Early entrapment of fourth ventricle following Pseudomonas meningitis in extreme prematurity: Case report

2020 ◽  
Vol 13 (4) ◽  
pp. 581-586
Author(s):  
P.E. Edison ◽  
S.K. Sanamandra ◽  
V.A. Shah ◽  
V.R. Baral ◽  
C.L. Yeo
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Fourth Ventricle ◽  
Pediatric Population ◽  
Prior History ◽  
Extreme Prematurity ◽  
Early Course ◽  
History Of ◽  
Perinatally Acquired ◽  
Trapped Fourth Ventricle ◽  
Neuro Imaging

Trapped fourth ventricle (TFV) as a complication of post-hemorrhagic hydrocephalus (PHH) is widely reported in the pediatric population with a prior history of ventriculo-peritoneal (VP) shunt placement. Characterized by disproportionate dilatation of the fourth ventricle on serial neuro-imaging, it is rarely encountered in the early course of preterm infants and the differentiating clinical features are subtle and non-specific. Clinical alertness and sonographic correlation hold the key to early diagnosis. We report an early emergence of TFV in an extremely low gestational age newborn (ELGAN) following fulminant Pseudomonas aeruginosa meningitis, approach to management, and the neurological outcome. Fourth ventricle entrapment as a complication of perinatally acquired Pseudomonas aeruginosa meningitis in a surviving ELGAN is extremely rare.

scholarly journals ECG Changes in 8-Year-Old Boy with Pulmonary Edema after Head Injury

2006 ◽  
Vol 6 ◽  
pp. 571-576 ◽  
Author(s):  
Bojko Bjelakovic ◽  
Vladislav Vukomanovic ◽  
Ljiljana Saranac ◽  
Ivan Stefanovic
Keyword(s):  
Pulmonary Edema ◽  
Pediatric Population ◽  
Skull Fracture ◽  
Experimental Studies ◽  
Creatine Kinase Activity ◽  
Prior History ◽  
Neurogenic Pulmonary Edema ◽  
Ecg Changes ◽  
History Of ◽  
Biochemical Evaluation

This is a case story of an 8-year-old boy with no prior history of cardiac disease who developed acute pulmonary edema with ECG changes similar to transmural myocardial infarction after basilar skull fracture. Biochemical evaluation showed elevated total creatine kinase activity –1,350 U/L with 12% MB isoenzyme fraction. The brain scan on admission showed cerebral edema with ethmoidal sinuses hemorrhage. Neurogenic pulmonary edema following CNS damage is an extremely rare entity in the pediatric population and there are few reports. There are many proposed mechanisms and explanations of its origin. Based on previous reports and experimental studies, the cause of “neurogenic” pulmonary edema may be of cardiac as well as of noncardiac origin.

scholarly journals Tracheal pseudomembrane secondary to aspiration pneumonia in a 6-year-old Ragdoll

2020 ◽  
Vol 6 (2) ◽  
pp. 205511692095997
Author(s):  
Hannah Kwong ◽  
Darren Fry ◽  
Gemma Birnie
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bronchoalveolar Lavage ◽  
Endotracheal Intubation ◽  
Aspiration Pneumonia ◽  
Complete Blood Count ◽  
Clinical Signs ◽  
Abdominal Ultrasound ◽  
Prior History ◽  
Gentle Traction ◽  
History Of

Case summary A 6-year-old female spayed Ragdoll presented with a 4-day history of acute onset non-productive retching, coughing and anorexia. A complete blood count, serum biochemistry, thoracic radiography and abdominal ultrasound were performed. Initially, aspiration pneumonia was suspected owing to an alveolar lung pattern in the right cranial ventral lung lobes seen on radiographs. The cat did not improve with empirical antibiotic therapy. Bronchoscopy and bronchoalveolar lavage were performed. An intraluminal tracheal mass was identified and removed via endoscopic guidance and gentle traction. Histopathology results were consistent with a fibrinous tracheal pseudomembrane. The cat was concurrently diagnosed with Pseudomonas aeruginosa pneumonia, which was confirmed on bronchoalveolar lavage. Pseudomonas aeruginosa was also cultured within the pseudomembrane. The cat was received antimicrobial therapy for his Pseudomonas pneumonia. In humans, fibrinous tracheal pseudomembranes occur uncommonly as a complication following endotracheal intubation and rarely due to infectious organisms. As there was no prior history of endotracheal intubation, the development of fibrinous tracheal pseudomembrane in this cat was suspected to be secondary to Pseudonomas aeruginosa aspiration pneumonia. Relevance and novel information The present case report is the first to describe a tracheal pseudomembrane in a cat. Bronchoscopy-guided gentle traction and subsequent removal of the tracheal pseudomembrane resulted in a complete resolution of the clinical signs.

scholarly journals Respiratory Presentation of Pediatric Patients in the 2014 Enterovirus D68 Outbreak

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Georgina Martin ◽  
Rachel Li ◽  
Victoria E. Cook ◽  
Matthew Carwana ◽  
Peter Tilley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Hospital Admissions ◽  
Pediatric Population ◽  
Retrospective Chart Review ◽  
Respiratory Illness ◽  
Prior History ◽  
Medical Comorbidities ◽  
History Of ◽  
Enterovirus D68

Background. In the fall of 2014, a North American outbreak of enterovirus D68 resulted in a significant number of pediatric hospital admissions for respiratory illness throughout North America. This study characterized the clinical presentation and risk factors for a severe clinical course in children admitted to British Columbia Children’s Hospital during the 2014 outbreak.Methods. Retrospective chart review of patients with confirmed EV-D68 infection admitted to BCCH with respiratory symptoms in the fall of 2014. Past medical history, clinical presentation, management, and course in hospital was collected and analyzed using descriptive statistics. Comparison was made between those that did and did not require ICU admission to identify risk factors.Results. Thirty-four patients were included (median age 7.5 years). Fifty-three percent of children had a prior history of wheeze, 32% had other preexisting medical comorbidities, and 15% were previously healthy. Ten children (29%) were admitted to the pediatric intensive care unit. The presence of complex medical conditions (excluding wheezing) (P=0.03) and copathogens was associated with PICU admission (P=0.02).Conclusions. EV-D68 infection resulted in severe, prolonged presentations of asthma-like illness in the hospitalized pediatric population. Patients with a prior history of wheeze and preexisting medical comorbidities appear to be most severely affected, but the virus can also cause wheezing in previously well children.

scholarly journals Resolution of precocious puberty following resection of fourth ventricular medulloblastoma: case report

2015 ◽  
Vol 16 (3) ◽  
pp. 287-290 ◽  
Author(s):  
Renata G. Medina ◽  
David P. Dempsher ◽  
Karen M. Gauvain ◽  
Thomas J. Geller ◽  
Samer K. Elbabaa
Keyword(s):  
Posterior Fossa ◽  
Precocious Puberty ◽  
Fourth Ventricle ◽  
Laboratory Tests ◽  
Obstructive Hydrocephalus ◽  
Prior History ◽  
Neurosurgical Department ◽  
Blood Samples ◽  
Inferior Surface ◽  
History Of

Medulloblastoma is a malignant embryonal tumor that arises in the cerebellum and invades the fourth ventricle, often resulting in obstructive hydrocephalus. Patients typically present with symptoms related to increased intracranial pressure and cerebellar dysfunction. The authors report a rare case of classic medulloblastoma with central precocious puberty (CPP) as its only presenting symptom. A 7-year-old boy with no prior history of medulloblastoma presented with Tanner Stage IV testicular enlargement and a 4-month history of acne and pubic hair. Laboratory tests of blood samples demonstrated highly elevated luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. Admission MRI of the brain revealed a mass in the posterior fossa, which bordered and compressed the fourth ventricle. The patient also exhibited mild lateral and third ventriculomegaly. Surgical options were discussed with the neurosurgical department. A suboccipital craniotomy and C-1 laminectomy were performed. A large mass was seen arising from the inferior surface of the vermis, and lying within the fourth ventricle. Gross-total microsurgical resection of the mass was performed. Histopathological investigation characterized the tumor as classic medulloblastoma. Follow-up laboratory tests of blood samples demonstrated a reduction of LH, FSH, and testosterone back to prepubertal levels. The patient then began radiation and chemotherapy. This report demonstrates that mild obstructive hydrocephalus due to a posterior fossa tumor may present with unexpected symptoms, such as CPP. To the authors’ knowledge, precocious puberty has not yet been associated with medulloblastoma, although it has been found with other posterior fossa tumors. Extensive imaging of the CNS for patients presenting with CPP is recommended.

scholarly journals Peritoneal Inclusion Cysts in Female Children: Pathogenesis, Treatment, and Multimodality Imaging Review

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Rachelle Goldfisher ◽  
Divya Awal ◽  
John Amodio
Keyword(s):  
Multimodality Imaging ◽  
Pediatric Population ◽  
Treatment Options ◽  
Adolescent Females ◽  
Cystic Mass ◽  
Prior History ◽  
Imaging Findings ◽  
History Of Surgery ◽  
Multiple Modalities ◽  
History Of

We report the multimodality imaging findings of peritoneal inclusion cysts in two adolescent females each with a prior history of abdominal surgery. The few reports of peritoneal inclusion cysts in the pediatric population have largely focused on the clinical and pathological features of this entity. We wish to emphasize the imaging findings of peritoneal inclusion cysts on multiple modalities, the advantage of MRI in confirming the diagnosis, and the need to keep considering this diagnosis in patients who present with a pelvic cystic mass, with a history of surgery, even if remote. Additionally, we review the pathology, pathophysiology, differential diagnosis, and treatment options of peritoneal inclusion cysts.

High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

2019 ◽  
Vol 16 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Jiann-Der Lee ◽  
Ya-Han Hu ◽  
Meng Lee ◽  
Yen-Chu Huang ◽  
Ya-Wen Kuo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Prior History ◽  
Multivariate Logistic Regression ◽  
Cart Analysis ◽  
Younger Age ◽  
History Of ◽  
One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

Dysbaric osteonecrosis associated with decompression sickness in a fishing diver

2019 ◽  
pp. 217-220
Author(s):  
Eduardo Briceño-Souza ◽  
◽  
Nina Méndez-Domínguez ◽  
Ricardo j Cárdenas-Dajda ◽  
Walter Chin ◽  
...  
Keyword(s):  
Femoral Head ◽  
Decompression Sickness ◽  
Small Scale ◽  
Prior History ◽  
Radiological Findings ◽  
Small Scale Fisheries ◽  
Left Limb ◽  
History Of ◽  
Decompression Stress ◽  
Probable Diagnosis

Diving as a method of fishing is used worldwide in small-scale fisheries. However, one of the main causes of morbidity and mortality among fishermen is decompression sickness (DCS). We report the case of a 46-year-old male fisherman diver who presented with chronic inguinal pain that radiated to the lower left limb. Living and working in a fishing port in Yucatan, he had a prior history of DCS. A diagnosis of avascular necrosis in the left femoral head secondary to DCS was made via analysis of clinical and radiological findings. The necrosis was surgically resolved by a total hip arthroplasty. Dysbaric osteonecrosis is a more probable diagnosis. In this region fishermen undergo significant decompression stress in their daily fishing efforts. Further studies regarding prevalence of dysbaric osteonecrosis among small-scale fisheries divers are needed. In a community where DCS is endemic and has become an epidemic, as of late, the perception of this health risk remains low. Furthermore, training and decompression technique are lacking among the fishing communities.

Role of Cervical Cytology in Surveillance after a Radical Trachelectomy in Patients with a Prior History of Cervical Cancer

2016 ◽  
Vol 143 (1) ◽  
pp. 204-205
Author(s):  
J.S. Shah ◽  
A.J. Brown ◽  
N.D. Fleming ◽  
A.M. Nick ◽  
P.T. Soliman ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Cytology ◽  
Prior History ◽  
Radical Trachelectomy ◽  
History Of
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