Congenital Rubella Syndrome with Blueberry Muffin Lesions and Extensive Metaphysitis

Ajij, Mohemmed; Nangia, Sushma; Dubey, Bhavna Sharma

doi:10.7860/jcdr/2014/10271.5293

Cited by 3 publications

(3 citation statements)

References 9 publications

(9 reference statements)

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“…If none of the above-mentioned tests are positive, possibility of other infective agents should not be forgotten—CMV [ 37 ], malaria [ 38 ], parvovirus b19 [ 39 ], influenza [ 40 ], rubella [ 41 ], hepatitis A [ 42 ], adenovirus [ 43 ], schistosomiasis [ 44 ], histoplasmosis [ 45 ], MAV [ 34 ], typhoid fever [ 47 ]—and the samples should be tested against these microorganisms.…”

Section: Discussionmentioning

confidence: 99%

Visceral leishmaniasis misdiagnosed as an upper respiratory infection and iron-deficiency anemia in a 20-month-old male patient: a case report

Chakhunashvili,

Kvirkvelia

2024

J Med Case Reports

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Background Visceral Leishmaniasis should be suspected in every patient with a history of splenomegaly, fever, and pancytopenia. It is one of the most dangerous forms of infection and prompt recognition is the key to positive outcome. Case presentation A 20-month-old Caucasian male patient was brought to our hospital as an outpatient with the complaint of persistent fever, which did not improve with empiric antibiotic treatment (> 96 hour after the initial dose). The antibiotic treatment had been prescribed by primary care physician at polyclinic, who also referred the patient to hematologist due to anemia, who prescribed iron supplement. Despite multiple subspecialist visits, bicytopenia was, unfortunately, left unidentified. Upon physical examination no specific signs were detected, however, spleen seemed slightly enlarged. Patient was admitted to the hospital for further work-up, management and evaluation. Abdominal ultrasound, complete blood count and c-reactive protein had been ordered. Hematologist and infectionist were involved, both advised to run serology for Epstein-Barr Virus and Visceral Leishmaniasis. The latter was positive; therefore, patient was transferred to the specialized clinic for specific management. Conclusion Both in endemic and non-endemic areas the awareness about VL should be increased among the medical professionals. We also recommend that our colleagues take the same approach when dealing with bicytopenia and fever, just as with pancytopenia and fever. The medical community should make sure that none of the cases of fever and pancytopenia are overlooked, especially if we have hepatomegaly and/or splenomegaly.

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Section: Discussionmentioning

confidence: 99%

Visceral leishmaniasis misdiagnosed as an upper respiratory infection and iron-deficiency anemia in a 20-month-old male patient: a case report

Chakhunashvili,

Kvirkvelia

2024

J Med Case Reports

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“…These include prematurity, intrauterine growth retardation, microcephaly, haemolytic anaemia, thrombocytopenia, purpuric rash, jaundice, hepatitis, hepatomegaly, splenomegaly, "blueberry muffin" spots (sites of dermal erythropoiesis, Figs 4 and 5), hypotonia, bulging anterior fontanelle, constricted maxillary arch, high palate, interstitial pneumonia, myocarditis, myositis, nephritis, meningoencephalitis, and striated radiolucencies in the long bone ("celery stalk" lesions). 4,7,25,[30][31][32][33][34][35] Many of these features are transient and may resolve spontaneously over days or weeks. 25 Delayed manifestations, in addition to sensorineural hearing impairment, include mental retardation, psychomotor retardation, speech delay, attention deficit hyperactivity syndrome, autism, behavioural disorders, progressive encephalopathy, insulin-dependent diabetes mellitus, thyroid dysfunction (hypothyroidism, hyperthyroidism, thyroiditis), Addison disease, growth hormone deficiency, and immunological defects.…”

Section: Congenital Rubella Syndromementioning

confidence: 99%

Rubella (German measles) revisited

Leung

Hon

2019

Hong Kong Med J

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“…[1] The various causes for blueberry muffin syndrome are mentioned in Table 1. [1345] The exact cause of prolonged dermal erythropoiesis in blueberry muffin syndrome is unknown, but it is hypothesized that during normal embryologic development, extramedullary hematopoiesis occurs in a number of organs, including the dermis and this activity persists until the fifth month of gestation. [1] The presence of blueberry muffin lesions at birth represents postnatal expression of this normal fetal extramedullary hematopoiesis.…”

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confidence: 99%