Septic arthritis can be a devastating condition that leads to further morbidity and potential mortality if not identified early in its course. Emergency providers must keep septic arthritis high on their differential of any joint-related pain in the pediatric population. We present a case of an eight-yearold female who initially presented with the chief complaint of chest pain and was subsequently diagnosed with septic arthritis of the left sternoclavicular joint in the emergency department.

Cyproheptadine is an H-1 antihistamine with anticholinergic and antiserotonergic effects.Cyproheptadine’s most common use has been in the management cold-induced urticaria. It is often usedin primary care for its side effect of appetite stimulation. Recently there has been increasing interest inits use in the treatment of drug-induced serotonin syndrome. Cyproheptadine overdose is uncommonlyreported in the medical literature. We report the rare case of a pediatric cyproheptadine overdose with aconfirmatory cyproheptadine level.

Alveolar hemorrhage is a rare yet devastating clinical entity if not identified and treated aggressively. Exceedingly rare are the cases of anticoagulant-induced alveolar hemorrhage with very few cases described in the current literature. The nonspecific presentation of an alveolar hemorrhage makes its diagnosis and appropriate treatment difficult in the emergency department. We report a case of a patient on warfarin for atrial fibrillation who was initially misdiagnosed as having community-acquired pneumonia, but subsequently was identified to have a fatal alveolar hemorrhage.