A special thank you to Alexandra Amaducci DO, MBA, FACEP, FACMT for organizing this year’s CPC competition during the PACEP26 Scientific Assembly. Congratulations to this year’s first place winners – Adam Reed, DO from St. Luke’s University Health Network for submitting the case and being the resident presenter, and Jiten Patel, MD from Thomas Jefferson University for being the attending discussant. PMHx: seasonal allergies PSHx: none Meds: none NKDA Social Hx: UTD on vaccines VS: HR 125 bpm, BP 136/74 mmHg, RR 22 bpm, Spo2 98% RA, Temp 99.8°F PE: General: awake, uncomfortable, clutching is head, diaphoretic Neuro: Photophobic, PERRL, gait normal, negative Kernig and Brudzinski signs HEENT: nasal congestion, inflamed nasal turbinates, erythematous oropharynx, no obvious edema noted to forehead CV: tachycardic, regular, no m/r/g Lungs: CTA b/l Abdomen: soft, nontender GU: unremarkable Remainder is unremarkable Pertinent Labs: WBC: 18.93 ANC: 13.90 Platelets: 515 Anion Gap: 16 PACEP SCIENTIFIC ASSEMBLY 2026 CPC HIGHLIGHT What is the Diagnosis? A Headache to Remember 7-year-old M presented with facial swelling, headache and neck stiffness x 1 day. Patient had a fever at home. Patient was seen the day before for URI symptoms which started 10 days ago, HA and one episode of vomiting. Patient had improvement with symptomatic meds and was discharged home. Over the last 3 days, symptoms worsened and now with recurrent vomiting. Parents are concerned that the forehead appears “swollen.” CPC CASE STUDY THE CASE What test will make the diagnosis? What is the final diagnosis? see conclusion on page 26 20 PACEP News
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