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The infant with acute, unexplained, excessive crying.

S R Poole1

  • 1Department of Pediatrics, University of Colorado School of Medicine, Denver.

Pediatrics
|September 1, 1991
PubMed
Summary
This summary is machine-generated.

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Excessive infant crying often signals serious conditions, requiring thorough physical exams for diagnosis. Infants who stop crying during assessment are less likely to have severe issues.

Area of Science:

  • Pediatrics
  • Emergency Medicine

Background:

  • Infants presenting with unexplained excessive crying to the emergency department pose a diagnostic challenge.
  • A significant percentage of these cases are ultimately diagnosed with serious underlying conditions.

Purpose of the Study:

  • To evaluate the diagnostic yield of history and physical examination in infants with unexplained excessive crying.
  • To identify predictors of serious pathology in this patient population.

Main Methods:

  • Retrospective review of 56 infants presenting with excessive crying over one year.
  • Analysis of diagnostic clues from patient history and physical examination findings.
  • Correlation of crying cessation during assessment with final diagnosis.

Main Results:

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  • 61% of final diagnoses were considered serious.
  • History provided diagnostic clues in 20%; physical examination was diagnostic in 41% and provided clues in 13%.
  • Persistent crying post-initial examination predicted serious causes, while crying cessation suggested benign etiology.

Conclusions:

  • A comprehensive physical examination is crucial for diagnosing serious causes of excessive infant crying.
  • Persistent crying in the emergency department is a key indicator of potential serious pathology.
  • A stepwise diagnostic approach is recommended for infants with unexplained crying.