Infant with irritability, feeding problems, and progressive developmental abnormalities presenting repeatedly to a pediatric emergency department

Emergency physicians often deal with diagnostically elusive cases that may present repeatedly over the course of illness. The infant presented here had a chronic history, prompting multiple physician contacts for initially seemingly common problems. Assessing the patientʼs progression of symptoms over time and eliciting a brief developmental history in the emergency department (ED) helped guide decision-making toward admission and appropriate diagnostic workup.