Case Reports in Pediatrics最新文献

{"title":"Oxygen Consumption and Oxygen Pulse Patterns in Two Pediatric Patients With Pulmonary Hypertension and Different Clinical Responses: A Case Report.","authors":"Allegra J VanderWilde, Kimberley G Miles, Kristian C Becker, Paul J Critser, Michelle Cash, Melissa Magness, Wayne A Mays, Russel Hirsch, Adam W Powell","doi":"10.1155/crpe/6697634","DOIUrl":"10.1155/crpe/6697634","url":null,"abstract":"<p><p>Two patients with repaired congenital heart disease (CHD) and CHD-associated pulmonary arterial hypertension (PAH) are presented to illustrate the utility of cardiopulmonary exercise testing in this population. Novel markers used include the oxygen pulse curve (O₂pulse) as an initial marker of PAH-CHD disease progression. Both patients had an abrupt decrease in their peak oxygen consumption on serial exercise testing. In addition to the decrease in the peak oxygen consumption, Patient 1 also had a fall in the O₂pulse curve during progressive exercise and an episode of concerning symptoms, prompting an alteration medication management. Patient 2 had a similar drop in peak oxygen consumption without a fall in the O₂pulse curve, and this patient remained stable on their current medical therapies. The overall aim of this case study is to highlight the utility of cardiopulmonary exercise testing in patients with CHD-associated PAH and showcase the utility of exercise testing in optimizing clinical management.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"6697634"},"PeriodicalIF":0.5,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013833","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":"Celiac Disease Presenting With Erythema Nodosum in a Child: Case Report and Review of the Literature.","authors":"Momcilo Pavlovic, Karolina Berenji, Zeljko Rokvic","doi":"10.1155/crpe/9684135","DOIUrl":"10.1155/crpe/9684135","url":null,"abstract":"<p><p>Celiac disease (CD) is a chronic autoimmune enteropathy with a wide spectrum of gastrointestinal and extraintestinal manifestations. Erythema nodosum (EN), the most common form of panniculitis in children, has only rarely been reported in association with CD, and the nature of this relationship remains unclear. We describe the case of a 2.5-year-old girl who presented with erythematous nodules on the lower extremities, which had been present for 3 weeks. Clinical evaluation confirmed the diagnosis of EN. Common infectious, inflammatory, and drug-related causes were excluded. Due to a history of long-standing constipation, serological testing for CD was performed, revealing markedly elevated antitissue transglutaminase IgA antibodies and positive antiendomysial IgA antibodies. CD was diagnosed according to ESPGHAN criteria, and a gluten-free diet (GFD) was initiated. The EN lesions resolved within 3 weeks, which is compatible with the known self-limiting course of the condition. We also reviewed previously published pediatric cases describing the co-occurrence of EN and CD. Most reported patients exhibited additional clinical features suggestive of CD, including gastrointestinal symptoms, growth impairment, anemia, arthralgia, asthenia, or a previously diagnosed CD with recent dietary nonadherence. Although a temporal association between initiation of a GFD and resolution of EN has been described, a causal relationship cannot be established based on the available evidence.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"9684135"},"PeriodicalIF":0.5,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970715","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":"Bilateral Skull Fractures in an Infant: Diagnostic Dilemma Between Accident and Abuse.","authors":"Tomohiro Hirade, Daisuke Koike","doi":"10.1155/crpe/4492559","DOIUrl":"10.1155/crpe/4492559","url":null,"abstract":"<p><p>Accidental head injury in infants is relatively common in the emergency department. However, abusive head trauma (AHT) should be considered in the differential diagnosis because of its strong association with morbidity and mortality. A 4-month-old male infant was admitted to the emergency department by his parents because of bilateral scalp swelling. Skull radiography and head computed tomography with three-dimensional reconstruction revealed bilateral linear parietal skull fractures. Although bilateral skull fractures are more commonly associated with AHT than single linear skull fractures, they may also result from a single accidental impact. Because skull fracture patterns alone cannot exclude AHT, a comprehensive medical evaluation is essential. If clinicians have even a slight suspicion of AHT, they should not hesitate to consult the hospital child protection team or Child Protective Services.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"4492559"},"PeriodicalIF":0.5,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970754","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":"Spontaneous Gastric Perforation in a Healthy Child Associated With <i>Sarcina ventriculi</i> Infection.","authors":"Dejan Nikolic, Sukrita Mysore, Matthew Boelig, Bilal Khan, Emily Scattergood, Debrah Meislich","doi":"10.1155/crpe/6955634","DOIUrl":"10.1155/crpe/6955634","url":null,"abstract":"<p><p>Spontaneous gastric perforation is a rare but morbid condition in children. Recent reports have suggested that finding <i>Sarcina ventriculi</i>, a rare, Gram-positive anaerobic bacterium in the stomach, could be associated with gastric ulcers and rarely gastric perforation, predominantly in adults. Here, we describe a case of an 11-year-old otherwise healthy child who presented with acute onset of severe, diffuse abdominal pain, tenderness, and distension and was found to have peritonitis and shock. The emergent exploratory laparotomy revealed a 4-cm gastric perforation, and histopathologic examination of the subtotal gastric resection showed abundant growth of <i>Sarcina ventriculi</i> at the site of perforation. To our knowledge, this represents one of the very few reported cases and possibly the first well-documented case occurring in a previously healthy child with no identifiable predisposing conditions.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"6955634"},"PeriodicalIF":0.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834076","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":"Uncommon Complications of Osteomyelitis: Deep Vein Thrombosis and Pulmonary Septic Emboli in Two Healthy Pediatric Patients: A Case Report and Literature Review.","authors":"Hala O Abdallah, Lara Haj Mohammed, Hobab Jehad Odeh, Alma Abu Lil, Amjad Rajab","doi":"10.1155/crpe/3736016","DOIUrl":"10.1155/crpe/3736016","url":null,"abstract":"<p><p>Acute osteomyelitis in children is typically a localized hematogenous infection; however, its presentation with deep vein thrombosis (DVT) and septic pulmonary emboli (SPE) is exceptionally rare. Fewer than fifteen similar cases have been reported in the literature. We describe two previously healthy pediatric patients who developed multifocal osteomyelitis, DVT, and SPE in the setting of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) bacteremia. Both children initially presented with nonspecific limb pain, fever, and markedly elevated inflammatory markers, with early imaging proving nondiagnostic. Each subsequently developed venous thrombosis and septic emboli prior to confirmation of osteomyelitis, reflecting an aggressive clinical pattern. MRI later revealed multifocal bone involvement with subperiosteal abscesses requiring surgical drainage. Management required prolonged targeted intravenous antibiotics, anticoagulation, and coordinated multidisciplinary care. These cases highlight the importance of early suspicion for musculoskeletal infection in febrile children with persistent limb pain and systemic MRSA infection. Early MRI and prompt recognition of thromboembolic complications are essential for improving outcomes.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"3736016"},"PeriodicalIF":0.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811331","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":"Severe Congenital Candidiasis due to <i>Candida dubliniensis</i> Treated With Fosfluconazole in a Preterm Infant.","authors":"Hiroyuki Higashiyama, Takeshi Futatani","doi":"10.1155/crpe/7680042","DOIUrl":"10.1155/crpe/7680042","url":null,"abstract":"<p><p>Congenital candidiasis is a rare but potentially lethal disease in preterm infants. Most cases are caused by <i>Candida albicans</i>; to date, there are no reports of <i>Candida dubliniensis</i> as the causative organism. Herein, we report a case of severe congenital candidiasis caused by <i>C</i>. <i>dubliniensis</i> in a very low-birth-weight infant. The patient was treated with fosfluconazole intravenously. However, candidiasis infection relapsed on Day 8 of life. Therefore, fosfluconazole administration was switched to 10 mg/kg/day of micafungin for the next 14 days as the inhibitory concentration of micafungin was lower than that of fluconazole. The candidiasis did not relapse again after discontinuation of micafungin. The patient was discharged on Day 59 without apparent sequelae. Some experiments have induced stable fluconazole resistance in vitro in fluconazole-sensitive <i>C</i>. <i>dubliniensis</i> strains after exposure to low concentrations of fluconazole. It may be advisable to consider an alternative antifungal drug when <i>C</i>. <i>dubliniensis</i> is a causative organism.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"7680042"},"PeriodicalIF":0.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763421","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":"Kernicterus Continues to Occur in the USA Despite Concerted Preventive Efforts.","authors":"Bailey B Zeiler, Timothy M Bahr, Robin K Ohls, Robert D Christensen","doi":"10.1155/crpe/5545697","DOIUrl":"10.1155/crpe/5545697","url":null,"abstract":"<p><p>Kernicterus spectrum disorder continues to occur in the USA, even after improvements in detecting and managing hyperbilirubinemia were brought about by the 2022 AAP revised guidelines. Three of eight new cases of kernicterus occurring in our state during the past 15 years were infants who were intentionally born at home following a low-risk term pregnancy where the AAP guidelines were not applied. Considering the number of births per year in each setting, infants born at home are 7 times more likely to develop kernicterus than infants born in a hospital. Herein, we report our most recent case. We then provide a practical recommendation for averting future cases of kernicterus following out-of-hospital births. Specifically, we recommend that hospital systems and/or health departments supply all midwives performing out-of-hospital births with the equipment and training necessary to comply with the AAP guidelines by quantitatively assessing hyperbilirubinemia on every neonate 24-48 h following birth. We propose that this noninvasive, simple, and rapid assessment should be free of charge to the midwife and to the family. We maintain that if this is done routinely after every out-of-hospital birth, it will identify the neonates who need phototherapy and who sometimes also need other medical care to prevent extreme hyperbilirubinemia. We believe that such a program will prevent acute bilirubin encephalopathy and kernicterus and that without such a program, the dreadful condition of kernicterus spectrum disorder will continue to occur among our population of infants born at home.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"5545697"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763395","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":"Management of Osteogenesis Imperfecta Complicated by Severe Pneumonia in a Resource-Limited Setting: A Case Report.","authors":"Bipesh Kumar Shah, Diwakar Koirala, Shilu Upreti, Megha Mahato, Bivek Mishra, Ramesh Sapkota, Dibya Raj Chaudhary","doi":"10.1155/crpe/2264928","DOIUrl":"10.1155/crpe/2264928","url":null,"abstract":"<p><strong>Introduction: </strong>Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility, skeletal deformities, and multisystem involvement, with respiratory complications representing a major cause of morbidity and mortality. Intrinsic pulmonary abnormalities, restrictive physiology from scoliosis, and impaired secretion clearance increase susceptibility to respiratory failure. Reports describing the management of OI complicated by severe pneumonia in resource-limited settings remain scarce.</p><p><strong>Case presentation: </strong>We report a 13-year-old male with genetically unconfirmed but clinically evident OI who presented with high-grade fever, productive cough, cyanosis, and severe respiratory distress. Chest X-ray demonstrated right-sided pneumonia and mild thoracic scoliosis. Airway evaluation showed no cervical spine instability or dentinogenesis imperfecta, and intubation was achieved without difficulty using a cuffed 6.5-mm tube. Mechanical ventilation provided stabilization, with arterial blood gases normalizing. A comprehensive infectious workup was negative. The child improved with intravenous antibiotics, supportive care, and extubation on Day 3.</p><p><strong>Discussion: </strong>Respiratory compromise in OI arises from both skeletal and intrinsic airway abnormalities, including altered collagen architecture, bronchial wall thickening, and reduced chest-wall compliance. Mild scoliosis and impaired airway clearance may have contributed to respiratory decompensation in this case. While BiPAP/CPAP may benefit selected OI patients, their use must be individualized; in this patient, noninvasive ventilation was not indicated due to discomfort risk and adequate response to invasive ventilation. Early screening for sleep-disordered breathing and pulmonary dysfunction is recommended in OI.</p><p><strong>Conclusion: </strong>This case highlights the complexity of managing pneumonia in OI within resource-limited contexts and underscores the need for multidisciplinary, individualized respiratory care.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"2264928"},"PeriodicalIF":0.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637997","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":"Early Recurrence of Mediastinal Germ Cell Tumor With Pathological Complete Response to Chemotherapy: A Case Report.","authors":"Risa Kanai, Satoshi Yokoyama, Daisuke Fukao, Masahiko Sakabe","doi":"10.1155/crpe/6687345","DOIUrl":"10.1155/crpe/6687345","url":null,"abstract":"<p><p>Primary malignant mediastinal germ cell tumors (GCTs) are rare pediatric tumors that have a poorer prognosis than GCTs occurring elsewhere in the body. Due to their rarity and aggressiveness, they are often locally advanced and unresectable at diagnosis, and currently, there is no standard optimal treatment approach. Herein, we present a rare case of pediatric anterior mediastinal yolk sac tumor (YST) diagnosed as pathological complete response (CR) to chemotherapy but prematurely required pulmonary metastasectomy of mixed GCT consisting of seminoma and YST. Testicular GCTs can relapse as tumors of subtypes that are pathologically different from the primary tumor, each having distinct pathogenesis, treatment modality, and prognosis; however, this phenomenon is seldom reported in mediastinal GCTs. This report reviewed the discordance of histological composition between primary and metastatic tumors. When treating mediastinal nonseminomatous GCTs, the possibility of early recurrence should be considered, even if the primary tumor is completely resected and diagnosed as pathological CR to chemotherapy.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"6687345"},"PeriodicalIF":0.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621795","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":"Nonoperative Management of a Pediatric Blunt Traumatic Distal Tracheal Injury.","authors":"Philip Stanic, Emily Vore, Laura Galganski, Charles M Myer, Erik B Hysinger, Richard A Falcone","doi":"10.1155/crpe/2356477","DOIUrl":"10.1155/crpe/2356477","url":null,"abstract":"<p><strong>Introduction: </strong>Blunt traumatic tracheal injury in children is rare and potentially life-threatening. Operative management has traditionally been recommended, though recent reports suggest that nonoperative management may be appropriate in selected patients.</p><p><strong>Case presentation: </strong>A previously healthy 10-year-old boy presented after an unwitnessed helmeted all-terrain vehicle crash with severe hypoxia, facial swelling, and diffuse subcutaneous emphysema. Initial evaluation at an outside hospital demonstrated bilateral pneumothoraces requiring bilateral chest tube placement. Following transfer, CT imaging revealed a 1 × 1.1 cm posterior tracheal laceration at the carina, pneumomediastinum, pneumopericardium, pneumoperitoneum, extensive subcutaneous emphysema, pulmonary contusions, and rib fractures. Bronchoscopy confirmed a carinal rupture with mediastinal tissue abutting the defect. Attempts to position the endotracheal tube distal to the injury were unsuccessful; therefore, the patient was intubated proximally with a 5.5 Microcuff® tube. Given the patient's hemodynamic stability, absence of active air extravasation, and ability to maintain ventilation with low pressures, operative repair was deferred. The patient was maintained on low-pressure ventilation, sedation with paralytics, and empiric antibiotics, with daily bronchoscopy for airway clearance and assessment. The injury progressively granulated, and the patient was successfully extubated 10 days after the injury. He was discharged uneventfully on hospital Day 17 and was clinically asymptomatic at follow-up.</p><p><strong>Conclusion: </strong>Severe blunt pediatric tracheal injury may be successfully managed nonoperatively when patients are hemodynamically stable and air extravasation remains controlled and minimal.</p>","PeriodicalId":9623,"journal":{"name":"Case Reports in Pediatrics","volume":"2026 ","pages":"2356477"},"PeriodicalIF":0.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367149","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}