The authors report the case of a four-year-old boy who, having been diagnosed as having uncomplicated Henoch-Schonlein purpura, returned five days later with a new crop of lesions and sudden onset of engorgement and oedema of the penis. Testicular and scrotal involvement has been well documented in Henoch-Schonlein purpura but involvement of the penis alone has not been widely reported.
These cases demonstrate the difficulties associated with antenatal counseling regarding long-term prognosis for infants with nonimmune hydrops and pulmonary sequestration. With optimal care in a tertiary perinatal center, a less pessimistic outlook than previously described in the literature may be appropriate.
Inflammatory polyps of the airways are now regarded as histopathologically distinct nonneoplastic endobronchial lesions, which in adults are associated with a variety of chronic inflammatory insults. However, their clinical presentation in the pediatric population is extremely rare, with the etiology of such polyps poorly defined. The clinical and histopathological data from four pediatric patients, identified in the histopathology files of the Royal Brompton Hospital, were retrospectively reviewed. Three out of 4 patients had a history of mechanical ventilation in the neonatal period. In these 3 patients, the polyps were all situated in the proximal airways on the right side. These 3 patients presented at 6 weeks, 7 weeks, and 2 years, respectively, and were successfully treated by polypectomy at rigid bronchoscopy, with subsequent return to normality. One patient, presenting at 12 years of age without history of iatrogenic intervention, underwent a left lower lobectomy for a polyp sited in a segmental bronchus. Presentation in 3 of the 4 patients was with lobar collapse. The fourth patient presented with hyperinflation. We conclude that inflammatory endobronchial polyps may be associated with a history of mechanical ventilation in the neonatal period, polyp formation perhaps being secondary to airway trauma. The small caliber of the main airways in neonates may also be a contributory factor in presentation.
TTTS treated with laser coagulation has reported eight (1.8%) cases of ABS. However, in this series, all the affected twins were recipient, seven out of eight donor twins died, and none of these had both feet affected (unlike our case). 2 Parents consenting for laser therapy in TTTS should be counselled for ABS.
Competing interests None.
Patient consent Obtained.Provenance and peer review Not commissioned; externally peer reviewed.Contributors SM diagnosed the case and was involved in researching the topic. SK and RR were involved in the management of the case. All three contributed to the writing of the article.
Group B hemolytic streptococcus (GBS) is the most common cause of neonatal sepsis and meningitis. However, hydrocephalus as a presentation of neonatal GBS meningitis has not been reported. We report herein the case of a 23-day-old male infant who presented with significant hydrocephalus and subtle seizures, without a febrile episode, due to GBS meningitis. The infant needed a 3-week course of antibiotics, a ventriculoperitoneal shunt and anticonvulsant therapy.
This paper presents a case of non-immune hydrops (NIH) which presented late at 28 weeks' gestation during an otherwise asymptomatic pregnancy. A severely hydropic female infant was born with significant cardiorespiratory compromise; however, aggressive resuscitation and postnatal treatment resulted in a favourable outcome. Parvovirus B19 DNA was subsequently detected in postnatal blood samples by nested polymerase chain reaction. This case emphasizes that survival is achievable even in those cases where intrauterine transfusion is not performed. It highlights the importance of prompt delivery and intensive neonatal support in such situations. ٖ Intrauterine transfusion, multisystem support, non-immune hydrops, parvovirus B19, polymerase chain reaction
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