unusual case of neonatal stridor

A 25-day baby neonate presented with fever and stridor. He had severe respiratory distress at admission. The systemic examination was unremarkable. The roentgenogram of soft tissues of neck revealed widening of superior mediastinum. Computed tomography of neck and upper chest revealed multiple abscesses in the retropharyngeal space, parapharyngeal space, and superior mediastinum. The child improved on aggressive antibiotic treatment protocol. It raises awareness among paediatricians to consider this diagnosis when confronting neonate with fever and stridor. An early diagnosis and aggressive appropriate management will reduce mortality and morbidity associated with this life-threatening condition. A thorough search for a primary source of infection should be done. Neonate should be screened for primary and secondary immunodeficiency disorders before discharge

Lichen scrofulosorum presenting as pyrexia of unknown origin

Cutaneous tuberculosis forms a subset of extra pulmonary tuberculosis. It accounts for about 1.5% of all the cases of extrapulmonary tuberculosis. Lichen Scrofulosorum is a rare form of cutaneous tuberculosis. It is usually seen in children or young adults and an important marker of occult tuberculosis. Usually, the eruption appears in children and adolescents with strong immune sensitivity to Mycobacterium tuberculosis and consists of tiny follicular papules. Underlying systemic involvement is more common in children, compared with adults. We report a case of 3 years old boy who was investigated for pyrexia of unknown origin and finally diagnosed as Lichen Scrofulosorum associated with tuberculous lymphadenitis of mediastinal lymph nodes. A skin biopsy showed extensive tuberculoid granulomas surrounding hair follicles which were consistent with the diagnosis of Lichen Scrofulosorum. The child was treated with antitubercular drugs and it showed improvement within 2 weeks of starting treatment with resolution of skin lesions