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Pediatric Consult Editor- Ln- Chi-ef
8‘ EDITION
Michael D. Cabana
Asscciale Editcrs
Paul R . Brake man
.
Megan L Cur r an
Linda A . DiMeglio
W. Christopher Galden
Robert E . Gold &by
Terry Kind
Carlton K . K . Lee
Jenifer R. Lightdale
Camille Sabella
Roan E. Tanei

Wolters Kluwer
The 5-Minute
Pediatric Consult
8m EDITION
ASSOCIATE EDITORS
Paul R. Brakeman, MD, PhD
Associate Professor of Pediatrics
Department of Pediatrics
University of California, San Francisco
Medical Director, Pediatric Kidney Transplant Program
UCSF Benioff Children’s Hospitals San Francisco and Oakland
San Francisco, California
Megan L. Curran, MD
Assistant Professor of Pediatrics
Department of Pediatrics
University of Colorado School of Medicine
Attending Physician
Section of Rheumatology
Children’s Hospital Colorado
Denver, Colorado

Linda A. DiMeglio, MD, MPH

Professor of Pediatrics
Department of Pediatrics, Section of Pediatric Endocrinology and Diabetology
Indiana University School of Medicine
Riley Hospital for Children at Indiana University Health
Indianapolis, Indiana

W. Christopher Golden, MD
Assistant Professor of Pediatrics
Division of Neonatology
Director, Pediatrics Core Clerkship
The Johns Hopkins University School of Medicine
Neonatologist and Medical Director
Newborn Nursery
The Johns Hopkins Hospital
Baltimore, Maryland
Robert E. Goldsby, MD
Professor of Clinical Pediatrics
University of California, San Francisco
Director, Survivors of Childhood Cancer Program
UCSF Benioff Children’s Hospital San Francisco
San Francisco, California

Terry Kind, MD, MPH

Associate Professor of Pediatrics
Assistant Dean for Clinical Education
The George Washington University
Children’s National Health System
Washington, DC

Carlton K.K. Lee, PharmD, MPH

Associate Professor, Pediatrics
The Johns Hopkins University School of Medicine
Clinical Pharmacy Specialist, Pediatrics
PGY-2 Pediatric Pharmacy Residency Program Director
Department of Pharmacy
The Johns Hopkins Hospital
Baltimore, Maryland
Jenifer R. Lightdale, MD, MPH
Professor of Pediatrics
Department of Pediatrics
University of Massachusetts Medical School
Division Chief, Pediatric Gastroenterology, Hepatology, and Nutrition
Chief Quality Officer
UMass Memorial Children’s Medical Center
Worcester, Massachusetts

Camille Sabella, MD
Associate Professor of Pediatrics
Vice-Chair for Education, Pediatric Institute
Director, Center for Pediatric Infectious Diseases
Cleveland Clinic Children’s Hospital
Cleveland, Ohio
Ronn E. Tanel, MD
Professor of Clinical Pediatrics
Department of Pediatrics
University of California, San Francisco
Director, Pediatric Arrhythmia Service
Division of Pediatric Cardiology
UCSF Benioff Children’s Hospital
San Francisco, California
The 5-Minute
Pediatric
,
Consult
8 h EDITION Edilor
Michael D. Calwm MO, MPH
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Buenos Aires Mang Kong Sydney Tokya SMinut Consult "
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8th Edition
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ISBN-13: 978-1-4963-8176-7

This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy,
comprehensiveness, or currency of the content of this work.
This work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration
of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to
the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and
not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments.
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Cover Photograph by Elisabeth Fall
I dedicate this book to my wife Jen and our children. Thanks for being patient with me while I wrote and
edited
–PAUL R. BRAKEMAN, MD, PhD

To Cewin, Alex, and Abi

–MICHAEL D. CABANA, MD, MPH

To my parents Donald J. Curran, DO, and Victoria Renz for instilling in me the value of education, to my
patients for teaching me on a daily basis, and to Adam for supporting me unconditionally
–MEGAN L. CURRAN, MD

To my patients, colleagues, friends, and family (especially Bob, Richard, Luke, and Max) who infuse my
life with purpose and joy
–LINDA A. DIMEGLIO, MD, MPH

To Chinessa and Cadence, how wonderful to have a new sister-in-law and niece and to evidence the love
between a new mother and child
–W. CHRISTOPHER GOLDEN, MD

To my family and all of the patients who have allowed me to be part of their lives
–ROBERT E. GOLDSBY, MD

Thanks to my pediatric and medical education colleagues, my patients, and my Kind-Simon family, all of
whom inspire me. Let’s grow together
–TERRY KIND, MD, MPH

To Joanne, Brendan, Chester, and my parents for all your support

–CARLTON K.K. LEE, PHARMD, MPH

Thank you to my family, as well as to Michael, Leanne, and all of my colleagues in pediatric GI, for their
trust, love, support . . . and patience. “Little by little, a little becomes a lot.” (African Proverb)
–JENIFER R. LIGHTDALE, MD, MPH

To my family for their love and support and to my father, in memory

–CAMILLE SABELLA, MD

To Sarah, Meghan, and Lauren

–RONN E. TANEL, MD
PREFACE

I
n a December 30, 1976 cover story interview in Rolling Stone magazine, author Maurice Sendak
commented, “There’s so much more to a book than just the reading. I’ve seen children touch books,
fondle books, smell books, and it’s all the reason in the world why books should be beautifully
produced.”1 Anyone who has given a book to a 1-year-old child in clinic has probably witnessed a child
touch, smell, and even taste a book. For a young child with a new book, every sense is engaged.
My colleagues and I now present a beautifully produced eighth edition of The 5-Minute Pediatric
Consult. Unlike Mr. Sendak and his young readers, we don’t expect you to literally smell or taste this
book; however, we have produced a beautiful book that figuratively can be consumed at many different
levels.
For those readers who need just a “taste” of each topic, each chapter is designed to give the reader a
quick overview. A clinician in a busy office or emergency department can quickly look up a description
of each condition, as well as what key questions to ask in a history, what findings to look for during the
examination, and what tests are most important to prioritize to confirm a diagnosis. Each chapter also
includes a differential of other diagnoses to consider and a concise summary of treatment options. For
clinicians who need more than just a brief taste of information, each chapter also includes more
information on the etiology, pathophysiology, risk factors, and prognosis of each condition. Finally, for
those who want to heavily consume the topic, there are suggestions for additional reading, as well as
potential “frequently asked questions” that add even further depth and flavor to each chapter.
There is also a second meaning to Mr. Sendak’s comment that “there’s so much more to a book than just
the reading.” Before any reading takes place, there is all the writing and editing that has already been
completed. Although each of the chapters is only two pages of reading, each topic represents years of
clinical experience as well as countless hours of research, writing, and editing. The authors of these
chapters have demonstrated great skill in distilling large amounts of information into an easily accessible
5-minute synopsis or “consult” on a range of clinical topics.
The eighth edition of the book, with over 500 topics, also reflects the continuing achievements and
ordeals of the field of pediatrics. With improvements in neonatal care, we now introduce a chapter
focused on “Follow-up of the NICU Graduate.” With each passing edition, it is also more difficult to find
experts on diseases now less common, such as Diphtheria, Measles, Rheumatic Fever, and Reye
Syndrome. However, our field also faces new challenges that are represented by new chapters focused on
Zika Virus, Chikungunya Virus, Ebola Virus Disease, and even Vaccine Refusal.
To organize this effort, I am fortunate to work with a diverse, distinguished, and talented team of
associate editors, who have recruited accomplished authors for each topic. This team of associate editors
includes Paul R. Brakeman, MD, PhD; Megan L. Curran, MD; Linda A. DiMeglio, MD, MPH; W.
Christopher Golden, MD; Robert E. Goldsby, MD; Terry Kind, MD, MPH; Carlton K.K. Lee, PharmD,
MPH; Jenifer R. Lightdale, MD, MPH; Camille Sabella, MD; and Ronn E. Tanel, MD. I have learned
from each comment on each draft of each chapter they edited and reviewed. I also give special thanks to
Angela Scheuerle, MD who reorganized and updated our Syndromes Glossary for this edition. This
updated section includes unique identifiers for dozens of genetic conditions, the associated inheritance
pattern, the involved gene(s), mechanism of disease, as well as a description of the associated clinical
findings. Finally, I would also like to thank the staff at Wolters Kluwer, especially Leanne Vandetty and
Harold Medina, who have helped us present this work so beautifully.
We hope this book will continue to be an indispensable resource for health care professionals who care
for children. With these acknowledgments, it is a pleasure to welcome you to this new edition of The 5-
Minute Pediatric Consult. And in the words of Mr. Maurice Sendak once again, “let the wild rumpus
start!”2
MICHAEL D. CABANA, MD, MPH
San Francisco, 2018

References
1. Cott J. “Maurice Sendak, King of All Wild Things.” Rolling Stone. December 30, 1976:48–59.
2. Sendak M. Where the Wild Things Are. San Francisco, CA: Harper Collins; 1963.
CONTRIBUTING AUTHORS

Bethlehem Abebe-Wolpaw, MD
Department of Pediatrics
Greater Baltimore Medical Center
Towson, Maryland

Erika L. Abramson, MD, MS†

Associate Professor
Pediatrics and Healthcare Policy & Research
Weill Cornell Medical College
New York, New York

Dewesh Agrawal, MD†

Associate Professor
Pediatrics and Emergency Medicine
The George Washington University School of Medicine & Health Sciences
Director
Pediatric Residency Program
Children’s National Medical Center
Washington, DC

Allison L. Agwu, MD, ScM

Associate Professor
Pediatric and Adult Infectious Diseases
Director, Pediatric and Adolescent HIV/AIDS Program
Medical Director, Accessing Care Early (ACE) Clinic
PI, JHU IMPAACT and ATN
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Jeremy T. Aidlen, MD
Associate Professor of Surgery, Pediatrics, and Urology
University of Massachusetts Medical School
UMass Memorial Children’s Medical Center
Worcester, Massachusetts

Akinyemi Ajayi, MBBS, FAAP, FCCP, FAASM

President, Medical Director
Children’s Lung, Asthma and Sleep Associates and The Children’s Sleep Laboratory
Medical Director, Florida Pediatric Research Institute
Winter Park, Florida
Ibukunoluwa C. Akinboyo, MD
Postdoctoral Fellow
Pediatric Infectious Disease
The Johns Hopkins University School of Medicine
Baltimore, Maryland

Temitope Akinmboni, MBBS

Clinical Assistant Professor, Pediatrics
University of Maryland School of Medicine
Baltimore, Maryland
Noura Al Dhaheri, MBBS
Medical Genetics Resident
McKusick-Nathans Institute of Genetic Medicine
The Johns Hopkins University School of Medicine
Baltimore, Maryland

Stamatia Alexiou, MD
Assistant Professor of Pediatrics
Division of Pulmonary Medicine
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Brittany B. Allen, MD
Clinical Instructor of Pediatrics
Pediatric Hospital Medicine
University of Michigan C.S. Mott Children’s Hospital
Ann Arbor, Michigan

Marilee C. Allen, MD
Professor of Pediatrics
The Johns Hopkins University School of Medicine
Co-Director, Infant Developmental Center
Kennedy Krieger Institute
Baltimore, Maryland
Craig A. Alter, MD
Professor of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Director, Neuroendocrine Center
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Lusine Ambartsumyan, MD
Assistant Professor of Pediatrics
University of Washington School of Medicine
Director, Gastrointestinal Motility Program
Seattle Children’s Hospital
Seattle, Washington
Prina P. Amin, MD
Assistant Professor
Department of Pediatrics
Division of Academic General Pediatrics
Weill Cornell Medical College
New York, New York
Evan J. Anderson, MD
Associate Professor
Departments of Pediatrics and Medicine
Emory University School of Medicine
Atlanta, Georgia

Lauren Andrade, MD
Pediatric Cardiology Fellow
Primary Children’s Hospital
Salt Lake City, Utah
John S. Andrews, MD
Associate Dean for Graduate Medical Education
University of Minnesota Medical School
Minneapolis, Minnesota

Ravit Arav-Boger, MD
Professor of Pediatrics
Division of Infectious Disease
Johns Hopkins University School of Medicine
Baltimore, Maryland

Kaveh Ardalan, MD, MS

Instructor
Pediatrics and Medical Social Sciences
Northwestern University Feinberg School of Medicine
Attending Physician
Pediatric Rheumatology
Ann & Robert H. Lurie Children’s Hospital of Chicago
Chicago, Illinois

Lisa M. Arkin, MD†

Assistant Professor
Department of Dermatology and Pediatrics
University of Wisconsin School of Medicine and Public Health
Director of Pediatric Dermatology
American Family Children’s Hospital
Madison, Wisconsin

Stephen S. Arnon, MD, MPH

Chief, Infant Botulism Treatment and Prevention Program
California Department of Public Health
Richmond, California
Allison M. Ast, MD
Pediatric Hematology/Oncology Hospitalist
St. Jude Children’s Research Hospital
Memphis, Tennessee

Darlene M. Atkins, PhD

Associate Clinical Professor of Pediatrics
The George Washington University School of Medicine & Health Sciences
Director, Donald Delaney Eating Disorders Clinic
Children’s National Health System
Washington, DC
Susan W. Aucott, MD
Associate Professor
Department of Pediatrics
Johns Hopkins University
Program Director
Neonatal-Perinatal Medicine Fellowship
The Charlotte R. Bloomberg Children’s Center
Baltimore, Maryland
J. Christopher Austin, MD
Associate Professor of Urology
Oregon Health & Science University
Division Chief, Pediatric Urology
Doernbecher Children’s Hospital
Portland, Oregon
Philippe F. Backeljauw, MD
Professor
Department of Clinical Pediatrics
Center for Pediatric and Adult Turner Syndrome Care
Director, Pediatric Endocrinology Fellowship Program
Cincinnati Children’s Hospital Medical Center
Cincinnati, Ohio

L. Charles Bailey, MD, PhD

Associate Professor of Clinical Pediatrics
Department of Pediatrics
Perelman School of Medicine
University of Pennsylvania
Divisions of Hematology & Oncology
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Christina B. Bales, MD
Assistant Professor of Clinical Medicine
Perelman School of Medicine at the University of Pennsylvania
Medical Director, Intestinal Rehabilitation Program
Division of Gastroenterology, Hepatology, and Nutrition
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania

Orkun Baloglu, MD
Clinical Assistant Professor
Department of Pediatrics
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Staff Physician
Department of Pediatric Critical Care Medicine
Medical Director, Pediatric Critical Care Transport Team
Cleveland Clinic Children’s Hospital
Cleveland, Ohio

Kristin W. Barañano, MD, PhD

Assistant Professor
Department of Neurology
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Jennifer M. Barker, MD
Associate Professor
Pediatric Endocrinology
University of Colorado Anschutz Medical Campus
Program Director
Pediatric Endocrinology Fellowship
Children’s Hospital Colorado
Aurora, Colorado
Meagan Barrett, MD
Pediatric Dermatology Fellow
Children’s Hospital Los Angeles
Los Angeles, California
Keisha R. Barton, MD
Fellow
Division of Pediatric Gastroenterology, Hepatology, and Nutrition
Baylor College of Medicine
Texas Children’s Hospital
Houston, Texas
Laurence S. Baskin, MD
Frank Hinman, Jr., MD Distinguished Professorship in Pediatric Urology
Chief, Pediatric Urology
UCSF Benioff Children’s Hospital
University of California, San Francisco
San Francisco, California
Anne S. Bassett, MD, FRCPC
Dalglish Chair in 22q11.2 Deletion Syndrome
Canada Research Chair in Schizophrenia Genetics and Genomic Disorders (Tier 1, 2009 to 2016)
Professor of Psychiatry, University of Toronto
Associate Staff, Division of Cardiology, University Health Network
Associate Member, Canadian College of Medical Geneticists
Director, The Dalglish 22q Clinic for Adults
Director, Clinical Genetics Research Program, Centre for Addiction & Mental Health
Toronto, Ontario, Canada

Hamid Bassiri, MD, PhD

Assistant Professor of Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Attending Physician, Pediatric Infectious Diseases
Faculty Member, Center for Childhood Cancer Research
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Irini D. Batsis, MD
Pediatric Gastroenterology, Hepatology, and Nutrition Fellow
The Charlotte R. Bloomberg Children’s Center
Johns Hopkins University
Baltimore, Maryland

Timothy S. Baumgartner, FS, MC, Lt Col, USAF†

Pediatric Urology Fellow
Division of Pediatric Urology
The James Buchanan Brady Urological Institute
Department of Urology
The Johns Hopkins Hospital
Baltimore, Maryland
Christopher E. Bayne, MD
Assistant Professor
Department of Urology
Division of Pediatric Urology
University of Florida College of Medicine
Gainesville, Florida

Suzanne E. Beck, MD
Professor of Clinical Pediatrics
Children’s Hospital of Philadelphia
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania

David K. Becker, MD, MPH, MA, LMFT

Clinical Professor of Pediatrics
UCSF Osher Center for Integrative Medicine
Co-Medical Director, Pediatric Pain Management Clinic
UCSF Benioff Children’s Hospital San Francisco
San Francisco, California

Shashank P. Behere, MD
Fellow
Nemours Cardiac Center
Nemours Alfred I. duPont Hospital for Children
Wilmington, Delaware
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
ElShadey Bekele, MD, MPH
Clinical Instructor
Department of Pediatrics
The George Washington University School of Medicine & Health Sciences
Attending Pediatrician
Children’s National Medical Center
Washington, DC

Kelly A. Benedict, MD
Pediatric Nephrologist
Pediatric Kidney Disease and Hypertension Centers
Phoenix, Arizona

Amanda K. Berry, MSN, CRNP, PhD†

Pediatric Nurse Practitioner
Division of Urology
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Kate Berz, DO
Assistant Professor of Pediatrics
Divisions of Sports Medicine and Emergency Medicine
University of Cincinnati College of Medicine
Cincinnati Children’s Hospital Medical Center
Cincinnati, Ohio

Anita Bhandari, MD
Associate Professor of Pediatrics
University of Pennsylvania
Director, Pulmonary Inpatient Services
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Vineet Bhandari, MD, DM
Professor of Pediatrics, Obstetrics, and Gynecology
Drexel University College of Medicine
Chief, Section of Neonatal-Perinatal Medicine
St. Christopher’s Hospital for Children
Philadelphia, Pennsylvania
Sumit Bhargava, MD
Clinical Associate Professor
Department of Pediatrics
Stanford University
Medical Director
Lucile Packard Children’s Hospital Pediatric Sleep Laboratory
Palo Alto, California
Diana X. Bharucha-Goebel, MD
Assistant Professor, Neurology
Children’s National Health System
Washington, DC

Mihir D. Bhatt, MD, FRCPC

Pediatric Hematologist/Oncologist
McMaster Children’s Hospital
McMaster University
Hamilton, Ontario, Canada
Samina S. Bhumbra, MD
Pediatric Infectious Diseases Fellow
Riley Hospital for Children at Indiana University Health
Indianapolis, Indiana
Cara L. Biddle, MD, MPH
Assistant Professor of Pediatrics
The George Washington University School of Medicine & Health Sciences
Associate Division Chief
Division of General Pediatrics and Community Health
Children’s National Health System
Washington, DC

Steven Bin, MD
Associate Professor
Department of Emergency Medicine and Pediatrics
University of California, San Francisco
Medical Director
Children’s Emergency Department
UCSF Benioff Children’s Hospital San Francisco
San Francisco, California

Mercedes M. Blackstone, MD
Associate Professor
Department of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Attending Physician
Department of Emergency Medicine
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Seth J. Bokser, MD, MPH
Associate Clinical Professor of Pediatrics
University of California, San Francisco
Pediatric Hospitalist
UCSF Benioff Children’s Hospital San Francisco
San Francisco, California

Brett J. Bordini, MD
Assistant Professor
Department of Pediatrics
Section of Hospital Medicine
Nelson Service for Undiagnosed and Rare Diseases
Medical College of Wisconsin
Milwaukee, Wisconsin
Emily C. Borman-Shoap, MD
Assistant Professor of Pediatrics
Director, Pediatric Residency Program
Vice Chair of Education
University of Minnesota
Minneapolis, Minnesota

Renee D. Boss, MD, MHS

Associate Professor
Department of Pediatrics
Division of Neonatology
The Johns Hopkins University School of Medicine
Johns Hopkins Berman Institute of Bioethics
Baltimore, Maryland

John Bower, MD
Associate Professor of Pediatrics
Associate Professor of Microbiology/Immunology/Biochemistry
Northeast Ohio Medical University
Rootstown, Ohio
Division of Pediatric Infectious Diseases
Akron Children’s Hospital
Akron, Ohio
Alison Boyce, MD
Endocrinologist
Skeletal Disorders and Mineral Homeostasis Section
National Institute of Dental and Craniofacial Research
National Institutes of Health
Bethesda, Maryland

Paul R. Brakeman, MD, PhD

Associate Professor of Pediatrics
University of California, San Francisco
Medical Director, Pediatric Kidney Transplant Program
UCSF Benioff Children’s Hospital San Francisco and Oakland
San Francisco, California
Wendy J. Brickman, MD
Associate Professor
Department of Pediatrics
Division of Endocrinology
Northwestern University Feinberg School of Medicine
Ann & Robert H. Lurie Children’s Hospital of Chicago
Chicago, Illinois

Lee J. Brooks, MD
Clinical Professor of Pediatrics
Division of Pediatric Pulmonology and Sleep
Perelman School of Medicine University of Pennsylvania
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Jeffrey P. Brosco, MD, PhD
Professor of Clinical Pediatrics, University of Miami Miller School of Medicine
Associate Director, Mailman Center for Child Development
Faculty Education Development Director, Department of Pediatrics
Director, Population Health Ethics, UM Institute for Bioethics and Health Policy
Chair, Pediatric Bioethics Committee, Holtz Children’s Hospital, Jackson Health System
Miami, Florida

Valerie I. Brown, MD, PhD

Associate Professor
Department of Pediatrics
Division of Pediatric Hematology/Oncology
Director, Experimental Therapeutics
Director, Pediatric Hematology/Oncology Fellowship Program
Attending Physician
Hematopoietic Stem Cell Transplant Program
Penn State Hershey Children’s Hospital and Penn State College of Medicine
Hershey, Pennsylvania

Terri Brown-Whitehorn, MD
Associate Professor
Department of Clinical Pediatrics
Division of Allergy and Immunology
Perelman School of Medicine at the University of Pennsylvania
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania

Ann Bruner, MD
Medical Director, Residential Youth Services
Mountain Manor Treatment Center
Baltimore, Maryland

Sara M. Buckelew, MD, MPH

Professor of Pediatrics
University of California, San Francisco
Medical Director, Division of Adolescent and Young Adult Medicine
UCSF Benioff Children’s Hospital San Francisco
San Francisco, California
Cynthia Burke, NNP-BC
Clinical Nurse
Neonatal Pediatric Nurse Practice
University of California, San Francisco
San Francisco, California

Vera Joanna Burton, MD, PhD

Assistant Professor of Neurology and Developmental Medicine
Kennedy Krieger Institute
The Johns Hopkins University School of Medicine
Baltimore, Maryland

Melissa A. Buryk, MD, MPH†

LCDR, MC, USN
Assistant Professor
Department of Pediatrics
Uniformed Services University of the Health Sciences
Associate Program Director
Department of Pediatrics
Staff Pediatric Endocrinologist
Portsmouth Naval Medical Center
Portsmouth, Virginia

Amaya L. Bustinduy, MD, MPH, PhD, FRCPCH

Associate Professor in Tropical Pediatrics
Clinical Research Department
London School of Hygiene & Tropical Medicine
London, United Kingdom
Lavjay Butani, MD, MACM
Professor
Department of Pediatrics
Chief of Pediatric Nephrology
University of California, Davis
Sacramento, California

Katherine A. Butler, MD†

Orthopedic Surgery Resident
MedStar Union Memorial Hospital
Baltimore, Maryland

Francesca A. Byrne, MD
Volunteer Clinical Faculty
Department of Pediatrics
Division of Cardiology
University of California, Irvine
Miller Children’s & Women’s Hospital Long Beach
Long Beach, California

Susanne M. Cabrera, MD†

Assistant Professor
Department of Pediatrics
Medical College of Wisconsin
Children’s Hospital of Wisconsin
Max McGee National Research Center for Juvenile Diabetes
Milwaukee, Wisconsin
Mark P. Cain, MD
Robert Garrett Professor of Pediatric Urology
Chief, Division of Pediatric Urology
Indiana University School of Medicine
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University of Pennsylvania
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Division of Orthopaedics
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
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Assistant Professor of Pediatrics, Pediatric Gastroenterology, and Nutrition
University of Massachusetts Medical School
UMASS Memorial Health Care
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University of Texas Health San Antonio
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UCSF Benioff Children’s Hospital
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Jefferson/Nemours Alfred I. duPont Hospital for Children
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KIDZ Multispecialty Group
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Perelman School of Medicine at the University of Pennsylvania
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania

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University of South Florida Health
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Lauren Castner, DO
Pediatric Pulmonary Fellow
University of Michigan C.S. Mott Children’s Hospital
Ann Arbor, Michigan
Elizabeth Candell Chalom, MD
Associate Professor, Pediatrics
Robert Wood Johnson Barnabas Health
Director, Pediatric Rheumatology
Saint Barnabas Medical Center
Livingston, New Jersey

Todd P. Chang, MD, MAcM

Associate Professor of Clinical Pediatrics (Educational Scholar)
Keck School of Medicine of USC
Director
Research and Scholarship
Division of Pediatric Emergency Medicine
Associate Fellowship Director
Children’s Hospital Los Angeles
Los Angeles, California
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Assistant Professor of Pediatrics
Division of Neonatology
Johns Hopkins University
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Postdoctoral Fellow
Division of Neonatology
The Johns Hopkins University School of Medicine
The Charlotte R. Bloomberg Children’s Center
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Division of Pulmonary Medicine and Cystic Fibrosis Center
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania

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Associate Professor
Department of Otolaryngology
University of Pittsburgh
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Department of Pediatric Otolaryngology
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University of Toronto
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University of California, San Francisco
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Another random document with
no related content on Scribd:
pesamment, pendant qu'Antoinette, de son côté, loin de lui et toute à
lui, sombrait aussi dans le sommeil, comme une petite brute.
Le valet de chambre préposé au service de Julien, la femme de
chambre d'Antoinette purent entrer dans les chambres à huit heures,
tirer les rideaux, Antoinette et Julien, à demi-morts, dormaient aussi
paisiblement dans le grand jour aveuglant que dans la clarté tamisée
du jour matinal. Quand ils s'éveillèrent entre midi et une heure, ils
eurent le même regard pour se chercher, et se sourirent du même
sourire à travers les murailles. Puis ils se retrouvèrent sur la
terrasse, devant tout le monde. Il s'inclina avec une politesse
parfaite et joyeuse. Elle eut pour lui un bonjour aimable, de
l'hypocrisie la plus charmante. Elle, qui avait si peur de mentir,
s'aperçut à ce moment-là que le mensonge peut devenir très facile,
quand il est imposé par la nécessité.
 ÉPILOGUE
A partir de ce jour, il ne fut plus question de Julien entre Anne et
Antoinette, ni d'Antoinette entre Lorgis et Julien.
Lorgis cessa d'être froid avec le jeune homme, et ils reprirent peu à
peu leurs bonnes relations et leurs conversations du matin.
Seulement, Lorgis qui avait fait toutes sortes de réflexions sur le cas
Julien-Antoinette, souffrait beaucoup de ne pouvoir les communiquer
à Julien. Cet homme sage et discret était bien souvent conduit à
l'indiscrétion par le besoin de montrer à quel point il pensait juste.
Il finit par prendre texte d'une histoire inventée, à peu près
semblable, arrivée jadis dans un autre milieu et dans le même
monde. Et il constata que chaque fois qu'un jeune homme fait la
cour à une femme mariée entourée d'amis, il éveille toujours des
hostilités parmi cet entourage. Mais aussitôt que l'irréparable est
commis, beaucoup de ces amis rebelles finissent par accepter la
situation, et une fois que le mal est fait, l'acceptent même avec une
sympathie qui va s'augmentant...
—C'est peut-être, dit Lorgis, que le monde a le goût des unions
sérieuses, et qu'une fois qu'un adultère lui paraît bien assorti, il
prend à ses yeux le caractère sérieux d'une union sympathique, bien
qu'extra-légale.
—C'est possible, répondait Julien, et il pensait à part lui:
«C'est possible, ce que dit Lorgis. Ce qui est certain, c'est que j'aime
Antoinette.»
Cela n'avait aucun rapport mais il disait «J'aime Antoinette» pour se
faire plaisir. Et le fait est qu'il l'aimait bien. Son amour avait triomphé
de tout, même des petits mensonges, des poses, des attitudes que
prescrivent la tradition, la littérature, et la mode, et dont
s'embarrasse si souvent la vraie sincérité.
FIN
 TABLE DES CHAPITRES
Pages.
I.—Julien. 1
II.—Un outsider. 12
III.—La Marquise. 23
IV.—Deuxième entrevue. 35
V.—L'invitation. 45
VI.—Vers du nouveau. 53
VII.—Dénombrement. 67
VIII.—Travail d'approche. 79
IX.—L'amie et l'ami. 97
X.—Vers l'amie. 105
XI.—Intermède: Rose Meulier. 109
XII.—Progrès. 117
XIII.—La galerie intervient. 121
XIV.—Effets d'une intervention. 133
XV.—Travail latent. 143
XVI.—Arrivée d'un personnage épisodique. 151
XVII.—Mise au point. 167
XVIII.—Répétition. 179
XIX.—Intermède: une nommée Fanny. 189
XX.—La matinée de verdure. 195
XXI.—Point de vue nouveau. 209
XXII.—Reprise des opérations. 219
XXIII.—Rapprochement. 231
XXIV.—La passion parle. 249
XXV.—La passion continue à parler. 259
XXVI.—En route. 263
 XXVII.—Dernier chapitre. 301
Épilogue. 307
SAINT-DENIS.—IMP. H. BOUILLANT, 47, BOUL. DE
CHATEAUDUN.—18049
 LIBRAIRIE PAUL OLLENDORFF
50, Rue de la Chaussée-d'Antin, PARIS
FRÉDÉRIC MASSON, de l'Académie française
Sur Napoléon (Conférences).

JEAN BERTHEROY
La Passion d'Héloïse et d'Abélard.

TRISTAN BERNARD
Le Roman d'un mois d'Été.

MAURICE STRAUSS
Le Citoyen Poire.

E. GRENET-DANCOURT
Choses à dire (comiques et dramatiques).

MARCEL DHANYS
La Fille de Racine.

ALEXANDRE ARNOUX
Au Grand Vent (Poèmes).

COLLECTION DES CONTEURS JOYEUX

Le volume: 95 cent.
ALPHONSE ALLAIS
En Ribouldinguant.
ADRIEN VÉLY
Les Petites Amies de Mr Saint-Gratien.

JULES MOINAUX
Les Tribunaux Comiques.

GEORGES COURTELINE
Les Gaietés de l'Escadron.
IMP. E. MONZEIN, 17, RUE GRANGE-BATELIÈRE, PARIS
 *** END OF THE PROJECT GUTENBERG EBOOK LE ROMAN
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