Case History A 10-year-old female presented to the audiology department at a large pediatric hospital. She recently failed a hearing screening in both ears at her pediatrician’s office. The patient reported she was unable to hear. She stated that sounds were muffled and she was unable to understand when spoken to. The audiologist attempted to converse with the patient; however, she responded inconsistently and frequently looked to her mother for clarification. Reported medical history was significant for recent complaints of hip pain and intermittent vomiting. The parent conveyed that her daughter’s symptoms began approximately one month prior. At that time, she was also notably lethargic. The patient was receiving counseling to address emotional concerns that developed around the time of her parents’ recent divorce. Two to three weeks following the onset of hip pain, but prior to her audiological evaluation, the patient was taken to the emergency department. Radiographs of the hips and pelvis were completed and there were no abnormal findings. The parent reported that the patient visited her primary care physician a few days prior to the audiology evaluation due to continued hip pain. During this examination, a sore was identified on her upper leg which was subsequently cultured for Lyme disease. Results of this culture were still pending at the time of the audiological evaluation. Although not reported by the parent during the initial case history, a thorough review of the medical record at a later date revealed that the patient had returned to the emergency department the day after discharge with continued hip pain and more frequent vomiting. Her abdominal symptoms were reported to be exacerbated under stress and the patient was discharged again with the recommendation to follow up with her primary care physician. Continued counseling was also recommended as it was believed symptoms were likely related to her parents’ recent divorce. This content is an exclusive benefit for American Academy of Audiology members. If you're a member, log in and you'll get immediate access. Member Login If you're not yet a member, you'll be interested to know that joining not only gives you access to top-notch resources like this one, but also invitations to member-only events, inclusion in the member directory, participation in professional forums, and access to patient resources, tools, and continuing education. Join today!