S. B. Bavdekar

Mycotic aneurysm: An uncommon cause for intra-cranial hemorrhage

Intra-cranial mycotic aneurysms due to an infective process elsewhere in the body constitute an uncommon cause of intra-cranial hemorrhage. The condition carries a grave prognosis. Mycotic aneurysms secondary to infective endocarditis (IE) rarely occur in children. This communication describes a seven-year-old girl who presented with fever and neurological abnormalities. She was diagnosed to have a mycotic aneurysm secondary to IE. Digital subtraction angiography (DSA) confirmed the diagnosis, delineated anatomical details and later detected the complete resolution of the aneurysm following conservative management with intravenous antimicrobial agents.

Thyroiditis as a presenting feature of mumps.

Thyroiditis complicating mumps is rare and occurs 1 week after the parotitis. A 9-year-old boy with a history of contact with a case of mumps presented with thyroid swelling. Thyroid scan showed a diffusely reduced uptake. The aspiration cytology showed lymphocytic thyroiditis. Thyroid function tests were normal and antithyroid antibodies were absent. Parotitis occurred 12 days after the onset of thyroiditis.

Selective testosterone secreting adrenocortical carcinoma in an infant

Adrenocortical carcinoma in children is a rare tumor of adrenal gland. An infant presented with signs of virilization due to selective testosterone hypersecretion. Diagnosis was established with the help of the computerized tomographic scan and histopathological examination. Following adrenalectomy patient made uneventful recovery and six months later does not have any clinical or laboratory evidence of recurrence or metastasis.

Paracetamol induced angioedema

anemia in adults: Incidence and treatment. J Natl Cancer Inst 1999;91:1616-34. 2. Ludwig H, Van Belle S, Barrett-Lee P, Birgegård G, Bokemeyer C, Gascón P, et al. The European Cancer Anemia Survey (EACS): A large, multinational prospective survey deÞ ning the prevalence, incidence and treatment of anemia in cancer patients. Eur J Cancer 2004;40: 2293-306. 3. Harrison L, Shasha D, Shiaova L, White C, Ramdeen B, Portenoy R. Prevalence of anemia in cancer patients undergoing radiation therapy. Semin Oncol 2001;28:54-9. 4. Guardiola E, Morschhauser F, Zambrowski JJ, Antoine EC. Management of anaemia in patient with cancer: Results of the F-ACT study (French Anaemia Cancer Treatment). Bull Cancer 2007;94:907-14. 5. Seshadri T, Prince HM, Bell DR, Coughlin PB, James PP, Richardson GE, et al. The Australian cancer anemia survey: A snapshot of anemia in adult patients with cancer. Med J Aust 2005;182:453-7. 6. Kitano T, Tada H, Nishimura T, Teramukai S, Kanai M, Nishimura T, et al. Prevalence and incidence of anemia in Japanese cancer patients receiving outpatient chemotherapy. Int J Hematol 2007;86:3741. 7. Bernardo G, Aglietta M, Amadori D, Beccaglia P, Belli G, Bianco R, et al. Prevalence of anemia in oncologic patients treated with chemotherapy: Italian survey at the national level. Recenti Prog Med 2001;92:580-8.

Congenital factor VII deficiency.

A 1 1/2-month-old baby with seizures, lethargy and refusal of feeds was diagnosed to have intracranial hemorrhage due to factor VII deficiency. MRI also demonstrated the unusual presence of a hemorrhagic infarct. The case underscores the importance of carrying out neuroimaging and appropriate hematological studies even in the absence of obvious external bleeding. Hypothesis for increased propensity for intra-cranial hemorrhage is discussed.

Neonatal Bartter syndrome.

A case of neonatal Bartter syndrome is reported. The baby born pre-term following a pregnancy complicated by polyhydramnios, presented at 7 months of age with failure to thrive, gastroenteritis and facial dysmorphisms. An unusual feature was the absence of the classical biochemical abnormality of hypochloremic alkalosis early in the course of the disease. Metabolic acidosis was the initial manifestation at 5 weeks of age. Awareness of this presentation is important to avoid delay in diagnosis and treatment.

Measles encephalitis: a report of two cases with variable manifestations.

Measles has always been considered as a disease associated with significant morbidity and mortality in children of the developing world. The high load of illness has been linked to infectious complications and malnutrition. The success of the immunization program has led to a decrease in the incidence of measles but of late, there have been reports of the program degrading, at least from some parts of the developing world.1 This is a concerning issue. Encephalomyelitis and encephalitis are two of the most devastating complications following measles. The latter is rarer than the first. Encephalitis usually occurs in children with measles modified by gamma globulin or occasionally in measles modified by live attenuated measles vaccine.2 Two cases of measles encephalitis are presented here that have occurred without modifying factors with unique atypical clinical and imaging manifestations, which have not been reported previously.

Importance of healthcare-seeking behavior of parents in response to childhood seizures.

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