Id |
Subject |
Object |
Predicate |
Lexical cue |
T17 |
0-17 |
Sentence |
denotes |
Case presentation |
T18 |
18-194 |
Sentence |
denotes |
A 13-month-old male presented to our pediatric emergency department (ED) in early April 2020 with the chief complaint of fussiness, decreased appetite, and fever for five days. |
T19 |
195-289 |
Sentence |
denotes |
His mother reported that there was no resolution of his fever despite the use of antipyretics. |
T20 |
290-415 |
Sentence |
denotes |
At the presentation time, his mother denied cough, runny nose, ear pulling, shortness of breath, rash, vomiting, or diarrhea. |
T21 |
416-472 |
Sentence |
denotes |
She reported no recent travel nor sick contacts at home. |
T22 |
473-607 |
Sentence |
denotes |
Social history was remarkable for crowded and close living conditions, with five other family members sharing a two-bedroom apartment. |
T23 |
608-738 |
Sentence |
denotes |
The patient remained isolated at home since the pandemic began, but other family members had been out of the house for groceries. |
T24 |
739-845 |
Sentence |
denotes |
He was nontoxic on physical exam, appearing but fussy and febrile with a temperature of 102.7°F (Table 1). |
T25 |
846-957 |
Sentence |
denotes |
Physical exam was remarkable for dry, cracked lips with fissuring along the vermilion border and labial mucosa. |
T26 |
958-1065 |
Sentence |
denotes |
His mucous membranes were dry, and there was pharyngeal erythema without exudates or tonsillar hypertrophy. |
T27 |
1066-1114 |
Sentence |
denotes |
The chest was clear to auscultation bilaterally. |
T28 |
1115-1236 |
Sentence |
denotes |
The patient had no conjunctivitis, lymphadenopathy, hepatosplenomegaly, nor edema or rash on the trunk, hands, and feet. |
T29 |
1237-1285 |
Sentence |
denotes |
Table 1 Vital signs of the patient on admission |
T30 |
1286-1328 |
Sentence |
denotes |
Vital signs Patient Normal range for age |
T31 |
1329-1363 |
Sentence |
denotes |
Temperature 102.7° F 95-100.3° F |
T32 |
1364-1421 |
Sentence |
denotes |
Heart rate 172 beats per minute 80-130 beats per minute |
T33 |
1422-1473 |
Sentence |
denotes |
Respiratory rate 32 breaths/min 40-60 breaths/min |
T34 |
1474-1707 |
Sentence |
denotes |
Oxygen saturation on room air 98% 94-100% Laboratory findings showed a negative respiratory viral panel, a normal complete blood count (CBC) with lymphocytic predominance (Table 2), elevated C-reactive protein (CRP) of 25.81 mg/dL. |
T35 |
1708-1839 |
Sentence |
denotes |
The comprehensive metabolic panel (CMP) revealed metabolic acidosis with a normal anion gap with ketones present in the urinalysis. |
T36 |
1840-1985 |
Sentence |
denotes |
We obtained blood and urine cultures, and the patient was admitted and started empirically on ceftriaxone, antipyretics, and intravenous fluids. |
T37 |
1986-2030 |
Sentence |
denotes |
Table 2 Complete blood count of the patient |
T38 |
2031-2264 |
Sentence |
denotes |
WBC - white blood cells; RBC - red blood cells; Hgb - hemoglobin; Hct - hematocrit; MCV - mean corpuscular volume; MCH - mean corpuscular hemoglobin; MCHC - mean corpuscular hemoglobin concentration; RDW - red cell distribution width |
T39 |
2265-2334 |
Sentence |
denotes |
Complete blood count Result Reference range (for patient age) Unit |
T40 |
2335-2362 |
Sentence |
denotes |
WBC 7.7 6.0-17.5 x 109/L |
T41 |
2363-2391 |
Sentence |
denotes |
RBC 4.46 3.8-5.4 x 10¹²/L |
T42 |
2392-2417 |
Sentence |
denotes |
Hgb 11.4 13.1-15.5 g/L |
T43 |
2418-2437 |
Sentence |
denotes |
Hct 35 39-47 L/L |
T44 |
2438-2460 |
Sentence |
denotes |
MCV 77 72.0-88.0 fL |
T45 |
2461-2479 |
Sentence |
denotes |
MCH 26 26-34 ρg |
T46 |
2480-2503 |
Sentence |
denotes |
MCHC 329 320-360 g/L |
T47 |
2504-2527 |
Sentence |
denotes |
RDW 12.9 11.5-16.0 % |
T48 |
2528-2559 |
Sentence |
denotes |
Platelet 357 130-400 x 109/L |
T49 |
2560-2593 |
Sentence |
denotes |
Neutrophil 2.5 1.5-8.5 x 109/L |
T50 |
2594-2627 |
Sentence |
denotes |
Lymphocytes 3.9 3-13.0 x 109/L |
T51 |
2628-2660 |
Sentence |
denotes |
Monocytes 1.1 0.1-1.9 x 109/L |
T52 |
2661-2693 |
Sentence |
denotes |
Basophils 0.2 0.0-0.3 x 109/L |
T53 |
2694-2930 |
Sentence |
denotes |
Eosinophils 0 0.0-1.5 x 109/L Due to persistent fever, a chest X-ray (CXR) was ordered, which showed bilateral interstitial infiltrates more prominent on the right peri-hilar area, which could represent atypical pneumonia (Figure 1). |
T54 |
2931-2970 |
Sentence |
denotes |
Urine and blood cultures were negative. |
T55 |
2971-3131 |
Sentence |
denotes |
However, the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) polymerase chain reaction (PCR) was positive 24 hours after admission to the hospital. |
T56 |
3132-3285 |
Sentence |
denotes |
The patient was subsequently started on azithromycin for clinical suspicion of atypical pneumonia related to COVID-19, correlating with the CXR findings. |
T57 |
3286-3389 |
Sentence |
denotes |
The fever subsided after the first day of antibiotics, and the cheilitis improved during the admission. |
T58 |
3390-3564 |
Sentence |
denotes |
The patient was discharged home with isolation guidelines and completed five days of azithromycin and seven days of amoxicillin clavulanate for suspected clinical pneumonia. |
T59 |
3565-3708 |
Sentence |
denotes |
Figure 1 Portable CXR: bilateral interstitial infiltrates more prominent on the right perihilar area, which could represent atypical pneumonia |
T60 |
3709-3726 |
Sentence |
denotes |
CXR - chest X-ray |