Cerebrovascular accident (CVA) is a rare neurological complication of diabetic ketoacidosis (DKA) in the paediatric population. The risk of developing CVA in DKA patients is often increased due to abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. Cerebral oedema, the most common neurological complication of DKA, may also predispose to CVA. We report the case of a -12-year-old adolescent with DKA complicated by CVA. She developed features of right hemispheric CVA while on admission and had radiological confirmation of an ischaemic CVA. This report highlights that cerebrovascular accidents in DKA can easily be missed or confused with cerebral oedema.

No abstract

Cushing syndrome (CS) is an uncommon morbidity in children. As a result of this rarity, there may be a delay in making the diagnosis or it may be missed completely resulting in progression to life-threatening complications. COVID-19 is an infectious disease that is currently the cause of a global pandemic although it affects children less commonly than adults. Our patient developed CS in early infancy which was diagnosed by elevated serum cortisol and left adrenal adenoma on abdominal magnetic resonance imaging (MRI). Unfortunately, the diagnosis of CS was missed earlier thereby delaying treatment and she also contracted the COVID-19 infection. The presence of these two medical conditions in a very young child may have resulted in a more advanced diseased state and increased chances of a poor outcome. A high index of suspicion for CS is necessary to forestall delay in commencement of appropriate treatment. Parental consent was obtained to publish this report.