 232
right 228
adrenals 230
aorta 231
epigastrium 230
gallbladder 229
gut 229
kidney 229, 230
liver 228
lymph nodes 231
pancreas 230
subphrenic abscess 229
Hypogastrium 228
Hypoglycemia 21f, 29f, 34f, 72, 94, 96, 197
Hypogonadism
hypergonadotropic 110
hypogonadotropic 109
Hypokalemia 91, 230
Hypomagnesemia tetany 96
Hyponatremia 230
Hypoparathyroidism, idiopathic 96
Hypopharynx, posterior 21f
Hypospadias 25f
Hypotelorism 297
Hypothalamic-pituitary region 110
Hypothermia 197, 218
Hypothyroidism 45f, 56, 107f
congenital 19f, 24f, 146, 146f, 200
goitrogenous 21f
Hypotonia 146
benign congenital 26f, 145
severe 91
Hypoxia, high altitude 127
Hypsarrhythmia 98
Hysteria 129
Hysterical fits 98
I
Ibuprofen 60
Ichthyosis
congenital 7f
vulgaris 8f, 303f
Icterus 195
gravis 197
Iliac fossa
left 228
right 61, 227
Imipramine 129, 194
Immersion burns 80f
Immune
function, altered 112
thrombocytopenic purpura 46f, 244, 258f
Immunoglobulin A nephropathy 174
Immunologic disorders 35f
Imperforate anus 28f
Impetigo 5f, 257f
Indian Childhood Cirrhosis 57, 186, 253
Indomethacin 60, 283
Infant's muscles 145
Infantile tremor syndrome 10f, 191, 191f
Infections
bacterial 248
chronic 263
congenital 269
Infectious diseases 5f
Infestations 5f
Inflammation 13f
Inflammatory bowel disease 246
Inflammatory skin diseases 5f
Inguinal canal 65
Inguinal hernia 227f
Inguinal lymphadenitis 223
Intensive investigational workup 262b
International League against Epilepsy 97b
Interphalangeal joints, proximal 17f, 205
Interstitial pneumonia 183
Intestinal intraluminal causes 112
Intestinal mucosal causes 112
Intestinal obstruction 23f
Intestinal parasitosis 91, 112, 148, 150
Intestinal tuberculosis 229, 230
Intestinal worm infestation 63, 68
Intra-abdominal air collection, abnormal 328
Intracranial calcification 331
Intracranial pressure 265
Intracranial space-occupying lesion 332f
Intracranial tumors 235
Intrauterine growth retardation 30f, 259
Intrauterine infections 14f, 197, 199, 265
Intravenous substance abuse 129
Intraventricular hemorrhage 122
Intussusception 61, 75, 330f
Involuntary movements 190
athetosis 192
choreiform movements 191
drug-induced 192
history 190
myoclonus 192
physical examination 190
psychogenic 192
seizure 192
tics 192
tremors 190
Iodine deficiency 21f
Iris
coloboma 300
periphery of 5f
Iron
absorption, inadequate 69
deficiency anemia 311f
causes of 69b
chronic 24f, 331f
supply, inadequate 69
Irritability 193
acrodynia 194
colic 194
drugs 194
food intolerance 194
history 193
hypoglycemia 194
insecurity 194
investigations 193
narcotic withdrawal syndrome 193
physical examination 193
pink disease 194
serious infections 193
teething 194
Irritable bowel syndrome 116
Isonex 129
Isoniazid 283
J
Japanese encephalitis 34f
Jaundice 195
acholuric 70
breast-milk 198
congenital acholuric 70, 201
familial nonhemolytic 198
in later infancy and childhood 200
in newborn 196
after first week 200
first day 196
fourth to seventh day 198
second or third day 198
persistent 200
physical examination 195
physiologic 198
Jejunal biopsy 18f
Jitteriness tremors 191
Jittery tremors 191
Joint
ankles 215
distal interphalangeal 17f
feet 215
fixed 206
hips 213
knees 214
spine 215
Joint pain 203
acute leukemia 207
ankylosing spondylitis 207
drugs 207
gut arthropathy 207
hemarthrosis 206
Henoch-Schönlein purpura 206
history 203
investigations 203
physical examination 203
psoriasis 207
reactive arthritis 207
Reiter disease 207
remaining causes of 208
rheumatic fever 205
septic arthritis 204
serum sickness 206
sickle cell anemia 206
systemic lupus erythematosus 206
trauma 203
tuberculous arthritis 204
viral arthritis 204
Jugular venous pressure 105, 127, 133, 134
Juxta-articular cysts 206
K
Kala-azar 269f
Kallmann syndrome 109
Kanamicin 147, 283
Kaposi sarcoma 183
Kartagener's syndrome 292
Kasabach-Merritt syndrome 244
Kawasaki disease 33f, 44f, 223, 247, 256, 256f
Kayser-Fleischer ring 33f, 190
Keck's classification 166t
Keratomalacia 39f
Kernig signs 218, 273
Ketoacidosis, diabetic 87f
Ketotic hypoglycemia 288
Kidneys 57
bilateral
large 329
small 329
unilateral
large 329
small 329
Kiesselbach's area 143
Kiesselbach's plexus 142
Klebsiella 114, 198
aeruginosa 198
infection 327f
Klinefelter syndrome 110
Knock-knee deformity 30f, 302
Krammer's guidelines 196t
Kwashiorkor 10f, 28f, 35f, 135f
type 57
L
Labyrinthitis, acute 72
Lactate dehydrogenase 185, 244
high serum 318
Lactic acidosis 21f, 34f
Lactose 63
Lange-Nielsen syndromes 278
Large head 209
causes of 209b
cerebral gigantism 211
gangliosidosis 212
history 209
hydrancephaly 212
hydrocephalus 210
investigations 210
megalencephaly 211
physical examination 209
vitamin D deficiency 211
Laryngeal cleft 279
Laryngeal disease 100
Laryngitis
acute infectious 189
acute spasmodic 189
Laryngomalacia 279
Laryngospasm 277
Laryngotracheobronchitis, acute 189, 276
Laurence-Moon-Biedl syndrome 33f, 238
Lead encephalopathy 96
Lead poisoning 91
Legg-Calve-Perthes disease 214
Leishmania donovani 182, 269
Leprosy 143
Lethargy 144, 218
anemia 218
chronic fatigue syndrome 219
history 218
infections 218
investigations 218
low-grade infection 218
physical examination 218
postictal stage 218
remaining causes of 219
Letterer-Siwe disease 252
Leukemia 13f, 16f, 57, 69, 252, 267, 323f
acute
lymphoblastic 38f, 207
lymphocytic 50f, 223
myeloid 50f
chronic
lymphocytic 50f
myeloid 50f
Leukemoid reaction 315, 315f
Leukocoria 299f
Leukocytosis 178
Leydig cell 109
tumors 239
Limb hypertrophy, congenital 302
Limping 213
bones 213
history 213
investigations 213
joints 213
neuromuscular frame 215
physical examination 213
remaining causes of 217
Lips, mucosal pigmentation of 23f
Listeria monocytogenes 198
Liver
abscess, amebic 182
biopsy 13f, 199
cirrhosis of 152, 200
disease, chronic 14f, 37f, 134, 199
disorder 135, 142
function test 133, 170
Lobar emphysema, congenital 122
Lobe consolidation, middle 327
Löffler's syndrome 124
Lovibond profile sign 82, 83f
Low serum
albumin 316
calcium 318
magnesium 319
phosphate 319
proteins 316
urea 319
Lower lobe pneumonia 62
Lumbar regions
left 226
right 226
Lump, intra-abdominal 225, 228
Lung
cysts 122
congenital 122
density
large 326
multiple 325
disease 120
chronic 82
fields, peripheral 124
radiolucency 326
Luteinizing hormone 239, 262
Lymph glands, groups of 220f
Lymphadenitis
acute 221
chronic 222
septic 222
filarial 223
Lymphadenopathy 220, 223
bilateral inguinal 35f
chronic 183
drugs 224
history 220
immunologic disorders 223
infections 221
inflammations 221
investigations 221
malignant diseases 223
neoplastic diseases 223
physical examination 221
Lymphangiectasia, congenital pulmonary 122
Lymphangioma 276
Lymphedema precox 137f
Lymphocytosis 314, 314f
Lymphogranuloma venereum 251
Lymphoma 323f
Lymphopenia 314
Lymphoreticulosis, benign 223
Lysergic acid diethylamide 87
M
Macrocephaly 295
causes of 209, 209b
Macroglossia 118, 299
Macroorchidism 306
Maculopapular rash 255
Magnesium, high serum 319
Malabsorption states 151
Malabsorptive disorders, major 111
Malaria 250, 267, 268f
chronic 16f, 182f
Malignant diseases 231
Mallory-Weiss syndrome 172
Malnutrition 134
acute 22f, 150f
chronic 22f, 149, 150f
Malodorous breath 161
Mantoux test 249, 291, 320
Maple syrup urine disease 10f, 95
Marble bone disease 31f, 71
Marfan's syndrome 15f, 39f, 147, 281f, 281t
Mass, palpable hard 90
Mastoiditis 249
Maternal blood, swallowed 74, 170
Maternal drug addiction 191
McCune-Albright syndrome 6f
Meadow's syndrome 175
Mean corpuscular volume 311
increased 311
Measles 40f, 255, 255f
encephalitis 22f
Meatal stenosis 131
Meckel's diverticulum 61, 69, 75
Meckel-Gruber syndrome 16f, 31f
Meconium aspiration syndrome 119, 119f, 122
Meconium ileus 61, 90, 90f
Meconium plug syndrome 90
Medastinum widening, posterior 324f
Mediastinal shift 323
Mediastinal widening, superior 324f
Mediastinum
enlargement
of middle 324
of posterior 324
of superior 324
widened anterior 323f
Medulloblastoma 73
Mefenamic acid 60, 71
Megakaryocytic hyperplasia 316
Megaloblastic anemia 312f
Meningitis 16f, 36f, 286, 305
recurring 305
Meningocele 18f
anterior 57
cranial 17f
Meningococcemia 245, 257, 258f
Meningomyelocele 22f, 210f
Mental development index 69
Mental retardation 138, 296
microcephaly with 19f
Mesenteric lymphadenitis 61
Metabolic acidosis 185
Metabolic diseases 26f
Metabolism, inborn errors of 197, 231
Metacarpal bones 261
Metacarpal sign 333
Metacarpophalangeal joints 17f
Metachromatic leukodystrophy 211
Metastasis 323f
Methemoglobinemia 103
Methicillin 175
Methotrexate 129
Methylphenidate 192
Microangiopathic hemolytic anemia 52f
Microcephaly 295
microphthalmia 16f
Microcytic anemia 311
Microcytic-hypochromic anemia, severe 184
Micrognathia 37f, 46f, 295, 295f
Microorchidism 306
Micropenis 306
Microphthalmia 14f
Micturition, frequency of 153
attention-seeking device 154
cystitis 153
diabetes
insipidus 154
mellitus 154
drugs 154
history 153
investigations 153
physical examination 153
posterior urethral valves 154
remaining causes of 154
Migraine 163
partial 163
Miliaria rubra 256
Miliary bronchopneumonia 325f
Milkmaid sign 191
Milroy's disease 37f, 132, 136f
Minocycline 283
Mitotic inhibitors 43f
Mitral incompetence 168
Molloscum contagiosum 258f
Monday morning pain 64
Moniliasis 159
Monocytosis 314, 314f
Mononucleosis, infectious 183, 250, 256, 256f
Monozygotic twins 28f
Moon-Biedl syndrome 110
Mouth breathing 101, 233
adenoids 233
choanal atresia 233
deviated nasal septum 234
foreign body 234
habit 234
history 233
investigations 233
maternal medication 233
nasal
allergy 233
polyp 234
physical examination 233
Mucoviscidosis 152
Mumps 42f, 136
Murmur 304
continuous 169
innocent 166
soft mid-diastolic 168
Muscle 147
flabby abdominal 56
pains 272
power, grading of 213b
traumatic avulsion of 214
Muscular dystrophy 216
Musculoskeletal disorder 213
Myalgia 222
epidemic 62, 78
Myasthenia
gravis 145, 189
neonatal 26f
Myocarditis 127, 327f
Myoclonic epilepsy, infantile 98
Myoglobinuria 173
Myopathy 217
Myotonic muscular dystrophy 216f, 217
N
Nail-patella syndrome 176
Nalidixic acid 283
Nappy rash 11f
Nasal discharge, unilateral 161
Natal teeth 29f
Nausea 34f
Neck
lymph glands of 220f
rigidity 305
short 297
Neonatal jaundice 196f, 197, 198f
causes of 196b
Neoplastic disease 35f
Nephritic syndrome 134
Nephritis 174
acute 135, 173
poststreptococcal 173
Nephroblastoma 11f, 230
Nephrotic syndrome 11f, 57, 133, 135f
Nerves, peripheral 147
Neuroblastoma 11f, 57, 186, 229, 252, 324f
Neurocysticercosis 97f
stages of 333f
Neurofibromatosis 6f
Neurologic signs, soft 307
Neurological defects 138
Neuromuscular
disorder 213
junction 147
Neuropathic state 101
Neutropenia 313, 313f
Neutrophil
leukocytosis 313
leukopenia 313
Neutrophilia 313, 313f
Niacin deficiency 160
Nicotinamide adenine dinucleotide, deficiency of 105
Niemann-Pick
cell 185
disease 71, 185, 199
Nikolsky sign 7f
Nitric acid test 137
Nitroblue tetrazolium test 223
Nitrofurantoin 71
rifampicin 129
Noncardiac pulmonary edema 119
Nondigestive tract 60b
Nonenhancing lesions 332
Non-Hodgkin's lymphoma 11f, 224, 252, 271
Nonsteroidal anti-inflammatory drugs 60
Nontyphoidal salmonellosis 96
Noonan's syndrome 37f, 110, 264
Normocytic anemia 311
Nose
depressed bridge of 297
picking 143
Nursemaid's elbow 203
Nutritional anemia 69
Nutritional deficiencies 109
Nutritional disorders 134
Nutritional marasmus 27f
Nutritional rickets 26f, 211, 301f, 333f
Nystagmus 235
congenital 236
jerky 236
pendular 236
history 235
investigations 235
labyrinthine 236
optokinetic 235
organic 235
physical examination 235
physiologic 235
simulating eye movements 236
O
Obesity 56, 126, 157, 237
causes of 238
endogenous 238
exogenous 237
history 237
hypoventilation 238
investigations 237
physical examination 237
Ocular motor dysmetria 236
Oliguria 35f
Omphalocele, congenital 226
Opaque hemithorax 327
Ophthalmoplegia 43f
Opisthotonos 36f, 305
causes of 36f
Optic atrophy, congenital 236
Oral malodor 161
Oral thrush 159
Organic vomiting, causes of 285
Oropharynx, posterior 21f
Orthopnea 117
Osgood-Schlatter disease 215
Osler-Weber-Rendu disease 245
Osmotic diarrhea 111, 114
Osteitis 78
Osteochondritis 214
Osteogenesis imperfect
congenital 27f
deformities in 333f
tarda 81
Osteomyelitis 16f, 204, 249
Osteopetrosis 31f
Ototoxic drugs, administration of 107
Oxycephaly 265
Oxyuriasis 151
P
Pain, colicky abdominal 62
Palpation, abdominal 60
Palpitations 190
P-aminosalicylic acid 244
Pancreas 57
Pancreatic cyst 57
Pancreatitis
acute 61
chronic 57
Pancreatogenous steatorrhea 149
Pansystolic murmur 168
Paper chromatography 137
Papilloma 276
Para-aminosalicylate sodium 129
Para-aminosalicylic acid 62
Paranasal sinusitis 24f
Parasitic infections 250
Parathyroid disease 331f
Paronychia 10f
congenital 29f
Parotid gland, swelling of 61
Parotid swelling 300
recurrent 300f
Parthenium 132
Pasqualini syndrome 109
Patau syndrome 14f, 47f
Patent ductus arteriosus 127, 166, 269
Pathologic fracture 333, 333f
Pectus carinatum 301, 301f
Pectus excavatum 41f, 301, 301f
Pel-Ebstein fever 251
Pemphigus vulgaris 9f
Penicillin 10f, 71, 129
Peptic ulcer 61
Periappendicitis 249
Pericardial effusion 327f
Pericarditis 78
constrictive 57
Pericardium 26f, 57
Perinatal hypoxia 107
Perinephric abscess manifests 230
Periodic acid-Schiff 180
Periodic fever 253
Periodic syndrome 64
Periorbital cellulitis 24f, 43f
Periorbital edema 173, 297
Peritoneum 26f
Peritonitis
acute 61
primary 61
secondary 61
sign of 56, 60
Perleche 159
Persistent fetal circulation 122
Perthes disease 214
Pertussis 13f, 23f, 101
Peter's anomaly 12f
Peter's plus syndrome 12f
Peutz-Jeghers syndrome 23f
Pharyngitis, bacterial 273
Phenacetin 71
Phenothiazines 283
Phenylbutazone 71
Phenylketonuria 194, 265
Phenytoin 159, 283
Philtrum, smooth 43f
Phocomelia 43f
Phosphate, high serum 318
Phosphaturia 319
Phosphokinase, high creatine 317
Photophobia 195
Phrynoderma 303f
Pickwick papers 126
Pierre-Robin syndrome 29f, 37f, 46f, 118
Pigeon chest 301, 301f
deformity 306
Pinpoint pupil 300
Pituitary dwarf 24f, 32f
Plasmodium falciparum infection 95
Platelet
sequestration of 315
survival, poor 315
Platypnea 117
Plethoric chubby appearance 36f
Pleura 26f
Pleural effusion 121, 124, 326f
massive 124f
Pleurisy 78
Pleuritis 101
Pleurodynia 62, 78
Pneumatocele 124f
multiple 124f
Pneumatosis intestinalis 75
Pneumococcus 204, 276
Pneumonia 78, 100, 120, 123
eosinophilic 124
postnatal 120
Pneumonic consolidation 123f
Pneumonitis 134
Pneumoperitoneum 55
Pneumothorax 120, 121f, 125
neonatal 121f
Poikilocytosis 70, 184
Polio 213
Poliomyelitis 21f, 215
Polyarteritis nodosa 251
Polyarticular arthritis, juvenile idiopathic 17f
Polychromasia 202
Polycystic kidney 229
Polydactyly 16f, 20f, 31f, 45f, 302
Polydypsia 141
Polymerase chain reaction 254
Polyp 69, 75
internal 75
Polyphagia 141
Polysyndactyly 31f
Polyuria 91, 141
Pontine glioma 73
Popliteal cysts 214
Porphyria 62
Postmeasles
encephalomyelitis 22f
pigmentation 41f
Postpolio residual paresis 35f, 215f
Pott's spine 27f, 204
Potter's facies 15f, 122, 307, 307f
Potter's syndrome 122, 307
Prader-Willi syndrome 144, 147
Precocious pseudopuberty 240
adrenogenital syndrome 240
feminizing adrenal tumors 241
tumors of testes 241
virilizing adrenocortical tumors 241
Precocious puberty 36f, 239
boys 239
central 239
girls 239
history 239
investigations 240
physical examination 239
Priapism 38f
Prickly heat 256
Prickly poppy 137
Primaquine 71
Primidone 194
Prochlorperazine 272
Progeria 16f
Proglottids 151
Proptosis 299
Prostatitis 131
Protein
bound iodine, low 146
energy malnutrition 26f, 56, 133, 144
high serum 316
Provocative stimulus 47f
Pseudoesotropia 298f
Pseudohermaphroditism
female 67
male 66, 66f
Pseudo-Hirschsprung's disease 91
Pseudohypertelorism 3f, 147
Pseudohypertrophy 216
muscular dystrophy 216f
Pseudohypoparathyroidism 20f
Pseudomembranous
colitis, antibiotic-associated 75
enterocolitis 61
Pseudomonas 198, 327f
aeruginosa 114
Psittacosis 251
Psoriasis 8f
besides 5f
Psychiatric stress 43f
Psychogenic epilepsy 98
Psychogenic involuntary movements 192b
Psychogenic pain abdomen 64
Psychomotor epilepsy 98
Ptosis 298
congenital 298f
familial 25f
unilateral congenital 298f
Pubertal stages
in boys 260t
in girls 260t
Puberty
constitutional delay of 109
delayed 109, 110f
signs of 240, 241
Pulmonary agenesis 122
Pulmonary alveolar
microlithiasis 126
proteinosis 126
Pulmonary arteriovenous hypertension 323f
Pulmonary disorders 83
chronic suppuration 83
Pulmonary edema 324f, 326
Pulmonary embolism 78, 127
Pulmonary hemorrhage 119
massive 120
Pulmonary hemosiderosis 126, 324f
Pulmonary hyperplasia 122
Pulmonary hypertension, persistent 119, 122
Pulmonary infarction 78, 127
Pulmonary metastases 327
Pulmonary stenosis 168
Pulmonary tuberculosis 83, 221
Pulmonary veno-occlusive disease 126
Pupillary reaction, pattern of 86
Purpura 242
complicating 9f
episodes of 242
fulminans 245
history 242
in later infancy and childhood 244
nonthrombocytopenic 244
physical examination 242
thrombocytopathic 244
thrombocytopenic 244
Purpura in newborn 243
causes of 243
disseminated intravascular coagulation 243
hemolytic disease 243
immune neonatal thrombocytopenia 243
intrauterine infections 243
maternal medication during pregnancy 243
septicemia 243
Pyelonephritis 62
Pyemic abscesses, part of multiple 16f
Pyogenic meningitis 94, 95, 272, 273
Pyrexia 37f, 222
of unknown origin, etiology of 246b
Pyridoxine deficiency 160
Q
Q fever 251
Quinidine 71
R
Rachitic rosary 301f
Radioactive iodine, low 146
Rash 254
appearance of 22f
causes of neonatal 255
history 254
investigations 254
physical examination 254
Rash in infancy 255
and childhood 255
Henoch-Schönlein purpura 258
herpes simplex-type i 257
herpes zoster 257
immune thrombocytopenic purpura 258
impetigo 257
leukemia 258
molluscum contagiosum 257
petechial 257
purpuric 257
vesicular 256
Rash in newborn 254
erythema toxicum 254
herpes simplex 255
impetigo neonatorum 255
neonatal
miliaria 255
varicella 255
staphylococcal skin infection 254
Rectal prolapse 18f, 49f
Red blood cells 68, 173, 244
normal 49f
Red cell production, inadequate 71
Redman syndrome 45f
Refsum's syndrome 73, 73f
Reifenstein syndrome 67
Renal disorders 135
Renal function test 133
Renal tuberculosis 229
Renal tubular acidosis 26f
Rendu-Osler-Weber disease 143
Respiratory distress 46f, 118b, 223
syndrome 29f, 118f, 118t, 119t
idiopathic 118
Respiratory infection 42f
Respiratory insufficiency 27f
Respiratory origin, cyanosis of 104
Respiratory stability 279
Respiratory tract infections
lower 100
upper 100
Restlessness 275
Reticular granular pattern 328
Retinoblastoma 299f
Retrolental fibroplasia 236
Retropharyngeal lymphadenitis 277
Reye's syndrome 126, 184, 288
Rhesus isoimmunization 23f
Rheumatic chorea 191
Rheumatic fever 205f
Rheumatic heart disease 129
Rheumatic pericarditis 129
Rheumatic stiff neck 273
Rheumatoid arthritis 246
juvenile 205f, 223, 251
Rheumatoid rash 223
Rhizomelia 33f
Rhizomelic chondrodysplasia 33f
Rib
crack of 78
fracture of 78
Riboflavin deficiency 159
Rickets 26f, 57f, 211, 296
advanced refractory 30f
Rickettsial diseases 251
Rickettsial infection 251
Rifampicin 71
Ritter's disease 7f
Rose-Bengal test 199
Roseola infantum 255, 255f
Rose-Thorn arthritis 208
Rotavirus 114
Rotor's syndrome 199
Rouleaux formation 312, 313f
Roundworm 112
Rubella 14f, 243, 256
syndrome, congenital 11f
Russell-Silver syndrome 4f
Ryle's tube trauma 75
S
Sacral lipoma 16f
Sacrococcygeal teratoma 47f
Salicylates 71, 129
Salmonella 16f, 61, 75, 114, 204
typhi 183, 268
Sarcoidosis 253
Scabies 8f
Scalp hair, light-colored 296
Scalp veins, prominent 210
Scaphocephalic skull 266f
Scaphocephaly 266f
Scarlet fever 44f, 256
rash 256f
Schamroth sign 82, 82f
Schistosoma mansoni infection 16f
Schizocytes 243
Sclerema 134
Scoliosis 30f, 304
Scorbutic rosary 32f
Scrofuloderma 222f, 303
Scrotal edema, idiopathic 136
Scrotal tongue 147
Scrotum 65
Scurvy 13f, 160, 333f
Seborrhea, infantile 5f
Seborrheic dermatitis 11f
infantile 5f
Secretory function, altered 112
Seizure 36f, 93
accidental injection of anesthesia 94
atypical febrile 22f
disorders
acute 95
chronic 97
recurrent 97
drug 95
withdrawal syndrome 94
electrolyte imbalance 94
history 93
hypocalcemia 94
hypoglycemia 94
hypomagnesemia 94
in later infancy 95
infections 94
investigations 93
metabolic disorders 95
perinatal problems 94
physical examination 93
pyridoxine dependency 94
Seizures in newborn 93
accidental injection of anesthesia 94
drug 95
withdrawal syndrome 94
electrolyte imbalance 94
hypocalcemia 94
hypoglycemia 94
hypomagnesemia 94
infections 94
metabolic disorders 95
perinatal problems 94
pyridoxine dependency 94
Sella turcica, J-shaped 331
Senile appearance 302
Sensorium 272, 284
Sepsis, neonatal 21f, 38f
Septic arthritis 214
Septicemia 183, 198, 200, 249, 286
advanced fulminant 243
neonatal 180
Serotonin 279
Serum
ascites albumin gradient 13f
glutamic
oxaloacetic transaminase 180, 250
pyruvic transaminase 180, 250
hepatitis 181
sickness 253
Sex maturation 240
Sex maturity stages
in boys 260t
in girls 260t
Sexually transmitted disease 223
Shagreen patch 6f
Shigella 61, 111, 114, 207
infection 75
Shigellosis 96
Shoe-like sella 331f
Short stature 259, 263f
causes of 259b
chromosomal disorders 264
chronic visceral diseases 263
constitutional 262
disproportionate 12f, 259
emotional deprivation 263
endocrinopathy 263
familial 262
genetic 262
history 259
investigations 261
nutritional stunting 263
physical examination 259
primordial dwarfism 263
proportionate 259
skeletal disorders 263
sophisticated tests 262
Shoulder 261
Sibling's development 239
Sick sinus syndrome 279
Sickle cell 50f, 69
anemia 38f, 64, 68, 70, 184, 203, 253
disease 16f, 143, 165, 267
Silk glove sign 228
Silver-beaten appearance 332, 332f
Silverman-Russell syndrome 45f
Silver-Russell syndrome 263
Simian crease 305
Sinus
bradycardia 303
tachycardia 303
Sinusitis 163, 164, 249
Situs inversus 328f
Skeletal dysplasia 66
Skin 24f
dry 303
hyperkeratotic 303
rash 254b
scaly 303
tuberculosis 303
Skull roentgenogram 265
Skull shape, abnormal 330
Skull sutures, premature union of 265
Small head 265
craniostenosis 265
craniosynostosis 265
familial 266
history 265
investigations 265
microcephaly 265
normal variation 266
physical examination 265
small infant 266
Small intestine, obstruction of 287
Snakebite 12f, 40f, 49f
Soap bubble appearance 328
Sodium excretion 57
Soft palate 21f
Soft tissue edema 21f
Solitary lung densities 325
Sore throat 272
Sotos syndrome 19f, 21f, 211
Sparse 10f, 296
Spasmus nutans 236
Spastic cerebral palsy 17f
Speech
delayed 301
phases of 106b
retarded 301
Spherocyte 50f, 69
Spherocytic cell 70
Spherocytosis 68, 202
congenital 200, 201
hereditary 70, 200, 201
Sphincter
external 139
internal 139
Spider leg deformity 230
Spinal cord 147
Spinal muscular atrophy 145, 145f
hereditary 26f
Splenic cysts, suspicion of 271
Splenic enlargement 267
Splenohepatomegaly 270f
Splenomegaly 267
abscess 271
congestive 231, 271
extrahepatic biliary atresia 271
hemangioma 271
hematogenous diseases 270
inborn errors of metabolism 271
infections 268
brucellosis 269
common viral 270
enteric fever 268
histoplasmosis 270
hydatid disease 270
infectious mononucleosis 270
infective endocarditis 269
intrauterine 269
kala-azar 269
malaria 268
neonatal hepatitis 270
septicemia 268
tuberculosis 268
investigations 268
malignant diseases 271
nutritional recovery syndrome 271
physical examination 267
splenic cysts 271
Still's disease 271
systemic lupus erythematosus 271
tropical 14f
Squint 298f
Staphylococcal
gingivitis 159
pneumonia 124f, 325f
Staphylococcus 5f, 114, 276
albus 269
aureus 182, 198
Starvation diarrhea 230, 286
Steatorrhea 82
Stein-Leventhal syndrome 238
Stenosis, congenital subglottic 276
Sternomastoid
muscle 273
tumor 23f
Steroid 132, 237
therapy 43f
Stevens-Johnson syndrome 8f, 160
Stiff neck 272
cervical lymphadenitis 273
congenital anomalies 273
history 272
investigations 272
meningitis 272
phenothiazine toxicity 272
remaining causes of 274
retropharyngeal abscess 273
trauma 273
viral torticollis 273
Still's disease 231
Stomach, foreign body in 171
Stomatitis, aphthous 18f
Stomatocyte 313, 313f
Strawberry tongue 44f
Streptococcal gingivitis 159
Streptococcus 5f, 204
viridans 269
Streptomycin 129
Stridor 275
congenital laryngeal 275
history 275
investigations 275
laryngeal edema 276
laryngomalacia 275
obstruction 276
physical examination 275
tumors 276
vascular rings 276
Strongyloides stercoralis 63, 75, 112
Strongyloidiasis 151
Strychnine poisoning 36f
Sturge-Weber syndrome 93, 165
Sudamina 256
Sudden infant death syndrome 156, 278
investigations 278
physical examination 278
Sudden severe weight loss 43f
Sulfas 10f, 71, 129, 283
Sunken eyes 35f
Sunset sign 34f, 298
Superior vena cava 133
Sutural diastasis 331
Sweat chloride, false negative 320
Sweating 222
absence of 248
Swyer syndrome 66
Syphilis 81, 93, 143, 222
congenital 269
Systemic bacterial infections 174
Systemic disease 132
Systemic lupus erythematosus 19f, 187, 191, 246, 251
nephropathy 174
Systolic murmurs 166, 167
six grades of 166t
T
Tachycardia, paroxysmal supraventricular 303
Taenia
saginata 151
solium 115
Talipes equinovarus 304, 304f
congenital 30f
Tall stature 280, 280b
cerebral gigantism 282
etiology of 280t
familial 281
history 280
homocystinuria 281
investigations 281
Klinefelter syndrome 281
Marfan syndrome 281
physical examination 281
Tanner's pubertal staging 109
Tapeworms 58, 63, 112, 151
Target cells 50f, 184, 311
Taste 319
Tay-Sachs disease 211
Tear drop cell 312, 312f
Teeth, discoloration of 299
Temporal lobe epilepsy 98
Tender hepatic enlargement 306
Testes, absence of 65
Testicular hormone deficiency 65
Tetanus 36f, 47f, 94
neonatal 34f
Tetracyclines 165
Tetralogy of Fallot 104, 128, 167f
Thalassemia 68
major 70, 70f, 270f, 331f
Thalidomide baby 43f
Thallium 43f
Thiabendazole 165
Thiazides 61, 283
Thigh, painful swelling of 302
Thiouracil 43f
Thorazine 175
Threadworms 130
Thrombocytopenia 245, 315, 315f
Thrombocytopenic purpura
drug-induced 244
idiopathic 13f, 51f, 52f, 75
Thrombocytopoiesis, poor 315
Thrombocytosis 52f, 315, 315f
Thrombophlebitis 19f
Thrombopoietin deficiency 244
Thrombosis 57
Thyroid
enlarged 190
stimulating hormone 21f, 189, 263, 283
Thyrotoxicosis 19f
Thyroxine 194
Tics 101, 192
types of 192
Tietze syndrome 78
Tiredness 69
Todd's paralysis 93
Toddler's diarrhea 116
Toilet training, poor 91, 140
Tongue protrudes 23f
Tonic-clonic movements 93
Tonsillar diphtheria 21f
Tonsillectomy 171
Tonsillitis 272
acute 62, 171
Torticollis, congenital 274
Total leukocyte count 249, 291
Toxic
alopecia 43f
hepatitis 201
shock syndrome 44f
synovitis 214
Toxocara canis 246
Toxoplasma gondii 246
Toxoplasmosis 93, 243, 246, 250
acquired 222
congenital 269
Tracheoesophageal fistula 122
Tracheomalacia 279
Transient synovitis 214
Transient tachypnea 120, 120f
Trauma, abdominal 74
Treacher-Collins syndrome 39f, 298f
Trendelenburg limping 213, 215f
Trepopnea 117
Trichinosis 250
Trichobezoar 230
Trichuriasis 151
Trichuris trichiura 63, 112
Tricuspid atresia 29f, 104
Tricyclic antidepressants 147
Triflupromazine 272
Trigonocephaly 44f
Trimethoprim 164, 283
Trisomy 13 47f
Trisomy 18 48f
Troxidone 164, 194
True precocious puberty 240
constitutional precocity 240
hypothyroidism 240
Mccune-Albright syndrome 240
organic brain lesions 240
rare causes of 240
Truncus 105
Tuberculin test 249, 291
false negative 320
Tuberculosis 82, 143, 149, 249, 327
diagnosis of 40f
disseminated 36f
generalized 268f
history of 100
Tuberculous
cervical lymphadenopathy 24f
lymphadenitis 222f
meningitis 3f, 24f, 273
spondylitis 27f
Tuberous sclerosis 6f, 25f
Tularemia 249
Turner's syndrome 4f, 24f, 33f, 36f, 39f, 110, 199, 238, 264
male 37f
Twin-twin transfusion 28f
Typhoid 267
Typhus 256
Tyrosinosis 57
U
Ulcerative colitis 61, 64, 69, 76, 116, 307
Ulcers 18f
aphthous 160
Umbilical granuloma 20f, 226, 227f
Umbilical hernia 304
large 226f
Umbilical region 226
Upper airway 276
dysfunction 279
Upper extremity 35f
Upper lobe, right 123f, 326f
Urea, high serum 319
Urea-creatinine ratio, high serum 319
Uremia 230, 288
Urethra, local factors involving 131
Urinary tract infection 64, 246, 249, 288
Urine
dipstick 133
color of 60
Uterine hernia syndrome 66
Uveitis, acute 300
V
Vaginal bleeding 306
Valproate 237
Valvular pulmonic stenosis 128
Vanishing testes syndrome 110
Vasculitis 247
Vena cava, inferior 57
Veno-occlusive disease 200
Ventricular enlargement, left 328
Ventricular septal defect 29f, 127f, 166
large 127
Versinia enterocolitica 114
Vertebral column, diseases of 78
Vertebral osteomyelitis 273
Vertigo 283
anemia 283
benign paroxysmal 283
drugs 283
epidemic 283
history 283
hypoglycemia 283
investigations 283
physical examination 283
remaining causes of 284
vasovagal response 283
Vesicular rash 256
Vibrio cholerae 114
Vincent's angina 159, 162
Vincristine 129, 164
Violent sneezing 13f
Viral bronchopneumonia 325f
Viral exanthema 254
Viral hepatitis 34f, 62, 200, 250
Viral infections 250
Viral myalgia 78, 272
Virilized clitoris 66f
Visceral larva migrans 246, 250
Visual defects 163
Vitamin
A deficiency 39f
D 30f
D deficiency 57f
rickets 26f, 151f
deficiency 199
diseases 150
K 71
deficiency 143, 271
Vitiligo 6f
Vocal cord paralysis 276
Vomiting 22f, 34f, 285
history 285
in later infancy 287
investigations 285
physical examination 285
projectile 156
severe 91
Vomiting after infancy 288
benign 288
infection 288
obstructive 288
organic 288
Vomiting in newborn 285
benign 285
organic 285
von Gierke disease 21f, 34f, 185
von Recklinghausen's disease 165
von Willebrand disease 143, 245
Vulvitis 154
W
Waardenburg syndrome 107f
Weight gain, excessive 157
Weil's disease 183
Werdnig-Hoffmann disease 144, 145, 189
Wheezing 289
acute bronchiolitis 290
asthmatic bronchitis 290
bronchial asthma 290
cystic fibrosis 291
drugs 292
foreign body 291
history 289
investigations 289
physical examination 289
pneumonia 291
poisons 292
remaining causes of 292
tropical eosinophilia 290
tuberculosis 291
White reflex 299
Whooping cough 18f, 101
diagnosis of 178
Widal's test 221
Wilm's tumor 11f, 57, 175, 229, 230, 252
Wilson's disease 185, 190
Wilson-Mikity syndrome 120
Wing-beating 190
Wiskott-Aldrich syndrome 244
Wormian bones 330, 330f
Worms sign, bag of 191
Worsening sensorium 22f
X
Xanthochromic cerebrospinal fluid 320
Xerophthalmia 32f
XXY syndrome 281
Y
Yersinia 204
enterocolitica 61, 114, 207, 250
infection 250
Z
Zinc deficiency 10f
Zoonotic infection 246
×
Chapter Notes

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Differential Diagnosis in PEDIATRICS (Including Color Atlas)
Differential Diagnosis in PEDIATRICS (Including Color Atlas)
Sixth Edition
Suraj Gupte MD FIAP FSAMS (Sweden) FRSTMH (London) Professor and Head (Emeritus) Postgraduate Department of Pediatrics Mamata Medical College and Mamata General andSuperspecialty Hospitals drsurajgupte@gmail.com www.drsurajgupte.com SKhammam, Telangana, India
Editor: The Short Textbook of Pediatrics; Recent Advances in Pediatrics (Series), Textbook of Pediatric Emergencies, Neonatal Emergencies, Pediatric Nutrition, and Pediatric Gastroenterology, Hepatology and Nutrition; Pediatric Infectious Diseases; Influenza: Complete Spectrum; Case-based Reviews in Pediatric Emergencies, Clinical Problem Solving in Neonatal Emergencies and Intensive Care, etc.
Author: Pediatric Drug Directory, Instructive Case Studies in Pediatrics, Influenza, Perspectives in Influenza, Nutrition in Neonatal ICU, Speaking of Child Care, etc. Chief Editor (Gastroenterology Section): International Journal of Gastroenterology, Hepatology, Transplant and Nutrition.
Co-editor: Asian Journal of Maternity and Child Health (Manila, Philippines). Section and Guest Editor: Pediatric Today (New Delhi).
Editorial Advisor: Asian Journal of Pediatric Practice (New Delhi). Editorial Advisory Board
Member/Reviewer: Indian Journal of Pediatrics (New Delhi), Indian Pediatrics (New Delhi), Indian Journal Child Health (Gwalior), Synopsis (Detroit, USA), Maternal and Child Nutrition (Preston, UK), Journal of Infectious Diseases (Turkey), EC Pediatrics (London), Journal of Clinical Pediatrics (Patna), etc.
Examiner: Several Universities, including National Board of Examinations (NBE) for DNB, New Delhi; All India Institute of Medical Sciences (AIIMS), New Delhi; Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh; Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar; Indira Gandhi National Open University (IGNOU), New Delhi
Pediatric Faculty Selection Expert: All India Institute of Medical Sciences (AIIMS), Punjab Public Service Commission, J&K Public Service Commission, Union Public Service Commission, etc.
Jaypee Brothers Medical Publishers (P) Ltd
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Phone: +91-11-43574357
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Overseas Office
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Phone: +44 20 3170 8910
Fax: +44 (0)20 3008 6180
© 2020, Manu Gupte, Executive Editor
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers/editors.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. the publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity. the CD/DVD-ROM (if any) provided in the sealed envelope with this book is complimentary and free of cost. Not meant for sale.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
Differential Diagnosis in Pediatrics (Including Color Atlas)
First Edition: 1986
Sixth Edition: 2020
9789352702473
Printed at
My Parents
Who always gave my efforts
the necessary blessings
Their inspiration has been a
tower of strength in
bringing out
this book and other books
Foreword
At the very outset, I wish to record my indebtedness to Prof Suraj Gupte, India's outstanding pediatric educationist, researcher and innovator with a multitude of high-quality books and other publications to his credit. He is gracious enough in asking me to again write a Foreword to the sixth edition of his noted book, Differential Diagnosis in Pediatrics.
Having carefully gone through the drafts of the new edition, I have no doubt that this already popular book has considerably improved its excellence and utility for the intended readership. The first section, i.e. Color Atlas, has many more high-quality photographs added to it. The contents of the 62 topics included in the second section are significantly improved and updated with fresh matter plus illustrations, tables and boxes. Additionally, incorporation of “investigative component” has further strengthened the usefulness of the book. Notably, each chapter in this section is provided with key references for further reading. The remaining three sections deal with differential diagnosis of select clinical signs, laboratory findings and radiologic signs. Prof Gupte has done well to complement these too with illustrative photographs.
Furthermore, all through this fine book, the presentation is simple, lucid, straightforward and easy-to-understand. Over and above the richness of the contents, Prof Gupte's well-known style of driving home the important points to the readers is not just profusely evident but also a very strong points of the title.
In my considered opinion, the sixth edition of Prof Suraj Gupte's Differential Diagnosis in Pediatrics is a strongly recommended treatise for the target audience (undergraduate and postgraduate medical students, residents, and practitioners of child health). By virtue of its several unique qualities, it has attained the powerful potentials to sharpen the readers’ skill in effectively dealing with signs and symptoms and quickly formulating the differential diagnoses in a given situation.
EA Robert MD PhD
Professor Emeritus
Department of Pediatrics
University School of Medicine
Formerly, WHO Regional Adviser
New York, United States
Preface to the Sixth Edition
The sixth edition of the Differential Diagnosis in Pediatrics, the pioneer and the solo textbook in the field from the Indian subcontinent stands thoroughly revised, updated, enlarged and further rendered state-of-the-art to meet the requirements of the medical students, residents, teachers and practitioner.
Section 1 exclusively presents Color Atlas comprising over 300 instructive clinical photographs with explanatory legends.
Section 2 presents chapters dealing with differential diagnosis of as many as 62 common presenting clinical manifestations such as abdominal distention, abdominal pain, chronic diarrhea, headache, short stature, jaundice, ambiguous genitalia, wheezing, etc. Each and every chapter is now complemented with key information about the investigative part over and above the clinical details.
Section 3 deals with the differential diagnosis of select clinical signs. Addition of clinical photographs has further enhanced its utility.
Section 4 is an illustrated spotlight on select laboratory findings and their significance.
Section 5 focuses on select radiologic signs. To enhance the impact, a multitude images are provided as illustrations.
Hopefully, the new revised, updated and enlarged edition of the Differential Diagnosis in Pediatrics shall receive yet warmer welcome and prove yet more beneficial to the target readership.
Preface to the First Edition
The vital importance of differential diagnosis, the backbone of deductive reasoning process and professional skill in clinical medicine, is widely recognized. Yet, for one or the other reason, the pediatric textbooks are not able to deal with this important aspect in a reasonably comprehensive way. A couple of books devoted exclusively to differential diagnosis are written by the European authors. These provide only very little information on problems relevant to the children of the developing countries and are, therefore, only of limited value in our settings.
The sustained and overwhelming demand from various quarters to fill this glaring “vacuum” has given birth to this new textbook, the first and the only one of its kind. I have designed it to provide a comprehensive up-to-date discussion on topics of day-to-day practical importance with special emphasis on problems encountered in the pediatric population in India and rest of the Third World.
As many as 48 topics ranging from abdominal distention, abdominal pain or anemias through diarrhea, failure to thrive or hepatomegaly to splenomegaly, vomiting or wheezing, are covered. Each topic organized alphabetically as a separate Section, starts off with an introductory note and sets out to highlight salient points in the history and physical examination having bearing on the differential diagnosis. Finally, I have discussed the various conditions that fall in the differential diagnosis, laying special stress on clinical features of particular diagnostic value. As and when indicated, a suitable reference is made to the investigative aspect.
All through this problem-oriented work, I have tried to be simple, straight-forward and lucid as also comprehensive and yet-to-the point. Hopefully, the volume would fulfill its aims and objectives and provide stimulating and informative reading for clinical diagnosis to the readers.
The book is addressed primarily to the medical students (both undergraduates and postgraduates), pediatric residents, junior pediatricians, family doctors and general practitioners whose clientage includes infants and children.
The eminent pediatric teacher, Dr N Sundaravalli, President, Indian Academy of Pediatrics, has done me great honor in writing the Foreword to this textbook at a time when she is extremely busy and preoccupied with, among the other things, affairs of the Academy. My salutation to her for recommending the volume so warmly!
The preparation of this textbook has needed cooperation of many people, including colleagues in and outside the country. I acknowledge my gratitudes to each one of them.
I record my sincere gratitudes to my parents and other family folks for providing generous help and encouragement while I was working on the manuscript. My wife, Shamma; daughter; Novy, and son, Manu; were gracious enough to make available to me the “time” that indeed needed to be spent with them. Their forbearance and understanding have contributed considerably to the entire endeavour taking the present solid shape.
Thanks are also due to the publishers, M/s Jaypee Brothers and their staff, for the excellent production qualities of the book.
Last, but in no way the least, any feedback for enhancing the practical utility of this textbook will be most welcome.
Suraj Gupte MD
November 1986
“Gupte House”
60 Lower Gumat
Jammu 180001
Special Acknowledgments
Grateful acknowledgments are hereby made to:
Finally, though all attempts have been made to acknowledge the source of information correctly here or in the text per se, error, if any, is unintentional and regretted.