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Pediatr Emerg Med Pract. 2014 Mar;11(3):1-17; quiz 17-8.

A systematic approach to the evaluation of acute unexplained crying in infants in the emergency department.


Crying is a common behavior of infancy that can be a signal of a broad spectrum of conditions ranging from the normal needs of hunger and sleep to significant medical or surgical pathology. In the medical setting, crying is often seen in concert with other signifiers of disease or distress, such as fever, vomiting, rash, or trauma. However, challenges in evaluation of infants may arise when crying is the only sign. A thorough, systematic, and appropriate history and physical examination are needed. Additionally, a broad range of medical possibilities coupled with caregiver concern need to be considered to ensure proper evaluation. In this issue, we will review crying as a chief complaint in the emergency department setting and provide a systematic and practical approach to the evaluation of crying infants.

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