Pediatric Reports最新文献

{"title":"Long-Term Sequelae in Patients Treated for Recurrent CNS Relapses of Pediatric B-Cell Acute Lymphoblastic Leukemia: 20-Year Follow-Up, Neurological Consequences, and Survivorship Burden-A Case Report and Literature Review.","authors":"Maciej Niedźwiecki, Monika Lejman, Mieszko Czapliński, Janusz Springer, Anna Synakiewicz, Eliza Wasilewska","doi":"10.3390/pediatric18050121","DOIUrl":"10.3390/pediatric18050121","url":null,"abstract":"<p><p>Central nervous system (CNS) relapse remains a major cause of treatment failure in pediatric acute lymphoblastic leukemia (ALL). Repeated isolated CNS relapse is particularly rare and associated with poor prognosis, while optimal therapeutic strategies remain insufficiently defined. Intensified CNS-directed therapy may improve disease control but is also associated with substantial long-term neurotoxicity and survivorship burden. We present the case of a boy with favorable-risk B-cell ALL who developed two isolated CNS relapses despite a good initial response to frontline therapy and absence of classical CNS relapse risk factors. The second relapse was associated with extensive meningeal involvement and optic nerve infiltration. The patient underwent intensive multimodal CNS-directed therapy, including repeated intrathecal chemotherapy, liposomal cytarabine administered according to the IntReALL 2010 protocol, cranial irradiation, and allogeneic hematopoietic stem cell transplantation (alloHSCT) from a matched sibling donor. Durable long-term remission was achieved despite the extremely unfavorable prognosis that is associated with a second isolated CNS relapse. A twenty-year follow-up extending into early adulthood revealed substantial late complications, including epilepsy, transient ischemic attack, optic nerve injury, endocrinopathies, obesity, secondary thyroid malignancy, neurocognitive difficulties, and depression requiring long-term psychiatric and psychological support. The present case illustrates the complex balance between effective CNS disease control and cumulative treatment-related neurotoxicity in pediatric ALL survivors. It also highlights the cumulative CNS injury and long-term survivorship burden that is associated with repeated CNS relapse and multimodal CNS-directed therapy.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Parents of Children with Cancer During Their Child's Illness: A Qualitative Interview Study in a Spanish Context.","authors":"Fernando Santamaría-Fraile, Rosa M Cárdaba-García, Inmaculada Pérez, Verónica Velasco-González, Baldomero de Maya-Sáchez, Carlos Durantez-Fernández, Lucía Pérez-Pérez","doi":"10.3390/pediatric18050120","DOIUrl":"10.3390/pediatric18050120","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Childhood cancer profoundly affects families, particularly parents, who assume demanding caregiving roles associated with significant emotional and social burden that remain underexplored qualitatively. To explore the experiences of parents of children with cancer during the disease process: diagnosis, treatment, follow-up, and their child's progress. <b>Methods</b>: An exploratory qualitative interview study was conducted using individual semi-structured interviews with six parents of children with cancer in Spain. Participants were intentionally recruited through a parent association. Interviews were conducted online, audio- and video-recorded with consent, transcribed verbatim, and analyzed using thematic analysis following Braun and Clarke. Sullivan's interpersonal theory was subsequently used as a conceptual framework to interpret the emerging themes, particularly in relation to interpersonal anxiety, security, emotional regulation, and significant relationships. <b>Results</b>: Six parents were included in the analysis, representing heterogeneous clinical trajectories, including active treatment, remission, and bereavement. Five axes, 12 categories, and 52 codes were identified. Parents described uncertainty and emotional disruption around diagnosis, the coexistence of perceived strength and distress during treatment, changes in family and interpersonal relationships, continuing concerns following remission, and profound grief and continuing bonds following the death of a child. These findings were interpreted through Sullivan's interpersonal framework. <b>Conclusions</b>: This exploratory study suggests that parents' experiences of childhood cancer are shaped by changes in interpersonal relationships, emotional regulation, perceived security, and support networks across different phases of the illness. The findings highlight potential areas for psychosocial support, although they should be interpreted cautiously given the small and heterogeneous sample.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Artificial Intelligence for Automated Assessment of Lines, Drains, and Airways on Pediatric and Adult Chest Radiographs.","authors":"Junqi Wang, Lili He, Gary R Schooler, Alexander J Towbin, Hailong Li","doi":"10.3390/pediatric18050119","DOIUrl":"10.3390/pediatric18050119","url":null,"abstract":"<p><p>The accurate placement of lines, drains, and airways (LDAs) is essential for the safe management of critically ill patients, as malpositioned medical devices can result in severe complications ranging from ineffective treatment to life-threatening injury. Chest radiography (CXR) is the primary imaging modality for confirming the placement of many LDAs; however, the growing volume and complexity of bedside CXRs have created increasing demand for rapid, reliable interpretation. Recent advances in artificial intelligence (AI) have enabled automated detection, localization, and position assessment of LDA devices, supporting opportunities to improve clinical workflow and patient safety. This review summarizes recent developments in AI algorithms for automated LDA assessment on CXRs, emphasizing their clinical applications, technical approaches, performance, and limitations. The review begins with clinical characteristics, radiographic appearance, and placement criteria of common LDA categories, followed by a survey of AI methods for presence detection, device localization, and position classification. Although some models have achieved performance approaching that of radiologists, most do not perform at the level needed for clinical deployment. Future research should prioritize multicenter validation, standardized annotation protocols, pediatric-specific datasets, and anatomically informed models capable of simultaneously evaluating multiple LDA devices. Advances in these areas will facilitate the integration of AI-assisted LDA assessment into clinical decision support and ultimately improve patient care.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline Predictors of Early Ventricular Recovery During Hospitalization in Children with Dilated Cardiomyopathy: A Short-Term Retrospective Study.","authors":"Adelina-Mihaela Sorescu, Cristina Isabel Viorica Ghiță, Smaranda Stoleru, Gabriela Duică, Alin Marcel Nicolescu, Eliza Elena Cinteză, Ion Fulga, Oana Andreia Coman","doi":"10.3390/pediatric18050118","DOIUrl":"10.3390/pediatric18050118","url":null,"abstract":"<p><strong>Introduction: </strong>Determining the prognosis and probable evolution of dilated cardiomyopathy (DCM) in pediatric patients has been an area of interest in the literature over the years. The aim of this study was to investigate baseline clinical, laboratory, and echocardiographic parameters associated with early ventricular recovery during hospitalization in children with dilated cardiomyopathy.</p><p><strong>Materials and methods: </strong>A retrospective, observational, single-center study was conducted including 56 pediatric patients diagnosed with DCM between 2015 and 2025. Baseline clinical and paraclinical variables were collected at admission. Changes in the left ventricular ejection fraction were assessed during hospitalization, and patients were categorized into recovery and non-recovery groups. Statistical analysis was performed to identify independent predictors of early ventricular recovery.</p><p><strong>Results: </strong>Early ventricular recovery occurred in 25 (44.64%) patients. In multivariate logistic analysis, Ross functional class was the only independent marker associated with early ventricular recovery (OR 2.547, 95% CI 1.179-5.501; <i>p</i> = 0.017). Bootstrap validation confirmed the robustness of the association. Troponin, NT-proBNP, mitral regurgitation and treatment strategy were not independently associated with recovery. ROC analysis demonstrated a modest discriminatory performance for the Ross functional class.</p><p><strong>Discussion: </strong>In this cohort of children with DCM, symptom severity was the only baseline variable consistently associated with early ventricular recovery. Clinical assessment was more useful than laboratory biomarkers and echocardiographic parameters in predicting short-term improvement in ventricular function.</p><p><strong>Conclusions: </strong>The Ross functional class was the only baseline variable independently associated with early ventricular recovery. These findings support the use of the Ross functional classification as a simple bedside tool, useful in early prognostic stratification in children with dilated cardiomyopathy, although its discriminatory performance was modest.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fundic Gallbladder Diverticulum Lesion in a Child Suspected to Be Congenital: A Case Report and Scoping Review.","authors":"Samentha Menager, Piero Farruggia, Salvatore Calderaro, Domenico Bivona, Giovanni Francesco Saia, Marco Guida, Antonino Levita, Chiara Marino, Federica Mescolo, Tiziana Guida Rutilio, Michelangelo Giovanni Sciortino, Barbara Torrente, Flavia Volpe, Giovanni Corsello","doi":"10.3390/pediatric18050117","DOIUrl":"10.3390/pediatric18050117","url":null,"abstract":"<p><p>Gallbladder diverticulum is an exceptionally rare congenital anomaly in children, with only isolated cases reported in the literature. We describe a 10-year-old girl with epilepsy and constipation who presented twice within 15 days with diffuse abdominal pain. Physical examination revealed generalized abdominal tenderness, and laboratory tests were unremarkable. Abdominal ultrasonography showed mild hepatic steatosis and a small fundal gallbladder outpouching measuring approximately 7 mm × 9 mm, suggestive of a diverticulum. Computed tomography (CT) also suggested a small fundal gallbladder diverticulum-like lesion. Notably, the family reported that the patient's older sister had undergone cholecystectomy for gallstones, during which a gallbladder diverticulum-like lesion was identified; however, because the event had occurred approximately 15 years earlier, only the first abdominal ultrasound report was available for review, and no histopathological reports could be retrieved. The scoping review systematically mapped the available evidence and confirmed that published pediatric experience remains extremely limited. Only two previously published pediatric cases were identified. Given the absence of complications for our patient, conservative management with gastroenterology follow-up was adopted. This case highlights the rarity of congenital gallbladder diverticulum in childhood, the diagnostic challenge of distinguishing true diverticula from anatomical variants, and the importance of correlating imaging findings with the clinical presentation.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Based Follow-Up After NICU Discharge: A Practice-Focused Narrative Review of Nursing and Midwifery Care for Preterm Infants.","authors":"Vikentia Harizopoulou, Angeliki Bolou, Evdoxia Tsiakiri, Maria Bouroutzoglou, Victoria Vivilaki, Dimitra Metallinou","doi":"10.3390/pediatric18050116","DOIUrl":"10.3390/pediatric18050116","url":null,"abstract":"<p><strong>Background/objectives: </strong>Preterm birth remains a significant global public health challenge, associated with increased morbidity, rehospitalisation, and long-term vulnerability. The transition from the neonatal intensive care unit (NICU) to the home environment represents a critical phase. This practice-focused narrative review synthesises current evidence on community-based post-discharge follow-up for preterm infants, with particular emphasis on the complementary contribution of community health nursing and midwifery within multidisciplinary follow-up models, endocrine-metabolic surveillance and coordinated care for medically complex infants.</p><p><strong>Methods: </strong>A narrative synthesis of review articles, clinical guidelines, and empirical studies published between 2016 and 2026 was undertaken. Searches were performed in PubMed, Scopus, and CINAHL using terms related to preterm birth, NICU discharge, community follow-up, family-centred care, community health nursing, midwifery, and metabolic disorders.</p><p><strong>Results: </strong>Community-based, family-centred follow-up programmes are associated with improved continuity of care, increased parental confidence, enhanced breastfeeding outcomes, and reduced healthcare utilisation. Community health nurses, midwives and health visitors contribute complementary expertise within multidisciplinary follow-up by coordinating continuity of care, providing clinical surveillance of growth and feeding, supporting caregiver education, facilitating early identification of complications, and ensuring timely referral. However, endocrine and metabolic vulnerabilities remain underrepresented in many follow-up models, while infants with complex healthcare needs require individualised, risk-stratified surveillance.</p><p><strong>Conclusions: </strong>Community-based, interdisciplinary, and family-centred follow-up after NICU discharge is essential to enhance the quality and safety of care for preterm infants. Integrated, risk-stratified models of follow-up that combine preventive surveillance, family education, multidisciplinary coordination, and continuity of care may facilitate earlier recognition of complications and improve long-term outcomes.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Alvarado Score with Alternative Diagnostic Tools in Pediatric Acute Appendicitis: A Literature Review.","authors":"Paul Tchouala Tchakoute, Alin Iuhas, Vlad-Ionuț Nechita, Andrei Vasile Pașcalău, Buzdugan Mihaela Ștefania, Ion Cosmin Puia","doi":"10.3390/pediatric18040115","DOIUrl":"10.3390/pediatric18040115","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is a leading pediatric surgical emergency. Timely diagnosis remains challenging, particularly in young children with atypical presentations. Clinical evaluation alone yields variable diagnostic performance, prompting the use of risk stratification tools.</p><p><strong>Objective: </strong>To evaluate and compare the Alvarado score against alternative clinical scoring systems, laboratory biomarkers, and imaging modalities in pediatric acute appendicitis.</p><p><strong>Methods: </strong>A narrative literature review with structured selection elements was conducted across PubMed, Scopus, and Web of Science for studies published between 2016 and 2026.</p><p><strong>Results: </strong>The Alvarado score demonstrates moderate diagnostic accuracy in children, with good sensitivity but limited specificity (57-76%) at standard cut-offs (≥7). Pediatric-specific scores like the Pediatric Appendicitis Score (PAS) offer higher sensitivity, while the Appendicitis Inflammatory Response (AIR) score provides superior specificity and better identifies complicated appendicitis (including gangrene, phlegmon, and perforation). Continuous risk models, notably the Pediatric Appendicitis Risk Calculator (pARC), outperform fixed additive scores in pediatric cohorts. Combining clinical scores with C-reactive protein, neutrophil-to-lymphocyte ratio, and selective ultrasonography enhances diagnostic precision. Computed tomography reserved for equivocal cases further optimizes diagnostic yield.</p><p><strong>Conclusion: </strong>The Alvarado score should not be used as a standalone tool. A structured, stepwise multimodal approach integrating clinical scores (such as pARC or PAS), inflammatory biomarkers, and selective imaging optimizes diagnostic accuracy and supports timely surgical decision-making in children.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Caries Risk Through Clinical and Salivary Parameters in Pediatric Patients with Cleft Lip and Palate.","authors":"Alícia Lima, Anabela Paula, Catarina Nunes, Raquel Travassos, Bárbara Oliveiros, Carlos Miguel Marto, Eunice Carrilho, Inês Francisco, Francisco Vale","doi":"10.3390/pediatric18040113","DOIUrl":"10.3390/pediatric18040113","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to assess caries-related indicators (DMFT and ICDAS indices), plaque index, salivary pH and buffering capacity, and dietary and oral hygiene habits in patients with cleft lip and/or palate undergoing orthodontic treatment, compared with a control group of healthy patients.</p><p><strong>Methods: </strong>This pilot case-control study included 26 patients undergoing orthodontic treatment, 13 patients with cleft lip and/or palate and 13 healthy individuals. The following variables were assessed: diet and oral hygiene through a questionnaire; salivary pH and buffering capacity; caries risk, using the DMFT and ICDAS indices; and plaque index, using the ImageJ Software.</p><p><strong>Results: </strong>No statistically significant differences were detected in the DMFT index, salivary pH, and plaque index; nor in the diet, oral hygiene and salivary buffering capacity. A slightly higher plaque index was observed in patients with cleft lip and/or palate compared to healthy patients. There was a statistically significant difference in the location of plaque, with a higher incidence in the upper central incisors in the study group.</p><p><strong>Conclusion: </strong>This pilot study suggests no statistically significant differences in the DMFT index, plaque index, salivary pH, and buffering capacity between patients with cleft lip and/or palate and healthy controls undergoing orthodontic treatment. However, a higher incidence of bacterial plaque on the upper central incisors was observed in patients with cleft lip and/or palate.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apparent Cerebellar Volumetric Stabilization and Emergent Cortical Hyperexcitability During Long-Acting Injectable Aripiprazole Maintenance in Adolescent Bipolar Disorder.","authors":"Erasmia I Koiliari, Christos Tsitsipanis, Marianna Evangelia Kapsetaki, Emmanouil L Pasparakis","doi":"10.3390/pediatric18040114","DOIUrl":"10.3390/pediatric18040114","url":null,"abstract":"<p><p>Background and Clinical Significance: This report investigates the complex intersection of macrostructural neuroprotection and cortical hyperexcitability during long-acting atypical antipsychotic maintenance. We present a novel clinical case demonstrating an apparent absence of detectable cerebellar vermis atrophy progression during long-acting injectable (LAI) aripiprazole maintenance, which temporally coincided with the emergence of a potential epileptogenic risk in an adolescent with bipolar disorder (BD) and cannabis use disorder. Beyond motor precision, the vermis modulates emotional-cognitive networks; deficits in these circuits impair impulse control, frequently driving comorbid substance use in youth. Case Presentation: A 16-year-old female with BD and cannabis use disorder presented with pronounced cerebellar and vermis atrophy on brain CT during an acute behavioral crisis. Following diagnostic reformulation, maintenance therapy was initiated via off-label monthly LAI aripiprazole (400 mg) alongside lithium. At 9-month follow-up, psychiatric relapses and cannabis use remitted completely. Repeat CT suggested macrostructural stability with zero apparent atrophy progression. However, during the 9th month, she abruptly developed daily generalized myoclonus. An awake electroencephalogram (EEG) revealed intense cortical hyperexcitability, documenting frequent interictal and ictal epileptiform discharges with generalized 3-4 Hz spike-wave complexes synchronized with the clinical myoclonus. Introduction of levetiracetam (500 mg BID) and cessation of adjunct methylphenidate led to complete clinical and neurophysiological remission. Conclusions: LAI aripiprazole may favorably influence the macrostructural trajectory of the cerebellum/vermis in adolescent BD, suggesting volume stabilization. However, clinicians must monitor for a drug-induced lowering of the seizure threshold, where macrostructural volume preservation coexists with microstructural electrical destabilization.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behind the Unilateral Rhinorrhea: Delayed Pediatric Intranasal Foreign Bodies Presenting as Chronic Sinonasal Disease and Severe Complications.","authors":"Constantinos Papadopoulos, Konstantina Dinaki, Ioanna Gravalidou, Rafail Ioannidis","doi":"10.3390/pediatric18040112","DOIUrl":"10.3390/pediatric18040112","url":null,"abstract":"<p><p>Background and Clinical Significance: Intranasal foreign bodies are common pediatric otolaryngologic emergencies and are usually diagnosed and removed without difficulty. However, delayed or occult retention may mimic chronic unilateral sinonasal disease and occasionally result in severe inflammatory or infectious complications. This study presents three illustrative pediatric cases of delayed intranasal foreign bodies supported by a seven-year institutional experience. Case Presentation: A retrospective review was conducted of all pediatric patients (≤16 years) presenting with intranasal foreign bodies at a secondary referral hospital between January 2019 and May 2026. Demographic characteristics, clinical presentation, management, and outcomes were reviewed to provide institutional context. Among 82 identified patients, three children with delayed diagnosis and severe complications were selected for detailed presentation because they represented distinct clinical manifestations of prolonged foreign body retention. These included chronic unilateral rhinosinusitis caused by a retained peanut fragment, a medial orbital subperiosteal abscess secondary to a retained plastic nasal piercing component, and a foreign-body granuloma associated with retained nasal packing material. The remaining patients underwent uncomplicated removal, predominantly in the emergency department. Conclusions: The presented cases illustrate the diverse spectrum of complications that may occur following delayed intranasal foreign body retention in children. Persistent unilateral foul-smelling rhinorrhea, nasal obstruction, recurrent unilateral epistaxis, or refractory unilateral sinonasal symptoms should prompt careful evaluation for a retained foreign body. By combining detailed case descriptions with institutional experience, this report highlights the importance of maintaining a high index of suspicion and timely endoscopic management in children with persistent unilateral sinonasal symptoms.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}