Shilpa Krishnapura Lakshminarayana, S. Devadas, K. Bharath, Mallesh Kariyappa, Bindushree Byadarahalli Keshavamurthy, Megha S Bagewadi, Sushma Veeranna Sajjan, Dadegal Vineet, Thanzir Mohammed
{"title":"Early congenital syphilis: missed opportunities in a mother owing to many problems during pregnancy – a case report","authors":"Shilpa Krishnapura Lakshminarayana, S. Devadas, K. Bharath, Mallesh Kariyappa, Bindushree Byadarahalli Keshavamurthy, Megha S Bagewadi, Sushma Veeranna Sajjan, Dadegal Vineet, Thanzir Mohammed","doi":"10.1080/20469047.2022.2044676","DOIUrl":"https://doi.org/10.1080/20469047.2022.2044676","url":null,"abstract":"ABSTRACT Untreated syphilis in pregnancy can result in an adverse outcome for the fetus. A multigravida woman with a previously poor obstetric history of early neonatal death, abortion and stillbirth was admitted in labour in the 7th month of pregnancy. On admission, syphilis screening with the qualitative rapid plasma reagin (RPR) test was negative. The infant had macules on the chest, abdomen and extremities, desquamating bullous skin lesions on the palms and soles, bilateral cataracts, an enlarged liver and spleen, anaemia, thrombocytopenia and conjugated hyperbilirubinaemia. A quantitative RPR test in the infant was positive in a 1:64 dilution and was subsequently positive in the mother in a 1:16 dilution after congenital syphilis was diagnosed. The mother later reported the father’s high-risk behaviour and her previous visits to healthcare facilities for genital ulcers. The quantitative RPR test in the father was positive in a 1:32 dilution, and the parents and infant were treated for syphilis. The case demonstrates the importance of timely identification of high-risk pregnant women, early screening, repetition of the non-treponemal test on diluted serum when a routine screening test is negative, proper advice from the laboratory regarding selection of the most appropriate tests, and screening with the treponemal test first (reverse) algorithm utilising an automated enzyme immunoassay/chemiluminescence assay for the initial screening in high-risk cases, even in resource-limited settings to prevent a missed diagnosis. Abbreviations: ANC, antenatal care; BPG, benzathine penicillin G; CS, congenital syphilis; CSF, cerebrospinal fluid; CIA, chemiluminescence assay; EIA, enzyme immunoassay; HIC: high-income countries; IgM, immunoglobulin M; LMIC, low- and middle-income countries; MTCT: mother-to-child transmission; NTT, non-treponemal test; POC, point of care; RPR, rapid plasma reagin; RST, rapid syphilis test; STI, sexually transmitted infections; TT, treponemal test; TPHA, Treponema pallidum haemagglutination assay; VDRL, venereal disease research laboratory; WHO, World Health Organization.","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"89 - 94"},"PeriodicalIF":1.8,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48676598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Akina Matsuda, N. Nishizaki, Hanako Abe, Akira Mizutani, T. Niizuma, K. Obinata, K. Oguma, S. Makino, Makoto Ishitate, Toshiaki Shimizu
{"title":"An infant of 26 weeks gestation with congenital miliary tuberculosis complicated by chronic lung disease requiring CPAP was diagnosed on Day 104 of life: congenital tuberculosis was confirmed by detection of calcified ovaries in his mother","authors":"Akina Matsuda, N. Nishizaki, Hanako Abe, Akira Mizutani, T. Niizuma, K. Obinata, K. Oguma, S. Makino, Makoto Ishitate, Toshiaki Shimizu","doi":"10.1080/20469047.2022.2076030","DOIUrl":"https://doi.org/10.1080/20469047.2022.2076030","url":null,"abstract":"ABSTRACT Introduction Early diagnosis of tuberculosis (TB) in infants is important but is commonly missed because the symptoms are often non-specific. Case presentation A Nepalese male infant born at 26 weeks gestation and weighing 1227 g (97th centile) was admitted to the neonatal intensive care unit (NICU) immediately after birth for the management of his prematurity. After extubation on Day 8, his oxygen saturation became unstable and he required nasal continuous positive airway pressure with oxygen for 3 months. On Day 104, further detailed evaluation was required because there was no improvement in his respiratory condition. A computed tomography (CT) scan demonstrated scattered miliary nodules in both lung fields. Acid-fast staining for the mycobacteria and TB polymerase chain reaction (PCR) of the sputum obtained directly by laryngeal aspiration confirmed Mycobacterium tuberculosis. On Day 105, he was therefore transferred to a tertiary care hospital for further intensive care. Pathology findings suggested placental involvement with TB owing to chronic endometrial infection. In addition, a maternal abdominal CT scan demonstrated bilateral calcified lesions in the ovaries. He completed antituberculous chemotherapy and was discharged 3 months later. At 18 months of age there are no sequelae and his development is almost normal. None of the infants or medical personnel who were exposed in the NICU developed secondary TB. Conclusion In neonates with persistent respiratory distress, neonatologists should consider TB infection as a differential diagnosis. Abbreviations CLD: chronic lung disease; CRP: C-reactive protein; CT: computed tomography; IGRA: interferon-γ release assay; IVF-ET: in vitro fertilisation-embryo transfer; N-CPAP: nasal continuous positive airway pressure; NICU: neonatal intensive care unit; PCR: polymerase chain reaction; PROM: premature rupture of membranes; TB: tuberculosis; WBC: white blood cells.","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"72 - 77"},"PeriodicalIF":1.8,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44392161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kiruthiga Sugumar, A. Chidambaram, B. Deepthi, S. Krishnamurthy, C. Delhikumar
{"title":"A rare cause of stroke in young children: minor head trauma associated with mineralising lenticulostriate angiopathy in three patients","authors":"Kiruthiga Sugumar, A. Chidambaram, B. Deepthi, S. Krishnamurthy, C. Delhikumar","doi":"10.1080/20469047.2022.2066386","DOIUrl":"https://doi.org/10.1080/20469047.2022.2066386","url":null,"abstract":"ABSTRACT Acute basal ganglia infarct following minor head trauma in association with mineralisation of lenticulostriate arteries is an increasingly recognised entity in childhood stroke. Three cases with a classical history and phenotypical features of mineralising angiopathy are described. Case 1 was a 2-year-old girl who presented with acute onset hemiparesis with a same-side upper motor neuron (UMN)-type facial palsy following minor head trauma. Case 2 was a 14-month-old boy who presented with a left side hemiparesis and a left UMN-type facial nerve palsy following a minor fall. Case 3 was an 8-month-old boy who, following a fall from his cot, had a sudden-onset hemiparesis on the right side and deviation of the angle of the mouth to the left. In brain computed tomography, all three cases demonstrated characteristic basal ganglia calcification of the mineralising angiopathy. Magnetic resonance imaging of the brain demonstrated features supportive of acute infarcts in the lentiform nucleus, caudate nucleus and putamen. Two of the patients had iron deficiency anaemia with haemoglobin of 7.0 g/dL and 7.8 g/dL, respectively. On follow-up, Case 1 had mild residual weakness and the other two made a complete recovery. None of the patients had a recurrence of stroke. Basal ganglia stroke with mineralising angiopathy should be considered in toddlers presenting with sudden-onset focal neurological deficits preceded by minor head trauma. Abbreviations: ADC: apparent diffusion coefficient; CT: computed tomography; DWI: diffusion-weighted imaging; Hb: haemoglobin; IDA: iron deficiency anaemia; MRI: magnetic resonance imaging; SLV: sonographic lenticulostriate vasculopathy; SWI: susceptibility weighted imaging; UMN: upper motor neuron.","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"67 - 71"},"PeriodicalIF":1.8,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43446004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A 17-year-old boy who presented with acute mononeuropathy was found to have Type 1 diabetes","authors":"Fatma Özgüç Çömlek, Y. Karal, Filiz Tütüncüler","doi":"10.1080/20469047.2022.2059879","DOIUrl":"https://doi.org/10.1080/20469047.2022.2059879","url":null,"abstract":"ABSTRACT Diabetic neuropathy in children and adolescents with Type 1 diabetes mellitus is rare and is usually subclinical and a complication of the late diabetes period. A 17-year-old boy admitted with a right foot drop of sudden onset was diagnosed with peroneal nerve palsy. He had had osmotic polyuria, polydipsia and weight loss for the past 2 months; his blood glucose was 25 mmol/L (<7.8), HbA1c 15.2% (4.0–5.6) and vitamin B12 125 pg/ml (180–914). The peroneal nerve palsy resolved within 3 months with blood glucose regulation and B12 supplementation. Diabetes should be borne in mind in the differential diagnosis of unusual cases of mononeuropathy. Abbreviations: DCCTS: Diabetes Control and Complications Trial Study; DM: diabetes mellitus; DN: diabetic neuropathy; GAD: glutamic acid decarboxylase; PN: peripheral neuropathy; T1DM: Type 1 diabetes mellitus.","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"105 - 107"},"PeriodicalIF":1.8,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46780018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suwanna Pornrattanarungsi, S. Eursiriwan, Y. Amornchaicharoensuk, C. Chavanisakun, O. Sirimongkolchaiyakul
{"title":"Concomitant rapidly progressive glomerulonephritis and acute rheumatic fever after streptococcus infection: a case report","authors":"Suwanna Pornrattanarungsi, S. Eursiriwan, Y. Amornchaicharoensuk, C. Chavanisakun, O. Sirimongkolchaiyakul","doi":"10.1080/20469047.2022.2046966","DOIUrl":"https://doi.org/10.1080/20469047.2022.2046966","url":null,"abstract":"ABSTRACT Acute post-streptococcal glomerulonephritis (APSGN) and acute rheumatic fever (ARF) are common immune-mediated complications after group A streptococcus (GAS) infection. The causative antigenic epitopes on GAS are different for APSGN and ARF, and their simultaneous occurrence is uncommon. A 12-year-old boy presented with fever and gross haematuria. He had subcutaneous nodules on the dorsum of both feet along with a new holosystolic murmur at the apex, and he developed hypertension and generalised oedema after admission. Investigation confirmed the diagnosis of ARF with APSGN. He received a corticosteroid to control inflammation of both the conditions. His clinical signs gradually improved but he still had rheumatic heart disease. As both diseases can occur in the same patient, treatment should be provided for both conditions. Abbreviations: APSGN: acute post-streptococcal glomerulonephritis; ARF: acute rheumatic fever; ASO: antistreptolysin O; Cr: serum creatinine; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; GAS: group A streptococcus; RBC: red blood cells; RPGN: rapidly progressive glomerulonephritis; S1: first heart sound; S2: second heart sound; TTE: transthoracic echocardiogram.","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"100 - 104"},"PeriodicalIF":1.8,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48469028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Bayramoğlu, R. Comert, B. Erginel, Abdulkadir Baziki
{"title":"Trichobezoar presenting as an acute abdominal obstruction in a 17-year-old girl","authors":"Z. Bayramoğlu, R. Comert, B. Erginel, Abdulkadir Baziki","doi":"10.1080/20469047.2022.2045691","DOIUrl":"https://doi.org/10.1080/20469047.2022.2045691","url":null,"abstract":"ABSTRACT Trichobezoars are hairballs that combine with food residue in the digestive tract as a result of ingesting hair. A 17-year-old girl was admitted to the emergency department with abdominal pain and vomiting for 3 days. She had been having digestive difficulty and bloating for the previous 2 months. An abdominal radiograph demonstrated air-fluid levels consistent with ileus, and an ultrasound showed hyperechoic material in the stomach and ileum. Computed tomography demonstrated images of trapped air which was considered diagnostic of a bezoar. At laparotomy, a large mass was removed from the stomach. As the bezoar extended through the pylorus and duodenum and there were mobile masses palpable in the ileum, it required a second incision to remove them. For some years she had had a habit of swallowing hair which she found on her pillow and there was a history of an obsessive personality trait and hyperactivity for which she agreed to attend a psychiatric clinic. Abbreviations: BMI: body mass index; CT: computed tomography; Hb: haemoglobin; IV: intravenous; WHO: World Health Organization","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"95 - 99"},"PeriodicalIF":1.8,"publicationDate":"2022-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46316083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Splenic rupture presenting with marked scrotal ecchymosis in a 2-day-old newborn.","authors":"Gaffari Tunc, Cengiz Güney, Utku Aygüneş","doi":"10.1080/20469047.2021.1971923","DOIUrl":"https://doi.org/10.1080/20469047.2021.1971923","url":null,"abstract":"<p><p>Splenic rupture is a rare and severe condition in neonates. The signs and symptoms are vague and non-specific and are often not recognised before the onset of hypovolaemic shock or death. A 2-day-old infant presented with scrotal ecchymosis, and ultrasonography detected haemorrhage in the scrotal, right inguinal and adrenal regions. Computed tomography demonstrated a peri-splenic haematoma. Haemoglobin (Hb) was 2.79 g/dL and, despite repeated transfusions, the Hb level could not be sustained. Exploratory laparotomy detected a large haematoma in the splenic region, and, because of the uncontrolled haemorrhage, splenectomy was required.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"45-47"},"PeriodicalIF":1.8,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39407570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute demyelination of the medulla oblongata owing to scrub typhus in a 7-year-old boy: case report.","authors":"Srinanda Majumder, Moumita Samanta, Tapan Kumar Sinha Mahapatra","doi":"10.1080/20469047.2022.2035622","DOIUrl":"https://doi.org/10.1080/20469047.2022.2035622","url":null,"abstract":"<p><strong>Abbreviations: </strong>ADEM: acute disseminated encephalomyelitis; CT: computed tomography; MRI: magnetic resonance imaging; PGCS: paediatric Glasgow coma scale; PICU: paediatric intensive care unit.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"48-51"},"PeriodicalIF":1.8,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39595937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A A Adepoju, A Akere, G O Ogun, B O Ogunbosi, A O Asinobi, O Bello, A E Orimadegun, S Allen, O O Akinyinka
{"title":"Co-existing sickle cell anaemia and inflammatory bowel disease: case report and review of the literature.","authors":"A A Adepoju, A Akere, G O Ogun, B O Ogunbosi, A O Asinobi, O Bello, A E Orimadegun, S Allen, O O Akinyinka","doi":"10.1080/20469047.2021.1936393","DOIUrl":"https://doi.org/10.1080/20469047.2021.1936393","url":null,"abstract":"<p><p>Sickle cell anaemia (SCA) is a chronic haemolytic anaemia associated with vaso-occlusive painful crises which may affect several systems including the gastro-intestinal system, resulting in abdominal pain. The concurrence of inflammatory bowel disease and haemoglobinopathy is rare. No previously reported concurrent cases of both SCA and ulcerative colitis (UC) in sub-Saharan Africa were found in the literature. A 16-year-old girl with concurrent SCA and UC is presented. She was admitted to University College Hospital, Ibadan with a 1-year history of recurrent peri-umbilical pain and bloody stools. These symptoms were mainly attributed to SCA at the referring hospital, and she was managed for chronic tropical diarrhoea without a remarkable clinical response. This case illustrates the concurrent presentation of SCA and ulcerative colitis which led to the missed and delayed diagnosis of ulcerative colitis.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"29-35"},"PeriodicalIF":1.8,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39395094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonietta Curatola, Serena Ferretti, Antonio Gatto, Piero Valentini, Ilaria Lazzareschi
{"title":"Iron-deficiency anaemia in childhood: a risk factor for severe venous thrombosis?","authors":"Antonietta Curatola, Serena Ferretti, Antonio Gatto, Piero Valentini, Ilaria Lazzareschi","doi":"10.1080/20469047.2021.1923301","DOIUrl":"https://doi.org/10.1080/20469047.2021.1923301","url":null,"abstract":"<p><p>Iron deficiency anaemia is a common disorder in the paediatric age-group. The association between iron deficiency and venous thrombosis in children without an underlying illness is rare. Two cases are described. A 17-year-old girl had been taking oestrogen-progestogen therapy for contraception for about 2 years and developed a lower-limb deep vein thrombosis associated with pulmonary embolism. A 3-year-old girl was admitted to the paediatric emergency department with pallor, weakness and vomiting, and a cerebral CT showed a recent cerebral venous thrombosis. Both cases had severe iron-deficiency anaemia which increases a thrombotic tendency and could be a further crucial trigger of venous thrombosis in patients at low risk; therefore, in cases of unexplained thrombosis, it must always be considered to be a risk factor.<b>Abbreviations</b> APCR: activated protein C resistance; CMV: cytomegalovirus; CT: computerised tomography; CVST: cerebral venous sinus thrombosis; CVT: cerebral venous thrombosis; DVT: deep vein thrombosis; DOACs: direct oral anticoagulants; EBV: Epstein-Barr virus; ID: iron deficiency; IDA: iron deficiency anaemia; LMWH: low molecular weight heparin; PE: pulmonary embolism; RDW: red blood cell distribution width; VT: venous thrombosis.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"42 1","pages":"36-40"},"PeriodicalIF":1.8,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2021.1923301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38993915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}