Post a good case, dammit.

[njac]

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Not my case, but one our medical director saw.

middle aged male suicide attempt, via consuming gobs of fiesta store brand curing salt.

For the med students/residents -

what's the problem ingredient here, and what's the treatment?

I'll give you a hint: treatment ends up being the same color as the patient at this stage of the game.

So many of these lately. Think there was even a NYT article about the suicide-wiki site promoting this Method.

 

[njac]

That looks like neither blood nor urine.

But, I'll play.

Septic workup minus LP and renal US.

Are we sure the diaper changer wasn’t just eating their daily Cheeto intake while caring for the baby?

 

[deleted1114045]

Are we sure the diaper changer wasn’t just eating their daily Cheeto intake while caring for the baby?

I guess I should have said, chief complaint of hematuria. It actually happened again while in ER. This red orange stuff came out of the kids urine. Penis uncircumcised. Not oozing. Mom denies putting cream on kid. UA doesn’t show blood. Kid looks fine. Afebrile. Nursing well for a three day old.

 

[BoardingDoc]

I guess I should have said, chief complaint of hematuria. It actually happened again while in ER. This red orange stuff came out of the kids urine. Penis uncircumcised. Not oozing. Mom denies putting cream on kid. UA doesn’t show blood. Kid looks fine. Afebrile. Nursing well for a three day old.

@VA Hopeful Dr already answered this one. It's just urate crystals. Normal in a newborn and go away on their own. Workup = reassurance and DC.

 

[deleted1114045]

@VA Hopeful Dr already answered this one. It's just urate crystals. Normal in a newborn and go away on their own. Workup = reassurance and DC.

Yup.

 

[turkeyjerky]

No...but you would probably look it up like everybody else. Or call someone. Anytime a 3 day old comes in, no matter what, I'm gonna call someone. What good thing can happen when a 3 day old comes in?

Nothing.

Unless the blood came from somewhere else. But the OP said "blood in urine" although he didn't say "urinalysis with blood"
There's a difference

I feel you, but in real life it seems like 90% of presentations in <1 week olds are completely normal development.

 

[deleted1114045]

Get a UA to be sure but that looks like the "brick dust" you get from urate crystals in newborns. Benign and self-limited.

Exactly. Good description of the appearance.

 

[thegenius]

So what would you do if you checked a UA and there was hematuria, in a 3 day old? Assume normal vitals and normal exam.

 

[RustedFox]

So what would you do if you checked a UA and there was hematuria, in a 3 day old? Assume normal vitals and normal exam.

Septic workup, minus abx and LP.
Add US kidneys.