Sadhna Lal

Co-infection of Sarcina and Giardia in a child

We present a case of 3-year-old boy who presented with vomiting and chronic diarrhoea, and the duodenal biopsy showed the presence of both Giardia and Sarcina. The clinical and pathological significance of Sarcina remains unknown in human beings and its co-existence with Giardia has not been reported.

An autopsy case of infantile GM1 gangliosidosis with adrenal calcification

We describe an autopsy case of a 1-year-old male baby presenting with failure to gain milestones, floppiness, and reddish skin lesions since birth. Fundoscopic examination revealed bilateral cherry-red spots in the macula. The baby died of respiratory failure and autopsy revealed numerous ballooned neurons and astrocytes with cytoplasmic storage material seen throughout central white matter, basal ganglia, cerebellum, choroid plexus, and brain stem. There was neuronal degeneration with loss of myelin in central white matter with axonal degeneration as well. The storage material was weakly positive with PAS and oil red-O stains. Ultrastructurally, multilayered lamellated bodies were seen within the ballooned neurons. Biochemical analysis of lysosomal enzymes done in leucocytes revealed β-galactosidase deficiency that is consistent with GM1 gangliosidosis. Extensive visceral deposition of similar material was also seen. Remarkably, both adrenals revealed extensive medullary calcification, which has not been reported in this lysosomal storage disorder, to the best of our knowledge.

Gastrointestinal fistulization in amebic liver abscess

BackgroundLiver abscess is a common deep seated abscess in children; amebic liver abscess is associated with more local complications.Case characteristicsWe report two preschool children presenting with short history of pain, fever and right upper quadrant pain. The abscess communicated with gastro-intestinal tract (ascending colon in case 1 and duodenum in case 2), and diagnosis of amebic liver abscess was confirmed by DNA PCR.OutcomeBoth children were successfully managed with intravenous antibiotics and catheter drainage.MessageGastrointestinal fistulization may be rarely seen in amebic liver abscess. Conservative management with antibiotics, catheter drainage and supportive care may suffice.

Kawasaki Disease Masquerading as Jaundice

While the myriad manifestations of Kawasaki disease are increasingly being recognized, there are still many instances where this diagnosis can come as a surprise to the clinician. The authors report one such child who appeared to have acute infective hepatitis at presentation but went on to develop the full clinical picture of Kawasaki disease. This is a rarely reported presentation of Kawasaki disease.

Bertiella studeri Infection—A Rare Cause of Chronic Abdominal Pain in a Child from North India

Bertiella is a common parasite seen in non-human primates. It is rarely seen in humans. We present the case of a 2-year-old child with bertiellosis. He had recurrent abdominal pain, and worm fragments were found in stool, which were refractory to albendazole therapy.

Incomplete functional and morphological recovery after acute and acute recurrent pancreatitis in children: Acute and acute recurrent pancreatitis

There is lack of data on functional and morphological recovery after an attack of acute pancreatitis (AP) or acute recurrent pancreatitis (ARP) in children. This study aims to evaluate the functional impairment and morphological changes in the pancreas after recovery.