Olfa Bouyahia

Neurological Variant of Lemierre's Syndrome with Purulent Meningitis: A Case Report and Literature Review

We report an unusual variant of Lemierres Syndrome (LS) in a 10-year-old-girl admitted to the intensive care unit for septic shock with meningitis. The primary infection was otitis media. A gram negative bacillus was identified in the direct exam of the purulent ear discharge and the cerebrospinal fluid but cultures were negative. Computerized tomography of the neck revealed a thrombus in the internal jugular vein. Septic shock improved rapidly under supportive treatment. The patient recovered without sequellae after a prolonged duration of parenteral antibiotherapy and hospital stay. Neurologic variants of LS with meningitis, previously reported in the literature, are reviewed.

Foetus-in-fetu an Unusual Cause of Abdominal Mass in the Newborn

Abstract Foetus-in-fetu (FIF) is a rare congenital condition in which a vertebrate foetus is incorporated within its twin. The authors report the case of a newborn girl with prenatal ultrasonographic diagnosis of an intra-abdominal mass. Abdominal ultrasonography and computed tomography of the abdomen showed a heterogeneous cystic mass containing multiple calcifications. The patient had a laparotomy at 18 days of age with excision of a well-encapsulated 6 χ 5 cm retroperitoneal mass, containing many organs. Anatomicopathologic examination showed a relatively well-differentiated FIF attached to an amniotic sac by a rudimentary umbilical cord. Encephalon, coroidal plexus, vertebral bodies, rudimentary limbs, thyroid gland and teeth were identified. The postoperative period was uneventful.

Reversible posterior leukoencephalopathy syndrome: A rare complication of hypertensive encephalopathy in children

Reversible posterior leukoencephalopathy syndrome is a recently defined cliniconeuroradiologic entity, rarely reported in children. Hypertensive encephalopathy is the most common cause. A 4-year-old boy presented with reversible posterior leukoencephalopathy syndrome manifested by headache, seizures, coma, papilledema and facial paralysis complicating severe arterial hypertension. Computed tomography scan of the brain showed bilateral low-density areas corresponding to the frontal, parietooccipital white matter and to the internal capsula. Blood pressure was controlled within 4 days and clinical recovery was obtained within 5 days. Magnetic resonance imaging, performed 2 months later, was normal. The arterial hypertension was caused by renal scars of bilateral vesico-renal reflux. The clinical course, pathophysiology and neuroimaging features of reversible posterior leukoencephalopathy syndrome in children are discussed.