Two boys presented with variable signs and symptoms of infectious disease that challenged diagnosis. One of the two patients had aortic valve vegetations and lower extremity aneurysms, and the other had calvarial osteomyelitis, epidural abscess, pleural effusions, and pulmonary nodules. Only after a battery of bacterial and fungal agglutination tests was the unsuspected diagnosis made in each of brucellosis from Brucella canis.
An 8-year-old boy developed vomiting and severe headache following minor head trauma. A CT scan of the head demonstrated a lytic lesion of the skull and adjacent epidural hematoma. Surgical evacuation and removal of the skull lesion and hematoma were carried out, and pathologic evaluation resulted in a diagnosis of Langerhans' cell histiocytosis (LCH). Epidural involvement of Langerhans' cell histiocytosis is very rare, and we report the first case of LCH presenting as an intracranial epidural hematoma.
We present a case of a rare congenital cardiac anomaly. Magnetic resonance imaging accurately demonstrated a left circumflex aortic arch. This finding was not apparent on a prior conventional angiogram or echocardiography. Magnetic resonance imaging documentation of this anomaly is uncommon. Review of the embryonic development, clinical presentation of complete and incomplete vascular rings, and additional associated cardiac anomalies are discussed. This is one of only a few reported cases of a left circumflex aortic arch.
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