A 14-month-old boy is brought to the Emergency Department with subdural hematomas and retinal hemorrhages. Child abuse is the presumed diagnosis, and the parents are separated from the child. However, one of the clinicians is guided by diagnostic decision support to think of a wider differential diagnosis and also considers the diagnosis of glutaric acidemia.
As part of the workup, urinary organic acid testing is done. SimulConsult, using the “Organic acid” filter on viewing useful tests, focuses attention on 3 organic acids most likely to be informative.