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The Pediatrician Next Door - Simple Advice on Parenting and Family Health
Ep. 139: Medical Mysteries: Monsters in the Mind & Other Spooky Stories
00:25:56
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- [00:01]
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- [00:26]
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- [00:59]
Dr. Wendy Hunter
I have never been more afraid of anything than when my own kids have been sick. Can you relate? And that's what today's episode is about. It's not about haunted houses or cursed mirrors, but it's about the invisible medical horrors that creep up on kids and scare us more than anything. Welcome to the Pediatrician next door. If you're new here, I'm Dr. Wendy Hunter and this is where I explore the mysteries we all wonder about when it comes to kids health. And every season for our Halloween episode, I like to tell real stories that make parents scratch their heads, maybe lose sleep and sometimes get a little scared. And today I will share three true medical mysteries told like the spooky stories they really are. So grab your flashlight, pull your blanket up tight and see if you can solve these cases before I reveal the true diagnosis. I am Dr. Wendy Fishguts Hunter and I'm the spooky pediatrician in the graveyard next door. I'm that mad scientist you call for unconventional advice about your kid's health. I mix the potions, poisons and witchcraft of modern medicine with the terrifying reality of parenting. Our first mystery begins with a two month old baby boy. It's the case of when the cry went quiet. This baby had been really healthy since he was born. He really never spit up. He didn't fuss with his feeds, nothing strange. But then one weekend, things changed. He started vomiting at first, just once or twice. No big deal. Two month olds spit up, right? But over the next two or three days, his vomiting became more more frequent, even when he hadn't had anything to eat. His parents thought it was a little strange, but they weren't that surprised because they know babies spit up. Then one afternoon, this poor little baby's body went sort of limp. All of a sudden and then his eyes rolled back in his head. He wouldn't respond to his parents, of course. They were really worried, panicked. So they rushed him to the emergency room. And at the triage nurse desk, they told the nurse all about the vomiting. You see, his parents assumed his vomiting was what was making him weak. So they didn't say anything to the nurse about his eyes rolling back or him being limp. But once the nurses and the doctors in the emergency room saw him, they became very concerned. This baby was gray, weak, and not crying like a baby should. The ER physician started working through all the possibilities. They needed to be quick. Could this be abuse? Could it be a fall? A shaking episode? An injury no one wanted to admit? Could it be a clotting disorder, like hemophilia, passed down in the family tree? Could it be a congenital malformation in his brain? The team worked quickly. They drew blood. They got a CAT scan of his head. But when the labs came back, the clues didn't fit any of their theories. His platelet count was normal. That means he should be able to clot his blood. But his coagulation studies, those are the tests that measure how well blood clots. They were sky high. In fact, they were so abnormal that the doctors assumed there must have been a mistake in the lab. So what did they do? They ordered the tests again. It kind of makes sense. Meanwhile, the results of the head CT came back, and it was worse than anyone feared. There was blood in the spaces around this baby's brain. He had what we call a subarachnoid hemorrhage. I know that sounds like tiny spiders, but it's not. It's still bad, though. The subarachnoid space is a thin coat cushion between the brain and the skull. And normally it's filled with clear fluid that protects your brain. But in this baby, that space wasn't filled with fluid anymore. It was filled with some blood. And blood doesn't just sit there quietly. It presses on that delicate brain tissue and irritates the nerves. And it can trigger seizures, coma, even death. The team froze for a moment. Was this trauma after all? Did someone hurt this baby? But the labs told another story. When the coagulation studies returned, they were just as abnormal as before. And the picture began to shift. This child was not clotting his blood at all. So the doctors went back to the parents with a simple but critical question. Did your baby get vitamin K at birth? Finally, the truth came out. No. The parents said they had declined it. They didn't think it was Important. So they didn't mention it to the doctors or nurses earlier, even when they asked for his medical history. And it was that one missing shot at birth that was the key to the whole puzzle. Without it, this baby's body had been unable to produce the clotting factors that he needed to stop bleeding. And over the first weeks of life, a slow clock had been ticking, and at two months, it ran out. This was a rare case of what's known as vitamin K deficiency bleeding. How does this happen? Who would have thought that skipping a vitamin shot could do this? It's a strange but true fact that every baby is born deficient in vitamin K. Unlike most nutrients, vitamin K does not cross the placenta. Not very well anyway. And breast milk contains only tiny amounts of it. So without a supplement, babies have almost none of the clotting factors that depend on vitamin K. And that's why every newborn within hours of delivery gets a small amount of slow release vitamin K. The shot is given just under the skin where it slowly releases into the bloodstream over weeks, protecting babies through the dangerous window when they're most at risk for bleeding. And when the shot is declined, the risk is small at first, but it's not zero. Early bleeds can happen in the first week, but the most dangerous form, called late vitamin K deficiency bleeding usually strikes between 2 weeks and 12 weeks of age. And most often it does strike in the brain. And that's what happened here. The ER team wasted no time. The baby was given IV vitamin K to immediately reverse his deficiency, was admitted to the intensive care unit, closely watched and supported through the brain swelling that ensued. The parents watched in shock as one small choice, declining that birth dose, unleashed a cascade of consequences. Fortunately for this family, the treatment worked. And the baby's been fine. I've heard he'll even eat his veggies because his parents know that vitamins are very important. Unfortunately, it's not just this one child. In Tennessee, there was a cluster of four babies whose parents all declined vitamin K and they all developed late vkdb. Three of these kids suffered catastrophic brain bleeds and two of them were left with permanent neurologic damage. In every case, the parents thought they were protecting their babies from toxins instead of. The true danger was hidden where no one could see it. And what makes this story so chilling is how preventable it was. One tiny injection at birth would have supplied weeks of slow release vitamin K, protecting the body against this catastrophe. The vomiting was the only warning. He had a seizure. That was the weakness. And that was the alarm bell. And by the time the diagnosis was clear, the bleeding had already started. In pediatrics, we often say babies don't read the textbook. They don't always present the way we expect. But vitamin K deficiency is one of the exceptions. The timeline is actually very predictable. The outcome is preventable, and the consequences are devastating if we miss it. So remember this story the next time someone tells you that a vitamin K shot is not necessary in an infant. The scariest dangers are the ones you can't see until it's too late. And sometimes the danger isn't hidden inside the body. It's hidden in plain sight. Shapes that crawl across the ceiling, shadows no one can see. And that brings us to the next story. It's called Monsters in the Mind. Our second story begins in the quiet suburbs with a little girl who should have been drifting peacefully into sleep each night. Instead, her nights were filled with spiders. She was just four years old, adopted into a loving home after a quite rough start in life. Her new parents wanted nothing more than to give her stability and safety. And for the most part, she was a happy, playful little girl. But at bedtime, something unusual began to happen. She started telling her mom, very matter of factly, there are spiders. There are spiders. At first, they came at night. She would lie in bed, look up at the ceiling, and see dark shapes crawling across the walls. The odd part? She wasn't scared. She didn't scream. She didn't cry. The spiders weren't monsters to her. They were just there, distracting and impossible to ignore. And as the weeks went on, the spiders started to appear. During the day, also. At school, on the playground, in the car, she'd point to the corners of the room or just mention casually that the spiders were back again. But at home, especially in the evenings, her mom noticed she talked about them a lot more. Her backstory made things more complicated. You see, she had been exposed to many different drugs in utero before she was born. And her adoptive mom couldn't help but wonder if that history was finally catching up with her. Could her visions be the long shadow of prenatal drug exposure? It seemed to make sense. We know prenatal substance exposure can cause a range of developmental and behavioral problems. Learning delays, sensory differences. It was easy to imagine that her hallucinations might be another result of this. The thought was terrifying, but also almost reassuring. At least it would explain why the spiders kept showing up. And her doctor wanted to think that was the cause at first. But she considered other explanations. Seizures were high on the list. And then there's occipital lobe epilepsy, which can produce visual phenomenon like flashing lights, colored shapes, even animals. But seizures are usually quick, like seconds to minutes long. And these spider sightings, they were happening any time of the day, lasting as long as she wanted to talk about them. And it didn't quite match the idea of seizures. So her doctors thought maybe it could be migraines. Children can have visual auras even even without a headache. They can see sparkles or zigzags or shapes. And in young kids, migraine auras can look really bizarre and can be mistaken for hallucinations. Of course, there was the frightening possibility of a brain tumor. A tumor, a lesion, a malformation, a hidden growth pressing on her visual system. Some rare conditions do produce lifelike images of animals and insects, but her physical exam showed nothing abnormal in her neurologic system. Totally normal in every way. Her doctor also thought that psychiatric illness seemed the least likely explanation. True psychosis in a four year old is extraordinarily rare. She described her visions casually, even playfully, to anyone who asked. So none of these possibilities really fit neatly. But each one did offer a thread to pull on. And like any good mystery, we're going to follow those threads after this quick break. Are you drinking enough water every day? If you're like me and you don't drink enough water, Cure makes it easy and enjoyable. I started using Cure hydration packs because plain water just didn't make me feel hydrated and I didn't want the sugar and additives that come in normal sports drinks. Cure is a clean plant based electrolyte mix with no added sugar and only 25 calories. I use it after a challenging workout, when I'm traveling or when I know I'm not drinking enough water. What I love most is that CURE is science backed and you know how important that is to me. Cure is formulated using the same proven ratio of electrolytes as an IV drip. So I know it works. It's made staying hydrated so much easier for me. I put a few packets in my bag and now I look forward to drinking more water through the day. You are going to love Cure too. It's great for busy parents, for student athletes, and anyone who wants hydration that tastes good. Staying hydrated isn't just about water. You also need electrolytes. That's why I love cure. It's clean, tastes great, and actually works for pediatrician next door listeners. You can get 20% off your first order at@curehydration.com Dr. Wendy with code Dr. Wendy that's dash R W E N D Y and if you get a post purchase survey make sure to let them know you heard about Cure right here. It helps support the show. Don't just try to drink more water. Upgrade it with cure.
- [15:04]
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- [15:33]
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- [15:56]
Dr. Wendy Hunter
When we left off, the doctors were puzzling over the possibilities for this child's hallucinations of spiders. But in the meantime, her mother carried a heavier suspicion. She couldn't shake the thought that this might be about her daughter's biological mother's drug use. A shadow from the past that still clung to her daughter. The suspicion was hard to shake. Could this be a permanent injury to her brain? A reminder that even though she's safe now, the past still has its grip on her? Doctors dug through the literature looking for connections between prenatal exposure and visual hallucinations in childhood. And they found reports of attention problems, behavioral challenges, learning struggles. But hallucinations? Nothing like that. As much as everyone wanted that answer to be the explanation, the evidence just wasn't there. And then, just as suddenly as they'd begun, the spiders started to fade away. At first she mentioned them less often. Then weeks went by without any sightings. By the time she was five, she stopped talking about them altogether. Her final diagnosis? It wasn't poisoning. It wasn't psychosis. Not a lifelong curse from prenatal exposure. The most likely explanation was a combination of migraine related visual aura, something that can cause odd and fleeting visual experiences in kids, mixed with the boundless imagination of a four year old. A brain developing, just firing off signals, overlying imagination and perception. What's remarkable is that the spiders were never frightening to her. They were just kind of part of her world. An extra detail that no one else could see. Her mom feared that they were the ghosts of her past, A permanent mark left on her before she was even born. But in the end, they were just a blend of imagination and migraine. The spiders weren't real, they weren't dangerous. But they do remind us that much of childhood is really mysterious. There's a thin line between play, perception and pathology. And sometimes the scariest part isn't what we see. It's how little we know about what's happening in a child's mind. But not all mysteries fade away on their own. Some grow larger and more stubborn with every passing week, Lurking just beneath the skin, refusing to be ignored. And that brings me to our last case. It's the case of the lump that wouldn't leave. This is the story of an eight year old boy who has autism. He is non verbal and he can't describe anything that happened to him. He walked into the clinic with his parents and his mother explained that a lump had appeared on the side of his neck a few weeks earlier. At first she thought it was just a swollen lymph node. They'd been through that before. Sometimes kids get them after colds or a sore throat. But this lump wasn't going away. It wasn't shrinking, it was growing. The boy didn't complain. Not with words anyway. He didn't say it hurts. He didn't say I feel sick. He didn't even seem bothered. But sometimes he would kind of tug at his neck or push food away. And then he started to become more irritable than usual. His parents always were very finely attuned to his subtle cues. They knew something was wrong. The pediatrician examined him. The lump was firm. It didn't seem tender. It was about the size of a golf ball, so it was quite big. And that's unusual for a child. Typically, lymph nodes from a viral infection are kind of small and rubbery and go away after a few weeks. This one looked a little more sinister. So the doctor prescribed antibiotics, thinking maybe it's a bacterial infection. The family tried really hard to give him the antibiotics, but he resisted. He just wouldn't take them. Every single dose was a battle. He gagged, spit, clamped his mouth shut. He refused to swallow. And after a few failed attempts, his parents were forced to take him to the hospital. And there the doctors kept him in the hospital for a few days and gave him antibiotics through his iv. Everything, everything seemed fine. So then they tried a different antibiotic by mouth and he would take it. So they sent him home. But the lump didn't change. A week went by, then another, and the lump got even bigger. So that's when other possibilities started to creep into everyone's mind. Could this be something worse than an infection? Certain cancers in kids like lymphoma often do show up as a painless, persistent swelling in the neck. That possibility terrified his parents. So they went back to the clinic, and their doctor ordered blood work and imaging. And the labs really didn't scream leukemia or lymphoma. They were normal. And the ultrasound of the lump showed enlarged lymph nodes. No big deal. Some had a little bit of a dark necrotic center, but not the typical look of a simple infection. So at this point, the mystery was really tightening its grip. A biopsy was ordered, and under anesthesia, a surgeon removed part of the swollen lymph node and sent it for pathology. The family waited, tense, sleepless, until finally, the results came back. The report confirmed what the clinicians were starting to suspect. Bartonella hensele. That's the bacteria carried by cats and the cause of cat scratch fever. Cat scratch disease is one of those infections that sounds harmless, just a scratch from the family kitten, but it can wreak havoc in the right conditions. Most cases cause nothing more than a mild swelling near the site of the scratch. But in some kids, the bacteria invade the lymph nodes, creating a large, stubborn, inflamed mass that just won't budge. And this boy, Bartonella found the perfect hiding place. So what's the treatment? It is antibiotics, usually azithromycin, sometimes combined with other drugs if the disease is severe. But remember, this boy had already made it clear he did not want to take his medicine willingly. He gagged, he spit it out, and he again refused every dose of the azithromycin. His parents felt absolutely helpless, so doctors tried to help brainstorm solutions. Could they flavor the antibiotic? Could he take a crush tablet mixed with food? Could a short hospital stay for IV antibiotics get him over the hump? Each option just felt like a mountain to climb. Meanwhile, the lump in his neck stayed exactly the same, looming like a monster that refused to leave. The family did what they could. They begged. They coaxed, they bargained. They hid medicine in his favorite foods. And some doses went down. Most didn't. And the lymph node did start to shrink a little bit. Then it held steady. Then it swelled again. Weeks grew into months. And eventually, with persistence and just partial treatment, his own immune system did pitch in. And the infection started to go away. The lump was still a little visible, but it softened and it shrank. And the family felt relief, finally. But the case left them shaken. What they thought was a simple swollen gland spiraled into biopsies and pathology reports and fears of cancer, as well as a prolonged fight against a tiny bacterium. So the scariest part of this story isn't the infection itself. It's how easily Bartonella hides in plain sight. A child with autism who can't describe his pain. A lump that looks ordinary at first, an antibiotic that's refused to be swallowed. Layer after layer of obstacles, each one making this mystery harder to solve. Bartonella is sometimes called the great imitator. It can cause swollen lymph nodes, fever, liver abscesses, bone pain, even neurologic symptoms like confusion. Some kids fight it off without any treatment. Others do have complications when it's ignored. And because it lurks inside lymph nodes, it it often does masquerade as something more sinister. For this family, the lesson was that even the most ordinary symptoms, a lump in the neck can turn into a mystery. And for the rest of us, it's just a reminder of how much we depend on communication to solve medical puzzles. When a child can't talk, the clues are harder to find. And maybe the stakes are higher. Sometimes what makes a case terrifying isn't the germ itself, but the silence. We've now seen three medical a baby whose brain bled silently after parents refused vitamin K, a little girl who saw spiders that only she could see, and a boy whose neck swelled with an infection that wouldn't yield. Three very different stories, but all united by the same haunting what you don't see can hurt you. And in pediatrics and in parenting, the scariest dangers often are the invisible ones. If you enjoyed these Halloween mysteries, share this episode with a friend or another parent who loves a good ghost story. And if you haven't already, follow the pediatrician Next door so you don't miss the next mystery. Until then, keep the lights on and keep asking questions. For more from the pediatrician Next Door, find me on the web@ pediatriciannextdoorpodcast.com if you've got a spooky question about the creepy things that kids do, send an email to helloediatriciannextdoorpodcast.com for a chance to hear your voice on the show. I'm Dr. Dr. Wendy Hunter and I'm the Pediatrician next Door. This show is produced by Red Rock Music. Make sure to subscribe and leave a review wherever it is you're listening. I'll be back next time.