My second-year resident ducked his head into my office in the pediatric clinic. “Hey, Dr. Cohen,” he said, “can you come and look at a girl with a lump on her arm?”
The area on the 7-year-old girl’s upper right arm had been swelling for about a week, he said, and it was getting bigger. She’d had a slight fever about a week ago, but none since. The lump was painful and hard, and yesterday the mother had noticed some slight redness of the skin. The child had been healthy, and her immunizations were up to date. She wasn’t taking any medications, and no one at home had been ill. The resident noted that she hadn’t had any injury, such as a bite, or any exposure to animals.
We went in to see the girl. I introduced myself and crouched down beside her.
“Hi. Can I check your arm?”
She ...
