A 7-year-old girl presented to the emergency department with an itchy rash. Eight days before presentation, she had been seen by her pediatrician for pharyngitis and received treatment with amoxicillin. At the current visit, her temperature was 39.8°C. Physical examination revealed generalized erythematous papules and macules involving her face (Panel A), her trunk (Panel B), and her arms and legs, sparing her palms and the soles of her feet. The tonsils were purulent, and the anterior and posterior cervical lymph nodes were enlarged. Laboratory studies showed a white-cell count of 8700 per cubic millimeter (reference range, 4000 to 11,500), with 66% lymphocytes (reference range, 20 to 40). A mononuclear spot test was positive. A diagnosis of amoxicillin rash in infectious mononucleosis was made. Patients who receive amoxicillin for the treatment of infectious mononucleosis consequent to infection with Epstein–Barr virus may be subject to the development of a morbilliform rash. However, this rash may not be predictive of a true allergy to penicillins. The patient’s parents were advised to stop the amoxicillin, and the patient’s rash resolved completely within 3 weeks.

Shock is a life-threatening circulatory failure that results in inadequate tissue perfusion and oxygenation. Vasopressors and inotropes are vasoactive medications that are vital in increasing systemic vascular resistance and cardiac contractility, respectively, in patients presenting with shock. To be well versed in using these agents is an important skill to have in the critical care setting where patients can frequently exhibit symptoms of shock. In this review, we will discuss the pathophysiological mechanisms of shock and evaluate the current evidence behind the management of shock with an emphasis on vasopressors and inotropes.

Acute and overuse shoulder injuries in pediatric sports have become more prevalent (seen in almost 40% of baseball pitchers) due to multiple factors such as increased participation in athletic events and games played, less recovery time, and sport specialization (i.e., intense year-round focus on a single sport). The differential is broad when approaching a pediatric athlete with shoulder pain. To complicate things, pediatric athletes are prone to conditions that are not typical in adults, such as proximal humeral epiphysiolysis or Little League shoulder (LLS). It is important to include brachial plexopathy and thoracic outlet syndrome in this differential due to different management strategies. Overall, this age group has a predilection for fractures and sprains as opposed to ligamentous or tendinous damage when insults to the shoulder occur owing to skeletal immaturity. The search was conducted on PubMed (from January 2010 to July 2025) and Scopus (from January 2023 to September 2025) producing a total of 178 reference (82 were included in this review); additional relevant references published before 2010 were also included. Although each shoulder injury presenting in an athlete may be distinct, this narrative review will demonstrate how these pathologies are closely related, how to approach diagnosis, and discuss the evidence and expectations for return to play.

Maxillofacial fractures and ocular trauma are significant injuries in soccer, with potential functional, aesthetic, and visual consequences if unrecognized. Few reviews have specifically examined both injury patterns in this sport. The purpose of this narrative review is to synthesize the current literature to identify injury patterns associated with maxillofacial fractures and ocular trauma in soccer, thereby aiding clinicians in timely diagnosis and management. Given the heterogeneity and limited quality of the available evidence, this review also highlights areas where further research is needed. The zygoma was the most commonly fractured maxillofacial bone in soccer (32.8%), followed by the nasal (28.4%), mandibular (25.8%), orbital (6.5%), maxillary (3.6%), and frontal sinus (2.8%) regions. Among mandibular fractures, the angle was the most vulnerable site, accounting for 39.2% of cases. Head-to-head contact was the most frequent mechanism resulting in injury; however, although less common, arm or elbow impacts were more likely to result in fracture when they occurred. Ocular injuries most often present as orbital or eyelid contusions and lacerations (37.1%) and hyphemas (19.5%), with direct ball impact as the primary cause. Boys (60.4%-69.5%) were at greater risk than girls for ball sport-related ocular trauma, particularly those aged 2-9 years, with soccer being the leading sport implicated. Overall, these trends are based largely on small case series, reflecting the low quality of available evidence. The zygoma is the most frequently fractured maxillofacial bone, typically resulting from head-to-head collisions. Direct soccer ball impact accounts for most ocular injuries in this sport, with orbital or eyelid contusions and lacerations most common, followed by hyphemas. Pediatric players may be particularly susceptible to soccer-related ocular trauma, possibly due to an underdeveloped orbital rim. Fundoscopic examination is essential after ball impact to detect vitreoretinal injury, even when visual acuity is normal. Further well-designed studies are needed to confirm these findings.