1/6. Descending suppurative mediastinitis: nonsurgical approach to this unusual complication of retropharyngeal abscesses in childhood.OBJECTIVE: To alert the pediatric emergency physician about suppurative mediastinitis as an unusual, life-threatening complication of retropharyngeal abscesses in children and to report an alternative therapeutic option for these cases. methods: We describe a case of suppurative mediastinitis secondary to a retropharyngeal abscess in a 19-month-old girl and discuss the pathophysiology, diagnosis, and treatment of this disease. RESULTS: Prompt diagnosis, based on clinical, radiographic, and CT findings, followed by immediate retropharyngeal drainage and appropriate antibiotic therapy, allowed conservative management of the mediastinal abscess, without the need for surgery. The child presented a good outcome and was discharged on hospital day 14. CONCLUSIONS: When evaluating a retropharyngeal abscess, the pediatric emergency physician should be aware of its complications. A chest radiograph should be prescribed for each patient presenting with an indolent course. Widening of the mediastinum should be considered as strong evidence of a mediastinal abscess for which the best therapeutic option is aggressive surgical drainage. In the rare cases in which marked improvement is achieved after retropharyngeal drainage, a nonsurgical approach to the mediastinal abscess could be attempted. CT scan and a simple chest radiograph have proved to be useful for diagnosis and follow-up.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/6. Oral presentation of Kaposi's sarcoma in a patient without severe immunodeficiency.Primary oral Kaposi's sarcoma of the "traditional type" (non-African, non-acquired immunodeficiency syndrome, nonimmunosuppressed) is a rare disorder. Presentation of this disorder at this site has not been well documented in the surgical pathology literature. This report describes a primary oral Kaposi's sarcoma in an older man without evidence of the acquired immunodeficiency syndrome or overt immunosuppression; this sarcoma recurred three times before a correct diagnosis was made. The case illustrates the importance of including Kaposi's sarcoma in the differential diagnosis. The lesions can easily be confused with pyogenic granuloma if the physician is unaware that primary Kaposi's sarcoma can occur at this site.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/6. Pseudohypopyon--an unusual presenting sign in retinoblastoma.retinoblastoma is the most common intraocular malignancy of childhood. A case of pseudohypopyon as an unusual first sign of retinoblastoma is presented. More common clinical presentations and diagnosis of this disease are also discussed. As some cases of retinoblastoma can mimic non-malignant disease, it is important that the physician have a high index of suspicion for this tumour.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/6. Multiple pyogenic granuloma-like lesions following hair transplantation.Multiple pyogenic granuloma-like lesions occurring at punch graft sites are an unusual complication of hair transplantation heretofore unreported. While the etiology and pathogenesis of such lesions remain elusive, physicians performing hair transplantations should be aware of this potential sequela.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
5/6. Hemodialysis fistula infections caused by legionella pneumophila.legionella pneumophila was found in the infected hemodialysis fistulas of two patients. The first patient developed an infection of the fistula during acute illness with Legionnaires' pneumonia. Legionella organisms were shown to be present in the graft by direct immunofluorescent staining. The second patient developed an infection of the hemodialysis fistula 3 weeks after completing a course of erythromycin therapy for Legionnaires' pneumonia. Legionella organisms were found by direct immunofluorescence in purulent material that was obtained from the graft, and serogroup 1 L. pneumophila was isolated from the pus. The frequency with which the organism causes infection of hemodialysis access sites is unknown. Increased awareness by physicians that L. pneumophila produces extrapulmonary disease may result in more frequent detection of these infections.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
6/6. Pyogenic arthritis complicating varicella infection.arthritis has not previously been reported as a complication in adult patients with chickenpox. In pediatric patients, the arthritis that complicates chickenpox is most commonly aseptic but does rarely result from bacterial infection. We report the case of a 21-year-old man who developed acute monoarticular septic arthritis due to Lancefield Group A beta-hemolytic streptococci. Despite the more common viral cause of arthritis in pediatric patients, physicians should not attribute arthritis associated with varicella in adults to a viral cause without diagnostic arthrocentesis.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |