Merlin C Lowe

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Journals/Publications

• Lee, J., Stanley, K., & Lowe, M. C. (2022). Plastic Bronchitis: A Rare Complication Following a Motor Vehicle Accident. Lymphology.
• Lowe, M. C. (2022). Childhood Respiratory Conditions: Lower Respiratory Tract Infection. FP essentials, 513, 20-24.
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  Bronchiolitis, a lower respiratory tract infection, commonly affects infants and children younger than 2 years. Respiratory syncytial virus is the most common cause. Nasal congestion, rhinorrhea, and mild fever occur in the first 1 to 3 days. Symptoms worsen for several days to include wheezing and other lower respiratory tract signs, and then resolve over days to weeks. However, some children develop hypoxemia and/or respiratory distress and require hospitalization. The diagnosis is clinical, based on the history and physical examination findings. Routine chest x-rays and blood tests are not recommended. Management is supportive, including nasal suctioning, oxygen (in cases of hypoxemia), and hydration. Use of bronchodilators (ie, albuterol, epinephrine) and systemic corticosteroids is not recommended in infants and children ages 1 to 23 months. Pneumonia, another common infection in infants and children, typically is caused by viruses or bacteria. The diagnosis is clinical, and chest x-rays and blood cultures are not required for patients well enough to be treated as outpatients. Antibiotics are not routinely required for preschool-aged children (ie, younger than 5 years) with pneumonia because most have viral infections. For immunized school-aged children with mild to moderate pneumonia suspected to be of bacterial origin, amoxicillin is recommended. In school-aged children, if atypical pathogens (eg, Mycoplasma) are suspected, a macrolide antibiotic should be prescribed.
• Lowe, M., Lee, J., & Stanley, K. (2022). PLASTIC BRONCHITIS: A RARE COMPLICATION FOLLOWING A MOTOR VEHICLE COLLISION. Lymphology, 55(2). doi:10.2458/lymph.5268
• Zudekoff, R. A., Pugliese, M. F., & Lowe, M. C. (2022). Concurrent Peritonsillar Abscess and Uvular Hydrops in a Pediatric Patient. Cureus, 14(1), e21701.
• El-Hage, L., Ratner, L., Sridhar, S., Jenkins, A., & Lowe, M. C. (2021). Lessons Learned From the Pediatric Overflow Planning Contingency Response Network: A Transdisciplinary Virtual Collaboration Addressing Health System Fragmentation and Disparity During the COVID-19 Pandemic. Journal of hospital medicine.
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  I am an author as cited in the manuscript - a member of the POPCoRN writing collaborative.
• Lowe, M. C., & Chiachio, S. (2021). Stretched to the Max: Acute Ogilvie Syndrome in a Pediatric Patient. Cureus. doi:10.7759/cureus.14506
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  Submitted, Pending acceptance
• Lowe, M. C., Kops, S., & Dunn, K. (2021). All the more reason to get a flu shot. Acute Hemorrhagic Leukoencephalopathy due to Acute Influenza A[H3N2]. Cureus. doi:10.7759/cureus.12885
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  Publication submitted, pending acceptance
• Lowe, M. C., Oesterle, C., & Stanko, S. (2021). High Resolution CT following Primary Spontaneous Pneumothorax in Adolescents: Useful tool or wasted radiation?. Cureus. doi:10.7759/cureus.14936
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  Pending acceptance. Submitted to Pediatric Pulmonology
• Lowe, M., Stanko, S., & Oesterle, C. (2021). High Resolution CT following Primary Spontaneous Pneumothorax in Adolescents: Useful tool or wasted radiation? Dr. Sarah Stanko, MD University of Arizona, Dr. Colette Oesterle, MD University of Arizona, Dr. Merlin Lowe, MD University of Arizona Keywords: primary spontaneous pneumothorax, pneumothorax, bleb, adolescent, pediatrics, chest tubes Correspondence: Dr. Merlin Lowe Dept. of Pediatrics 1501 N. Campbell Ave. Tucson, AZ 85724 520-626-6614 520-626-2883 lowe@peds.arizona.edu. Cureus. doi:10.22541/au.161123621.18335435/v1
• Walpert, A., Thomas, I., Lowe, M. C., & Seckeler, M. (2018). RSV prophylaxis guideline changes and outcomes in children with congenital heart disease. Congenital Heart Disease, 13(3), 428-431. doi:10.1111/chd.12590
• Lowe, M. C. (2017).

  A Stinging Suspicion Something Was Just Not Right

  . Pediatric Emergency Care, 33(11), e124-e125. doi:10.1097/pec.0000000000001301
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  The sting from Centuroides sculpturatus, commonly known as the bark scorpion, is a serious medical problem and can be potentially fatal to young children. Centuroides sculpturatus envenomation can cause a wide spectrum of symptoms, often including autonomic dysfunction, cranial nerve abnormalities, and somatic motor abnormalities. We discuss a 6-month-old male infant who presented with signs and symptoms consistent with bark scorpion envenomation, later found to be secondary to methamphetamine toxicity. Emergency pediatricians should be aware of the strong similarities between scorpion envenomation and methamphetamine toxicity in pediatric patients residing in or having visited the southwestern region of the United States. Methamphetamine toxicity should be considered in their differential diagnosis.
• Pariury, H., Steineger, A., & Lowe, M. C. (2017). A Stinging Suspicion Something Was Just Not Right: Methamphetamine Toxicity in Infant Mimics Scorpion Envenomation. Pediatric Emergency Medicine, 33(11), e124-e125. doi:10.1097/PEC.0000000000001301
• Arcinegas-rodriguez, S., Gaspers, M. G., & Lowe, M. C. (2011). Metabolic acidosis, hypoglycemia, and severe myalgias: an attempt to mask urine drug screen results.. Pediatric emergency care, 27(4), 315-7. doi:10.1097/pec.0b013e3182131592
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  Adolescent use of illicit substances remains a significant problem. In attempts to hide their use of these substances, some are using Internet-recommended methods of masking these drugs on drug screens, potentially exposing the adolescent to severe and possibly dangerous adverse effects. We report a 16-year-old patient who ingested approximately 13 g (twenty-six 500-mg tablets) of niacin during a 48-hour period in an attempt to mask his use of tetrahydrocannabinol on an upcoming drug screen. He subsequently developed severe chest and abdominal pain as well as extreme diffuse myalgias (previously unreported in association with niacin use). In addition, he developed severe hypoglycemia, acidosis, transaminitis, and coagulopathy. He required significant fluid resuscitation and bicarbonate infusion. Over approximately 5 days his symptoms resolved and he ultimately did well. Given increasingly available home drug screens and the abundance of false information readily available to adolescents via the Internet regarding "masking" of drug use, it is likely that cases such as ours will become more prevalent. Pediatric emergency physicians and pediatricians should maintain a high suspicion for use of niacin or other substances to obscure detection of illicit substances when patients present with symptoms similar to those of our patient.
• Lowe, M. C., & Woolridge, D. (2007).

  The Normal Newborn Exam, or Is It?

  . Emergency Medicine Clinics of North America, 25(4), 921-46. doi:10.1016/j.emc.2007.07.013
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  Despite the broad technologic advancements of medicine, screening for illness in infants is highly reliant on a complete physical exam. For this reason it is critical that the examining physician not only have a thorough understanding of abnormal findings but also the normal findings and their variants. The vast majority of infants are healthy and findings predictive of future health problems are subtle and infrequent. Yet, outcomes can be devastating. Therefore it is critical the physician remain diligent when screening for these. It is our hope that this article will assist you in this task and allow for more accurate and timely diagnosis that prevents or minimizes long-term health problems in children.
• Barber, B. J., Lowe, M. C., Bagatell, R., Hainstock, M., & Samson, R. A. (2005). The perfect storm: Torsades de Pointes in a child with leukemia. Pediatric Blood & Cancer, 49(7), 996-999. doi:10.1002/pbc.20712

Poster Presentations

• Lowe, M. C., & Chiachio, S. (2019, June). Stretched to the Limit: Ogilvie Syndrome in a Pediatric Patient. Pediatrics in the Red Rocks. Sedona, Arizona: Arizona chapter American Academy of Pediatrics.
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  Poster presentation of a young child who presented with Ogilvie syndrome.