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Cai H, Ren AQ, Zhang ZY, Zhou MZ, Wu YJ, Yue JX, Zhou LQ, Tian Y, Zhou T. Pediatric Pterygopalatine Fossa Schwannoma Presenting as Vision Loss: A Case Report and Literature Review. Ear Nose Throat J 2024:1455613241235537. [PMID: 38411128 DOI: 10.1177/01455613241235537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Neurosynovial tumors, originating from Schwann cells within nerve sheaths, are benign entities, with 25% to 45% manifesting in the head and neck region. However, occurrences in the pterygopalatine fossa (PPF) are exceptionally rare, and only a handful of cases have been documented. In this report, we present the unique case of a 6-year-old child exhibiting a sizable soft tissue mass in the left PPF, extending into the inferior orbital fissure. The patient underwent successful intranasal endoscopic removal of PPF schwannoma utilizing the prelacrimal recess approach, with postoperative pathology confirming the diagnosis of schwannoma. Schwannomas within the PPF are particularly uncommon, and instances of such tumors in pediatric patients are even more exceptional. This case highlights the diagnostic and therapeutic challenges associated with PPF schwannomas in children, emphasizing the significance of a multidisciplinary approach for optimal management. In addition, a comprehensive literature review is presented to provide insights into the existing knowledge on this rare entity, further contributing to the understanding of pediatric PPF schwannomas.
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Affiliation(s)
- Hua Cai
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - An-Qi Ren
- The First Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhuo-Ya Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ming-Zhu Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ying-Jie Wu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jian-Xin Yue
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liu-Qing Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuan Tian
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tao Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
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2
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Kostara M, Serbis A, Pavlou M, Kotanidou E, Tsabouri S, Vlahos A, Makis A, Siomou E. Unusual Manifestations of Kawasaki Disease in the COVID Era: A Case Series and Review of the Literature. Cureus 2023; 15:e51104. [PMID: 38274908 PMCID: PMC10809307 DOI: 10.7759/cureus.51104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/27/2024] Open
Abstract
Kawasaki disease (KD) is an acute medium-vessel vasculitis, mainly affecting infants older than six months and children under five years. It predisposes to the development of coronary artery aneurysms and constitutes the leading cause of acquired heart disease in children. Its diagnosis is based on clinical criteria, namely, fever lasting for ≥ five days together with at least four of the five principal clinical features of the disease. Occasionally, children with KD present with fever, but they fulfill only some of the five principal criteria, and this is described as incomplete KD. Furthermore, "atypical" KD is a term that is usually used for cases that appear with rather unusual clinical manifestations, which complicate clinical judgment and may delay diagnosis and treatment. In this case series, we present four cases of KD with rather unusual clinical features: a five-year-old boy with lobar pneumonia, a six-year-old girl with orange-brown chromonychia appearing on the 10th day of the disease, a 2.5-month-old infant with prolonged fever and urinary tract infection, and an 18-month-old infant with refractory KD and high suspicion of multisystem inflammatory syndrome in children (MIS-C). A literature review on the unusual manifestations of atypical KD was performed to identify clinical findings that must alert the clinician to consider this clinical entity.
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Affiliation(s)
- Maria Kostara
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, GRC
| | - Anastasios Serbis
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, GRC
| | - Maria Pavlou
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, GRC
| | - Eleni Kotanidou
- Second Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, GRC
| | - Sofia Tsabouri
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, GRC
| | - Antonios Vlahos
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, GRC
| | - Alexandros Makis
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, GRC
| | - Ekaterini Siomou
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, GRC
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Lubis IND, Farah S, Pasaribu AP, Evalina R, Daulay RS, Wijaya H. A pediatric case and literature review of mucormycosis: Diagnostic and treatment challenges in a resource poor setting. Narra J 2023; 3:e426. [PMID: 38450345 PMCID: PMC10914060 DOI: 10.52225/narra.v3i3.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/15/2023] [Indexed: 03/08/2024]
Abstract
Mucormycosis is an emerging disease that primarily affects immunocompromised patients; however, it has also been reported in immunocompetent individuals. Studies in the pediatric population are limited and reported mostly in case studies or series. The aim of this case report is to present a pediatric mucormycosis originated from Sumatra Island, Indonesia. A 13-year-old boy was referred to a tertiary hospital with facial necrosis involving the nasal, oral, and left maxillary areas, as well as left periorbital edema. No known underlying conditions were documented. The diagnosis was confirmed by histopathological findings of broad, pauci-septate, ribbon-like hyphae branching at 90°. The patient was managed by a multidisciplinary team consisting of the ear, nose, and throat, infectious diseases, dermatology, surgery, microbiology, and pathology departments. Management of the patient included debridement of the necrotic lesion and antibiotics and anti-fungal (fluconazole). Due to unavailability, the patient was not treated with amphotericin B. The patient died after 30 days of admission. This case highlights the importance of maintaining a high suspicion of invasive mucormycosis, even in immunocompetent children, when symptoms and signs are present, especially in resource-limited settings.
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Affiliation(s)
- Inke ND. Lubis
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- University of Oxford, Oxford, United Kingdom
- Menzies School of Health Research, Darwin, Australia
| | - Sara Farah
- University of Oxford, Oxford, United Kingdom
| | - Ayodhia P. Pasaribu
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Rita Evalina
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Rini S. Daulay
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Hendri Wijaya
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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4
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Ulas B, Ozcan AA, Kaya I. IgG4-related orbital disease in a pediatric patient: Case report. J Fr Ophtalmol 2023; 46:976-979. [PMID: 37085374 DOI: 10.1016/j.jfo.2022.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 04/23/2023]
Affiliation(s)
- B Ulas
- Ophthalmology department, Faculty of medicine, Cukurova University, Adana, Turkey.
| | - A A Ozcan
- Ophthalmology department, Faculty of medicine, Cukurova University, Adana, Turkey
| | - I Kaya
- Ophthalmology department, Faculty of medicine, Cukurova University, Adana, Turkey
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5
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Kononowicz JE, Farhan Ali M, Palko W, Pyper S, Agasthya N. Rapidly Progressing Autoimmune Hemolytic Anemia in a Pediatric Patient With COVID-19. Cureus 2023; 15:e45633. [PMID: 37868512 PMCID: PMC10588281 DOI: 10.7759/cureus.45633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
SARS-CoV-2 is a novel virus that is known to have a predilection for complications associated with the respiratory system. Although COVID-19 has a wide spectrum of manifestations, the pathophysiology of severe illness remains poorly understood but is thought to be associated with fulminant cytokine release. While severe complications secondary to COVID-19 in the pediatric population are considered rare, they do happen. Children with and without comorbidities have required intensive care unit admissions for respiratory distress and, more notably, multisystem inflammatory syndrome in children (MIS-C). While MIS-C is associated with hematologic complications, such as thrombocytopenia and coagulopathies, it is not associated with blood hemolysis. In this report, we describe a case of a 23-month-old previously healthy female, who presented with lethargy and positive COVID-19 PCR status. This case illustrates the rapid and fatal sequela caused by autoimmune hemolytic anemia (AIHA) from COVID-19. It stresses the importance of thorough workup and management of AIHA secondary to COVID-19 illness. Currently, there is limited understanding of AIHA from COVID-19 illness in children. Our aim is to describe this rare complication of COVID-19 illness in pediatric patients and discuss the best practices to manage it.
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Affiliation(s)
- Julia E Kononowicz
- Department of Pediatrics, University of Kansas School of Medicine, Wichita, USA
| | - Mohammed Farhan Ali
- Department of Pediatrics, Division of Nephrology, Children's Mercy, Wichita, USA
| | - William Palko
- Department of Pathology, Wesley Medical Center, Wichita, USA
| | - Sean Pyper
- Department of Pediatrics, University of Kansas School of Medicine, Wichita, USA
| | - Nisha Agasthya
- Department of Pediatrics, University of Kansas School of Medicine, Wichita, USA
- Department of Pediatrics, Division of Critical Care Medicine, Wesley Medical Center, Wichita, USA
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6
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Gleichmann N, Creighton E, Zhu A, Willard N, Yang J, Herrmann BW. Concurrent Pediatric Lingual and Submental Dermoid Cysts: Case Report and Literature Review. Cureus 2023; 15:e42429. [PMID: 37637563 PMCID: PMC10448783 DOI: 10.7759/cureus.42429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/29/2023] Open
Abstract
This pediatric case report describes the novel finding of concurrent submental and lingual dermoid cysts, which to our knowledge, has not been previously reported in the literature. The etiology of cysts involving the tongue, floor of the mouth, and submental neck is varied, representing congenital, inflammatory, and neoplastic sources. Dermoid cysts involving these regions are uncommon and are most frequently reported in the submental, sublingual, and lingual spaces. Presenting symptoms vary with cyst size and position relative to the mylohyoid muscle. MRI is the preferred modality to differentiate dermoid cysts from other etiologies. While interventional techniques have been utilized to treat dermoid cysts in other head and neck locations, surgical excision remains the preferred treatment for those involving oral and floor-of-mouth structures.
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Affiliation(s)
- Natasha Gleichmann
- Otolaryngology - Head and Neck Surgery, Children's Hospital Colorado, Aurora, USA
| | - Elizabeth Creighton
- Otolaryngology - Head and Neck Surgery, University of Colorado School of Medicine, Aurora, USA
| | - Austin Zhu
- Otolaryngology - Head and Neck Surgery, University of Colorado School of Medicine, Aurora, USA
- Otolaryngology - Head and Neck Surgery, Children's Hospital Colorado, Aurora, USA
| | - Nicholas Willard
- Pathology, University of Colorado School of Medicine, Aurora, USA
- Pathology, Children's Hospital Colorado, Aurora, USA
| | - Jeremy Yang
- Otolaryngology - Head and Neck Surgery, University of Colorado School of Medicine, Aurora, USA
- Otolaryngology - Head and Neck Surgery, Children's Hospital Colorado, Aurora, USA
| | - Brian W Herrmann
- Otolaryngology - Head and Neck Surgery, University of Colorado School of Medicine, Aurora, USA
- Otolaryngology - Head and Neck Surgery, Children's Hospital Colorado, Aurora, USA
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7
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Sambangi C, Collins P, Patel J, Chan J. Autoimmune Polyendocrinopathy in a Pediatric Patient Presenting With Multisystem Inflammatory Syndrome in Children (MIS-C). Cureus 2023; 15:e38407. [PMID: 37265890 PMCID: PMC10232015 DOI: 10.7759/cureus.38407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 06/03/2023] Open
Abstract
Multisystem inflammatory syndrome (MIS) is a well-known potential sequela of COVID-19 infection. Though prevalence is higher in certain populations, this syndrome is a rare occurrence in children. Beyond MIS, there has been increasing research into COVID infection and the subsequent onset of autoimmune conditions, such as diabetes. However, evidence of a poly-endocrinopathy developing after COVID infection is lacking, and evidence within the pediatric population is virtually nonexistent. In this case, we present the evolution of an autoimmune polyglandular syndrome (APS) type 2 phenotype, consisting of type 1 diabetes, Graves' disease, and adrenal insufficiency, after diagnosis of multisystem inflammatory syndrome of children (MIS-C) in a pediatric patient. A 15-year-old biracial female without significant past medical history tested positive for COVID-19 and two weeks later presented with respiratory symptoms and other systemic signs. She was admitted for further evaluation and was found to have elevated inflammatory markers, EKG (electrocardiogram) abnormalities, and lab evidence of organ damage. The patient was diagnosed with MIS-C, and treatment was initiated with eventual discharge. One year after this initial visit, the patient returned to the hospital due to weight loss, difficulty breathing, polyuria, polydipsia, nausea, vomiting, and fatigue. A steroid course for MIS-C treatment had been completed three months prior. Exam and lab results confirmed diabetic ketoacidosis (DKA), and the patient was diagnosed with new-onset type 1 diabetes. Further testing determined that she was glutamic acid decarboxylase 65 (GAD-65) positive. DKA was managed in the hospital, and the patient was subsequently discharged with an insulin regimen and endocrine follow-up. A couple of months later, the patient returned to the emergency department (ED) due to two weeks of dyspnea on exertion and dizziness. Since her previous admission for DKA, the patient had contracted COVID-19 again and recovered from her respiratory symptoms. Physical exam and labs were grossly unremarkable; however, the patient had EKG abnormalities and an episode of severe bradycardia, prompting hospitalization. Thyroid workup revealed thyrotoxicosis due to Graves' disease. Due to intermittent hypotension, adrenal labs were obtained. She was found to have adrenal insufficiency as well, with a positive 21-hydroxylase antibody. Throughout these hospitalizations, the patient suffered from skin and hair changes as well, ultimately requiring dermatological intervention.
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Affiliation(s)
- Chaitanya Sambangi
- Pediatrics, Medical College of Georgia at Augusta University, Augusta, USA
| | - Patrice Collins
- Pediatrics, Medical College of Georgia at Augusta University, Augusta, USA
| | - Julisa Patel
- Pediatric Rheumatology, Children's Hospital of Georgia at Augusta University, Augusta, USA
| | - Jacqueline Chan
- Pediatric Endocrinology, Children's Hospital of Georgia at Augusta University, Augusta, USA
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Harikrishna GV, Ca J, Joshi A, Shuhab A, Kodapala S. Pediatric Posterior Reversible Encephalopathy Syndrome Secondary to Post-Streptococcal Glomerulonephritis: A Case Report. Cureus 2023; 15:e38996. [PMID: 37378234 PMCID: PMC10292161 DOI: 10.7759/cureus.38996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/29/2023] Open
Abstract
This case report presents a unique case of a 15-year-old male with post-streptococcal glomerulonephritis (PSGN) who developed posterior reversible encephalopathy syndrome (PRES). The patient presented with symptoms of fever, headache, emesis, visual disturbances, and involuntary movements of all four limbs. On examination, the patient had elevated blood pressure, decreased visual acuity of the left eye, leukocytosis, and uremia. MRI findings showed symmetrical enhancement of superficial and deep watershed areas, predominantly in the occipital and temporal regions. Treatment with antibiotics and anti-hypertensives resulted in the complete resolution of hyperintense lesions seen in brain MRI after three weeks, and the patient remained symptom-free for one month. This case highlights the rare association between PSGN and PRES and emphasizes the importance of monitoring and managing hypertension in patients with PSGN. Understanding the association between these two conditions may lead to earlier diagnosis and treatment of PRES, ultimately improving patient outcomes.
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Affiliation(s)
| | - Jayashankar Ca
- Internal Medicine, Vydehi Institute of Medical Sciences & Research Centre, Bangalore, IND
| | - Amey Joshi
- Internal Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Aman Shuhab
- Internal Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Suresha Kodapala
- Neurology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
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Khedkar K, Lamture YR, Lohia S, Tayade HA. A Female Infant with Rectovestibular Fistula and Imperforate Hymen. J Indian Assoc Pediatr Surg 2023; 28:177-178. [PMID: 37197247 PMCID: PMC10185036 DOI: 10.4103/jiaps.jiaps_116_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 05/19/2023] Open
Abstract
In a female neonate with anorectal malformation (ARM), the diagnosis is usually simple. But when there are two openings in the introitus and absent anal opening at the normal site, the scenario poses a diagnostic challenge. Careful and detailed evaluation of anomaly is therefore necessary before planning definitive correction. Imperforate hymen, although is not commonly associated with ARM should always be kept in mind as a differential diagnosis and other vaginal anomalies like Mayer-Rokitansky-Küster-Hauser syndrome should be ruled out before definitive surgical correction.
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Affiliation(s)
- Kiran Khedkar
- Department of Surgery, JNMC, DMIMS, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Yashwant R Lamture
- Department of Surgery, JNMC, DMIMS, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Sham Lohia
- Department of Paediatrics, JNMC, DMIMS, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Harshal Atul Tayade
- Department of Surgery, JNMC, DMIMS, Sawangi (Meghe), Wardha, Maharashtra, India
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10
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Senanayake J, Haji Rahman R, Safwat F, Riar S, Ampalloor G. Asymptomatic Lead Poisoning in a Pediatric Patient. Cureus 2023; 15:e34940. [PMID: 36938268 PMCID: PMC10017113 DOI: 10.7759/cureus.34940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 02/16/2023] Open
Abstract
Lead poisoning is a harmful condition, potentially resulting in irreversible impairments in neurocognition and behavioral development in the pediatric population. Rarely, life-threatening complications may ensue. We report a case of an asymptomatic four-year-old patient presenting with elevated lead levels (74.7 µg/dL) detected on routine blood lead screening at a well-child examination. The patient has a history significant for atopic disease, namely atopic dermatitis, seasonal allergic rhinitis, and food allergies. Overall, the asymptomatic nature of lead poisoning warrants judicious screening in the pediatric population due to the potential for neurologic complications.
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Affiliation(s)
| | | | - Fady Safwat
- Research, Washington University School of Medicine, San Pedro, BLZ
| | - Suman Riar
- Medicine, John F. Kennedy University of Medicine, Willemstad, CUW
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11
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Banjar TA, Abdulwahab RA, Al Hawsawi KA. Confluent and Reticulated Papillomatosis of Gougerot and Carteaud: A Case Report and Review of the Literature. Cureus 2022; 14:e24557. [PMID: 35651451 PMCID: PMC9138193 DOI: 10.7759/cureus.24557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Confluent and reticulated papillomatosis (CARP) of Gougerot and Carteaud is a rare chronic disease with exacerbation and remissions typically affecting young people. Classic clinical characteristics include asymptomatic scaly hyperpigmented macules, patches, and papules in the trunk's confluent and reticular pattern. A 12-year-old girl, otherwise healthy, presented with itchy, persistent skin lesions all over her body for one year. Skin examination revealed generalized scaly brownish patches, thin papules, and plaques all over her body, including her face, neck, middle of the chest, abdomen, back, upper extremities, elbows, lower extremities, and knees. Wood's lamp examination of her skin lesions was unrevealing. Skin biopsy showed papillomatosis, hyperkeratosis, acanthosis, and hypergranulosis. The dermis showed perivascular inflammatory cellular infiltrate. Based on the above clinicopathological findings, the patient was diagnosed with CARP. In our case, a generalized form was reported. CARP is diagnosed based on clinical and histopathological features. Oral antibiotics are the cornerstone of treatment. Our patient responded well to oral minocycline 85 mg one tablet daily, tacrolimus 0.1% ointment twice daily, and selenium sulfide shampoo twice weekly for two months. The classic clinical characteristics of CARP include asymptomatic scaly hyperpigmented macules, patches, and papules in a confluent and reticular pattern on the trunk. A generalized form, as in our case, has been reported. CARP is diagnosed based on clinical and histopathological features. Oral antibiotics are the cornerstone of treatment.
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12
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Bhatti DS, Khan MAAK, Rodriguez DU, Cadogan J, Burge T. Paediatric Burns From Deployment of a Concealed Aviation Seatbelt Airbag. Cureus 2021; 13:e15824. [PMID: 34306888 PMCID: PMC8296360 DOI: 10.7759/cureus.15824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 11/12/2022] Open
Abstract
The advantages of airbags in reducing the rate of severe injuries and fatalities in motor vehicle crashes are well known but the physical act of airbag deployment can lead to injury to the passenger and the spectrum of airbag trauma resulting from deployment of vehicle airbags has been extensively reported. We present the first reported case of a pediatric burn injury resulting from the accidental deployment of an airbag in an aircraft. A four-year-old female child sustained injuries to the left side of her face and body while she was aboard a stationary airplane and the airbag concealed within the seat belt of her airplane seat unexpectedly and inexplicably deployed just before departure. We are presenting the case to increase awareness of the possibility of this injury in aircraft and to enable minimization of such accidents as well as help establish protocols for dealing with such mishaps if there were to happen.
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Affiliation(s)
| | | | | | - Julia Cadogan
- Paediatric Burns Service, Frenchay Hospital (North Bristol NHS Trust), Bristol, GBR
| | - Timothy Burge
- Plastic and Burns Surgery, Frenchay Hospital (North Bristol NHS Trust), Bristol, GBR
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Messelmani M, Akkari M, Souissi W, Mrissa R. Isolated Cervical Pain Revealing a Common Carotid Artery Dissection in a Child Following a Minor Trauma: A First Pediatric Case Report and a Review of the Literature. Neurol India 2021; 69:478-479. [PMID: 33904480 DOI: 10.4103/0028-3886.314524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Cervical artery dissections are not exceptional in the pediatric population. Typically, it affects the internal carotid artery or the vertebral artery. To our knowledge, this is the first case of common carotid artery (CCA) dissection in a child. Case We present a case of a 7-year-old-boy admitted to our neurology department complaining of cervical pain after a minor neck trauma. The neurological examination was normal. The ultrasound showed a mural hematoma with an intimal flap. The magnetic resonance angiography revealed an irregular segment of the left CCA just before its bifurcation. The diagnosis of an acute dissection on the left CCA was confirmed and antiplatelet therapy was started. Conclusion The diagnosis of cervical artery dissections remains a challenge because of its variable clinical presentation. It should be suspected in the context of neck trauma and treatment should be initiated rapidly to reduce the risk of ischemic stroke.
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Affiliation(s)
- Mariem Messelmani
- Department of Neurology, Military Hospital of Tunis, Monfleury, Tunis, Tunisia
| | - Manel Akkari
- Department of Neurology, Military Hospital of Tunis, Monfleury, Tunis, Tunisia
| | - Wala Souissi
- Department of Neurology, Military Hospital of Tunis, Monfleury, Tunis, Tunisia
| | - Ridha Mrissa
- Department of Neurology, Military Hospital of Tunis, Monfleury, Tunis, Tunisia
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14
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Nakamura H, Morisako H, Ohata H, Kuwae Y, Teranishi Y, Goto T. Pediatric giant cell reparative granuloma of the lower clivus: A case report and review of the literature. J Craniovertebr Junction Spine 2021; 12:86-90. [PMID: 33850388 PMCID: PMC8035581 DOI: 10.4103/jcvjs.jcvjs_182_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
Giant cell reparative granuloma (GCRG) is a benign nonneoplastic granulomatous lesion and is rare in the cranial bone. We present a pediatric case of this lesion arising from the condyle and lower clivus. A 9-year-old girl presented with slowly progressive hoarseness and dysphagia. She showed left glossopharyngeal, vagus, and hypoglossal nerve palsy. An osteolytic lesion around the lower clivus and condyle joint was accompanied by deformation of the craniovertebral junction. An endoscopic endonasal approach was used to decompress the cranial nerve and confirm the pathological finding. The lesion around the condyle was not resected to preserve occipito-cervical stability. The residual lesion has been observed carefully for 6 months, and regrowth has not occurred. GCRG is a rare granulomatous lesion in the cranial bone. This case is the first report of a pediatric clival GCRG. Treating pediatric GCRG may be helpful.
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Affiliation(s)
- Honami Nakamura
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroki Morisako
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroki Ohata
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yuko Kuwae
- Department of Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yuichi Teranishi
- Department of Otolaryngology and Head and Neck Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takeo Goto
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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15
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Nazzal K, Nazzal O, Ahmed A, Alaradi H, Alhindi S. Magnet Beads Impacted in the Appendix of a Child: A Case Report and Review of the Literature. Cureus 2020; 12:e9777. [PMID: 32953295 PMCID: PMC7491694 DOI: 10.7759/cureus.9777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/15/2020] [Indexed: 12/17/2022] Open
Abstract
Foreign body ingestion is a commonly encountered problem in the pediatric population, which can be a source of severe distress to parents and caregivers. Certain foreign bodies such as magnets, bones, and button batteries can be particularly dangerous and lead to some serious complications like gastrointestinal obstruction, perforation, or bleeding depending on the nature of the foreign body, the location of impaction, and the period since ingestion. In this report, we discuss a case of a 23-month-old girl who ingested multiple magnets that got trapped within the appendix resulting in continuous vomiting.
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Affiliation(s)
| | | | - Alya Ahmed
- Internal Medicine, Salmaniya Medical Complex, Manama, BHR
| | | | - Saeed Alhindi
- Pediatric Surgery, Salmaniya Medical Complex, Manama, BHR
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16
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Abstract
We herein report the first pediatric case (a 13-year-old girl) of relapsing eosinophilic granulomatosis with polyangiitis (EGPA) successfully treated with mepolizumab (anti-interleukin-5). She was classified as having EGPA based on the presence of asthma, eosinophilia, pulmonary infiltrates, and extravascular eosinophil infiltration confirmed by a biopsy. She achieved remission after initial oral prednisolone (PSL) therapy, but EGPA relapsed during PSL tapering. Subsequent combined therapy with PSL and tacrolimus did not improve the recurrent disease. Intravenous methylprednisolone pulse therapy was started, followed by oral PSL. During PSL tapering, mepolizumab was added to the treatment, which resulted in sustained remission and successful PSL tapering.
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Affiliation(s)
- Mizuho Nara
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan
| | - Masaya Saito
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan
| | - Fumito Abe
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan
| | - Atsushi Komatsuda
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan
| | - Hideki Wakui
- Department of Life Science, Akita University Graduate School of Engineering Science, Japan
| | - Naoto Takahashi
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan
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17
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Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic illness that causes a range of debilitating symptoms. While most research has focused on adults, the illness also presents in children and adolescents. Many physicians find it difficult to diagnose the illness. In this commentary paper, we discuss a range of salient themes that have emerged from our ongoing research into the prevalence of ME/CFS in children and adolescents. We discuss reasons why pediatric prevalence estimates vary widely in the literature, from almost 0% to as high as 3%. We argue that there is considerable misdiagnosis of pediatric cases and over-inflation of estimates of pediatric ME/CFS. Many children and teenagers with general fatigue and other medical complaints may meet loose diagnostic criteria for ME/CFS. We make recommendations for improving epidemiological research and identifying pediatric ME/CFS in clinical practice.
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Affiliation(s)
- Keith James Geraghty
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care, University of Manchester, Manchester, United Kingdom
| | - Charles Adeniji
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care, University of Manchester, Manchester, United Kingdom
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18
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An YC, Sung CC, Wang CC, Lin HC, Chen KY, Ku FM, Chen RM, Chen ML, Huang KY. Molecular Identification of Diphyllobothrium latum from a Pediatric Case in Taiwan. Korean J Parasitol 2017; 55:425-428. [PMID: 28877575 PMCID: PMC5594734 DOI: 10.3347/kjp.2017.55.4.425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 06/27/2017] [Accepted: 07/02/2017] [Indexed: 11/23/2022]
Abstract
Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.
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Affiliation(s)
- Yu-Chin An
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Cheng Sung
- Departments of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taiwan
| | - Chih-Chien Wang
- Departments of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taiwan
| | - Hsin-Chung Lin
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuang-Yao Chen
- Department of Parasitology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Fu-Man Ku
- Molecular Regulation and Bioinformatics Laboratory, Department of Parasitology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ruei-Min Chen
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Mei-Li Chen
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuo-Yang Huang
- Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei, Taiwan
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19
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Abstract
We herein report a child case of autoimmune hepatitis (AIH) accompanied with Graves' disease. Elevated aminotransferase levels were found in a 12-year-old Japanese girl with Graves' disease. In her first liver biopsy, necrosis and inflammation was limited to the centrilobular area, while the second biopsy showed different findings. Namely, portal injury newly appeared, including interface hepatitis, which represents the histological characteristics of AIH. As the histological findings at the onset of AIH do not always show typical findings, a re-biopsy is considered to be important in individuals suspected to have AIH. AIH should be included in the differential diagnosis of liver dysfunction in Graves' disease, even in children.
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Affiliation(s)
- Mamiko Yamada
- Department of Pediatrics, Keio University School of Medicine, Japan
- Tachikawa Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Japan
| | - Hironori Shibata
- Department of Pediatrics, Keio University School of Medicine, Japan
| | - Yohei Masugi
- Department of Pediatrics, Keio University School of Medicine, Japan
| | - Tomohiro Ishi
- Department of Pediatrics, Keio University School of Medicine, Japan
| | - Kaori Kameyama
- Department of Pathology, Keio University School of Medicine, Japan
| | - Hirotoshi Ebinuma
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
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20
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Chinbo M, Addebbous A, Moutachakkir M, Rada N, Bouskraoui M, Chabaa L, Soraa N. [Gemella haemolysans brain abscess in a child with complex congenital heart disease]. Ann Biol Clin (Paris) 2014; 72:487-90. [PMID: 25119809 DOI: 10.1684/abc.2014.0976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gemella haemolysans, a Gram positive cocci which are deemed to be the normal inhabitant of the mucous membranes of the oropharynx, has been recognized as a pathogen involved in abscess formation. The aim of this case report is to demonstrate that it is also involved in brain abscess in children. We report, to our knowledge, the first pediatric case of Gemella haemolysans brain abscess in an 11 years old child carrying a complex congenital heart disease (dextrocardia with single right ventricle) which evolved favorably under antibiotic therapy. Because of its similarity with Streptococcus viridans groupe, Gemella haemolysans often remains under-diagnosed in the laboratory. The contribution of microbiologists in its correct identification is very important.
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21
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Szabó L, Szegedi I, Kiss C, Szikszay E, Remenyik É, Csízy I, Juhász I. Excessive pediatric fasciitis necrotisans due to Pseudomonas aeruginosa infection successfully treated with negative pressure wound therapy. Dermatol Ther 2015; 28:300-2. [PMID: 26032296 DOI: 10.1111/dth.12252] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The case of a 10-year old female child is described with a history of myeloproliferative disorder having skin, bone and visceral involvement. Bone marrow biopsy revealed histiocytosis X. During chemotherapy necrotizing fasciitis of the lower abdominal wall was diagnosed. Multiple microbiological cultures taken from the wound base revealed Pseudomonas aeruginosa infection. Surgical necrectomy and application of negative pressure wound therapy (NPWT) was started together with intensive care treatment for sepsis. As both wound and general condition of the patient improved, autologous split thickness skin grafting was carried out in two sitting under continuing NPWT application. The applied skin grafts showed excellent take, the perilesional subcutaneous recesses resolved and complete healing was achieved after 28 days of NPWT treatment. Proper dermatological diagnosis and immediate escharectomy complemented with application of NPWT can be life-saving in the treatment of necrotizing fasciitis.
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Affiliation(s)
- Levente Szabó
- University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary
| | - István Szegedi
- University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary
| | - Csongor Kiss
- University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary
| | - Edit Szikszay
- University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary
| | - Éva Remenyik
- University of Debrecen Clinical Center, Dept. Dermatology, Burn and Dermatosurgery Unit, Debrecen, Hungary
| | - István Csízy
- University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary
| | - István Juhász
- University of Debrecen Clinical Center, Dept. Dermatology, Burn and Dermatosurgery Unit, Debrecen, Hungary.,University of Debrecen, Faculty of Dental Medicine, Dept. of Surgery and Operative Techniques, Debrecen, Hungary
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