Herpes simplex virus (HSV) infection in a newborn is commonly due to HSV 2 and less commonly due to HSV 1.1,2 Mixed HSV 1 & 2 infection in newborn is rarely reported.3 Neonatal HSV infection can present as- a) Localized skin, eye and mouth (SEM) affection; b) Central nervous system (CNS) disease or c)Disseminated disease.1,4,5 We report an unusual case of HSV infection in a neonate due both HSV 1 & HSV 2. It led to initial manifestation just like septicemia and ultimately prolonged cholestasis that responded to acyclovir therapy.
Multiple sclerosis is a demyelinating disease affecting people in early to middle adulthood and is uncommon in childhood. Here we report a patient of multiple sclerosis who presented much before 10 years of age with features suggestive of acute disseminated encephalomyelitis and altered sensorium which is quite different from the features of multiple sclerosis in adults. Diagnosis in this patient was made on the basis of predominant white matter involvement with clinically remitting and relapsing course of the disease on follow up over 3 1/2 years, substantiated by finding multiple areas of demyelinating plaques in magnetic resonance imaging, while visual evoked potential and cerebrospinal fluid study supported demyelination. Hence, children with initial diagnosis of acute disseminated encephalomyelitis need long term follow up as they may develop multiple sclerosis.
Recurrent abdominal pain is a common problem among children. Since its first description by John Apley in 1958, the condition has remained poorly understood with a multitude of factors being implicated in causation. The symptoms tend to be vague and investigations seldom show organic disease. But the importance to evaluate each child with recurrent abdominal pain should be considered important nevertheless, particularly, in protracted cases. Here, we present a case who presented with history of recurrent abdominal pain for several years before being diagnosed as a case of hereditary pancreatitis. This stresses the importance of evaluating each case with a detailed and complete history, physical examination and selected investigations.
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