An 8-month-old boy presented with high fever with seizures and weakness of legs. Cerebrospinal fluid analysis revealed acute pyogenic meningitis and magnetic resonance imaging revealed anterior sacral meningocele with epidural abscess. He was managed by surgery through posterior approach along with antibiotics. Clinical presentation, differential diagnosis, diagnostic modalities and management of this rare clinical condition is briefly discussed in this article.
The current onset and expeditious increase of COVID-19, caused by severe acute respiratory distress syndrome coronavirus (SARS-CoV-2), has established a global health predicament. Declared as pandemic and public health emergency by the World Health Organization (WHO), it follows an extremely heterogeneous course from mild flu like symptoms to severe acute respiratory distress syndrome. This outbreak intimidates the public with human to human escalation, which is the primary concern worldwide with a still unforeseeable result. With limited data on plausible therapy and vaccination, it is significant to unravel the virulence mechanism of SARS-CoV-2 to delineate chemoprevention that might curb the fatal outcome. It may be acknowledged here that the primary stage of disease prevention depends on the protective immune response to eliminate the virus. This postulation kindles interest in the intervention of vitamin D micronutrient, which might unfold the feasibility of slowing disease advancement and decreasing the risk of mortality. Taking into account, the wide spectrum of beneficial effects ascribed to vitamin D like antiviral, immunomodulatory, anti-inflammatory, and antioxidant action, it can be administered to affect immune cell proliferation and angiotensin-converting enzyme (ACE) 2 expression, which is the basis of pathogenesis of transmission of SARS-CoV-2. Recently, several observational clinical and epidemiological studies underline the hypothesis regarding mean vitamin D level and COVID-19 mortality. More so some retrospective analysis reported the correlation between vitamin D level and disease severity. Nevertheless, potential clinical researches and randomised control trials are recommended in COVID-19 patients with different levels of disease extremity to appraise the useful outcomes.
Sirenomelia is a rare congenital malformation, characterised by abnormal development of caudal part of body with variable degree of fusion of lower limbs. VACTERL is an acronym used for a group of sporadic non-random birth defects involving multiple organ systems, namely vertebral (V), anal (A), cardiac (C), tracheoesophageal (TE), renal (R) and limb (L) defects. Combination of both the anomalies is very rarely reported in literature. Survival is extremely rare and early prenatal diagnosis may allow for termination of pregnancy. Here we present a case of sirenomelia phenotype, with a complete spectrum of autopsy findings, suggestive of VACTERL association.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.