Case of the Week
A two-week-old baby boy is brought in by his mother for a “bump” on his head that
has recently become more apparent.  The child was born full term via normal spontaneous delivery without complication.  There has been no history of trauma, fever, or change in intake, output, or behavior.  The boy’s first well-child appointment is tomorrow morning, but an alarmed family member convinced the family to seek help tonight.

On examination, the child is well appearing with normal vital signs and an otherwise normal total body check.  The area of concern is shown below:
Which of the following is the BEST course of action?

    A. CBC, blood cultures, incision and drainage, admission to the hospital
    B. Tie base of lesion with silk suture, observe briefly, outpatient follow-up
    C. Watchful waiting and referral to primary medical doctor
    D. Obtain stat MRI

In the meantime, a quote – 

Festina lente.

[Make haste slowly.]

– Classical adage


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