Circumcision may be the oldest known surgical procedure. For the past 100 years, it has consistently been the most frequently performed surgery in the world.1 The procedure is performed on almost all males in the Jewish and Muslim communities.
I read with interest Drs Ha and Wilson's "What's Your Diagnosis?" case of an infant with a history of wheezing and dry cough ("History of Cough in an Infant and a Toddler") (Figure). In a setting such as this, one should also consider the possibility of foreign-body aspiration, which can result in recurring wheezing and pneumonia.
A 10-month-old boy with an asymptomatic rash is brought to your office by his mother. The rash, which began on the legs and spread to the arms, face, and buttocks, has been present for 3 days. Other than rhinorrhea and nasal congestion for the past 3 to 5 days, the infant has been well, although fussier than usual, especially at night. His appetite is normal.
The mother of this 11-month-old Somalian girl expressed concern about a light-colored patch over her daughter's right brow. She was worried that the infant had vitiligo.
It has long been recognized that non-nutritive sucking is a normal, pervasive method of self-soothing in infancy.1 In a longitudinal study of the sucking behavior in almost 800 children from birth to age 8 years, Bishara and colleagues2 found that at age 1 year, 31% of the children engaged in finger-sucking.
At his first well-child visit after a family move, an 8-year-old boy was noted to have bilateral erythematous plaques on the surfaces of his hands and feet. Mother reported that the condition had been present since he was 2 or 3 months old. Patient's father and other male relatives on the paternal side (uncles, grandfather, great-grandfather) were similarly affected. No other associated symptoms, such as hyperhidrosis, reported.
During hospitalization of a 6-month-old boy for respiratory syncytial virus infection, spiking fevers led to a bacteremia workup. This revealed Klebsiella species in his urine. A subsequent renal sonogram showed left-sided hydronephrosis, with a dilated, kinking, and tortuous ureter (A). The infant was given antibiotic prophylaxis and was scheduled for a voiding cystourethrogram as an outpatient.
A 16-year-old girl with internal jugular phlebectasia presented for followup ultrasound evaluation. At age 15 months, she was noted to have a right-sided neck mass that appeared when crying or straining. Her weight, height, and head circumference were normal. She had no cardiac anomalies and was otherwise healthy.
An otherwise healthy 5-year-old girl presented with 2 papillary lesions just below the left lower outer lip. Five months earlier, she had had a common wart on the dorsal side of the web space between her left thumb and index finger. This wart was treated with electrocautery desiccation and curettage. The pictured lesions appeared after the wart on the left hand had been removed.
Circumcision may be the oldest known surgical procedure. For the past 100 years, it has consistently been the most frequently performed surgery in the world.1 The procedure is performed on almost all males in the Jewish and Muslim communities.
I read with interest Drs Ha and Wilson's "What's Your Diagnosis?" case of an infant with a history of wheezing and dry cough ("History of Cough in an Infant and a Toddler") (Figure). In a setting such as this, one should also consider the possibility of foreign-body aspiration, which can result in recurring wheezing and pneumonia.
The mother of this 11-month-old Somalian girl expressed concern about a light-colored patch over her daughter's right brow. She was worried that the infant had vitiligo.
At his first well-child visit after a family move, an 8-year-old boy was noted to have bilateral erythematous plaques on the surfaces of his hands and feet. Mother reported that the condition had been present since he was 2 or 3 months old. Patient's father and other male relatives on the paternal side (uncles, grandfather, great-grandfather) were similarly affected. No other associated symptoms, such as hyperhidrosis, reported. 
During hospitalization of a 6-month-old boy for respiratory syncytial virus infection, spiking fevers led to a bacteremia workup. This revealed Klebsiella species in his urine. A subsequent renal sonogram showed left-sided hydronephrosis, with a dilated, kinking, and tortuous ureter (A). The infant was given antibiotic prophylaxis and was scheduled for a voiding cystourethrogram as an outpatient.
A 16-year-old girl with internal jugular phlebectasia presented for followup ultrasound evaluation. At age 15 months, she was noted to have a right-sided neck mass that appeared when crying or straining. Her weight, height, and head circumference were normal. She had no cardiac anomalies and was otherwise healthy.
An otherwise healthy 5-year-old girl presented with 2 papillary lesions just below the left lower outer lip. Five months earlier, she had had a common wart on the dorsal side of the web space between her left thumb and index finger. This wart was treated with electrocautery desiccation and curettage. The pictured lesions appeared after the wart on the left hand had been removed.
