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Chew SJ, Low KB, Chong CY, Maiwald M, Thoon KC, Ong RY, Yung CF, Li J, Nadua KD, Kam KQ, Tan HK, Lian DW, Tan LY, Tan NW. Paediatric actinomycosis: A 16-year, single-institution retrospective review of cases. J Paediatr Child Health 2023. [PMID: 37017147 DOI: 10.1111/jpc.16400] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 12/01/2022] [Accepted: 03/21/2023] [Indexed: 04/06/2023]
Abstract
AIM Actinomycosis is a rare subacute to chronic granulomatous infection which can mimic other infectious or malignant diseases. This study examined the epidemiology and treatment outcome of actinomycosis in children. METHODS A retrospective study on children admitted for actinomycosis in a tertiary paediatric hospital in Singapore, from January 2004 to December 2020. Clinical profile, therapeutic interventions and outcomes were examined. RESULTS A total of 10 patients were identified; 7 were female. The median age at first presentation was 9.8 years (range 4.7-15.7). The most common presenting symptom was fever (n = 6, 60%), followed by facial or neck swelling (n = 3, 30%) and ear pain (n = 3, 30%). Actinomycosis occurred predominantly in the orocervicofacial region (n = 6, 60%). Four patients (40%) had preceding dental infections in the form of dental caries or gingivitis. One patient had poorly controlled insulin-dependent diabetes mellitus. Actinomycosis was confirmed via culture in four patients, histopathology in four patients and both methods in two patients. All except one patient (n = 9, 90%) underwent surgical procedures. All patients received ampicillin or amoxicillin/clavulanate or other beta-lactams, for a median duration of 6.5 months (range 1.5-14). Complications included osteomyelitis (n = 4, 40%), mastoiditis (n = 2, 20%), brain abscess (n = 1, 10%) and recurrent neck abscess (n = 1, 10%). There was no mortality and all patients achieved complete resolution. CONCLUSIONS Paediatric actinomycosis was rare in our 16-year review, but had a high complication rate. It can occur in immunocompetent patients, and dental infection was the predominant risk factor identified. Prognosis was excellent after surgical intervention and appropriate antimicrobial therapy.
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Affiliation(s)
- Siu-Jun Chew
- Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Kelly Bb Low
- Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Chia-Yin Chong
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Matthias Maiwald
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Koh-Cheng Thoon
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Rina Yl Ong
- Department of Pharmacy, KK Women's and Children's Hospital, Singapore
| | - Chee-Fu Yung
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Jiahui Li
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Karen D Nadua
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Kai-Qian Kam
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Henry Kk Tan
- Department of Otolaryngology, KK Women's and Children's Hospital, Singapore
| | - Derrick Wq Lian
- Department of Pathology, National University Hospital, Singapore
| | - Leon Yr Tan
- Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Natalie Wh Tan
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
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Tan LY, Tan AP. A rare case of paediatric meningioma masquerading as intra-axial lesion. Med J Malaysia 2018; 73:439-440. [PMID: 30647227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Meningiomas are neoplasm arising from meningoepithelial cells, most commonly in the fifth to sixth decade of life. Meningiomas are rare in paediatric population, accounting for 0.4-4.1% of all paediatric tumours and less than 3% of paediatric brain tumours. However, meningiomas represent the most common dural based tumours in children. We describe a rare case of paediatric fibroblastic meningioma within the left middle cranial fossa masquerading as an intra-axial mass lesion. Our discussion will be centred on atypical features of paediatric meningiomas and differential diagnosis of extra-axial mass lesion in the paediatric population.
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Affiliation(s)
- L Y Tan
- National University of Singapore, Department of Diagnostic Imaging, Singapore.
| | - A P Tan
- National University of Singapore, Department of Diagnostic Imaging, Singapore
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