Pediatrics Book

Crying

Head

Neurology

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Inconsolable Crying in Infants

Aka: Inconsolable Crying in Infants
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  1. See Also
    1. Infantile Colic
    2. Crying Infant
  2. Differential Diagnosis
    1. Common Causes of an inconsolably Crying Infant
      1. Infantile Colic
      2. Corneal Abrasion or Eye Foreign Body
      3. Hair tourniquet (hair strangulating appendage)
        1. Finger
        2. Toe
        3. Penis
    2. Gastrointestinal Causes
      1. Constipation
      2. Cow's Milk Protein Intolerance
      3. Gastroesophageal Reflux
      4. Lactose Intolerance
      5. Rectal fissure
    3. Infectious Causes
      1. Urinary Tract Infection
      2. Otitis Media
      3. Pharyngitis
      4. Pneumonitis
    4. Serious Causes
      1. Meningitis
      2. Intussusception
      3. Intestinal Malrotation and Midgut Volvulus
      4. Trauma (e.g. Fracture, subdural): Consider abuse
  3. Precautions
    1. Stranger anxiety is a diagnosis of exclusion
      1. Does not start until age 8 to 9 months
      2. Should not obviate a thorough evaluation for serious cause
  4. Red Flags: Suggest organic cause
    1. Symptoms
      1. Apnea
      2. Cyanosis
      3. Shortness of Breath
    2. Signs
      1. Lethargy
      2. Tachypnea
      3. Decreased Capillary Refill
      4. Poor weight gain or weight loss
      5. Fever > 100.4 F
      6. Complete examination for organic cause especially:
        1. General exam for signs of trauma or Fracture
        2. Eyes for foreign body or Corneal Abrasion
        3. Ears for infection
        4. Lung exam for respiratory disease
        5. Abdominal exam for acute abdominal signs
        6. Neurologic Exam
  5. References
    1. Roberts (2004) Am Fam Physician 70:735-42

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