This is Emergency Medicine Cases, EM Quick Hits podcast, and I'm your host, Dr. Anton Hellman. EMCases is brought to you by Shremi, the Schwartz-Rizman Emergency Medicine Institute. That's a non-profit organization dedicated to improving EM care through high-quality research and education. The opinions expressed on this podcast are intended for general information and educational purposes only, and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a substitute for medical advice from qualified practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in their individual capacity, not on behalf of the Institute nor medicine cases. First, a word from our sponsor Metricade, the experts in complex physician scheduling since 2012. I've been using Metricade's incredible scheduling system for a decade, and it's been a game changer for me and my colleagues.

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It's my pleasure to have back on the show, Dr. Deb Schoenfeld, pediatric EM educator for

a best of University of Toronto EM Quicket. Welcome back, Dr. Seanfeld.

Thanks for having me. Let's jump right into a case from Janus General. I understand that you had a

case of a 12-year-old boy who came in with fever and back pain.

I do. So this case involved a 12-year-old male who was brought in with five days of just feeling unwell, some myalgas and fever, and two days of some gradually worsening back pain. He actually was brought in because he

reported to his parents this afternoon that he hadn't actually urinated since the night prior,

and that's really what prompted them to bring him into the emergency department. When he was

asked about these urinary symptoms, he had a pretty typical adolescent response and offered something

along the lines of a, I don't know, it just feels weird when I pee. He saw his family doctor,

actually, at the onset of illness, of this febrile illness, and his family doctor did some basic

testing, and actually they got a call yesterday that he had a positive monospot test.

All right. So if this was an adult, I mean, as soon as you put back pain and fever together,

...