Myalgia Cruris Epidemica: an unusual presentation of dengue fever.

We describe a 5-year-old girl who had sudden onset difficulty in walking after 3 days of febrile illness. In the emergency department her creatine kinase level was elevated but urine myoglobin was normal. She was diagnosed as having benign acute childhood myositis. Because of poor oral intake and dehydration, she was admitted to the pediatric ward. The next day she had a petechial rash over the antecubital fossa, and dengue IgM back was positive. She was treated conservatively and recovered uneventfully. Despite dengue fever being endemic in Malaysia, this is the first case report of myositis following dengue infection in Malaysia.

Enfermedad de bornhold o mialgia epidémica / Bornhold disease or epidemic myalgia

Infección viral aguda de la musculatura de la pared torácica, de evolución fugaz (algunos días) y curación espontánea). Su importancia deriva de la necesidad de hacer la diferencia con otros cuadros causantes de dolores torácicos.

Dermatomiositis juvenil: un reto diagnóstico / Juvenile dermatomyositis: a challenge diagnoses

La Dermatomiositis Juvenil es una enfermedad inflamatoria y degenerativa del músculo estriado capaz de ocasionar errores diagnósticos y tratamientos inadecuados, debido a que su baja incidencia conduce a una falta de conocimiento entre los médicos. Presentamos un caso, ocurrido en el Hospital Privado Centro Médico de Caracas en Febrero de 1966, en un adolescente de 13 años con un cuadro clínico característico, pero con cifras alarmantes de creatininquinasa. La respuesta terapéutica fue excelente

Caracterización de 7 brotes de ciguatera / Characterization of 7 ciguatera outbreaks

Se estudiaron 64 pacientes con ciguatera de 7 brotes ocurridos en un período de 6 meses en 3 provincias de Cuba, con el objetivo de caracterizarlos desde el punto de vista clínico-epidemiológico. Los síntomas principales fueron gastrointestinales y neurológicos (diarrea y vómitos entre los primeros, y la artralgia y mialgia entre los segundos). Los síntomas cardiovasculares no estuvieron presentes. Las medianas de los períodos de incubación oscilaron entre 3 y 5 h. Las especies responsables fueron la picúa o barracuda (Sphyraena barracuda) en 3 brotes y el gallego o jurel (Caranx fallax) en 4. Seis brotes brotes ocurrieron en domicilios y uno en un acto deportivo militar. El predominio de los síntomas gastrointestinales y neurológicos, así como el período de fueron similares a los registrados en otras zonas endémicas. La región oriental de Cuba no está exenta de ciguatera

Varied manifestations of viral myocarditis.

Nine children in the age group of new born to 10 years were seen during the period October 1989 to January 1993 with varying manifestations of Myocarditis. This ranged from cardiogenic shock due to fulminant cardiac failure, recurrent wheezy episodes (mistakenly treated as bronchial asthma) bronchiolitis and rhythm disturbances. Clinical picture was collaborated by radiological evidence of cardiomegaly, ECG changes of low voltage QRS complexes with ST depression, T wave inversion or signs of left ventricular dilatation. SGOT, SGPT, CPK, LDH were elevated significantly in 7 cases. Echocardiographic changes ranged from left ventricular dilatation to global hypokinesia and mild mitral incompetence. Viral studies suggested infection with Coxsackie B1 in 4 cases, B4 in 2, B5 in 2 and Dengue 3 in 1 case. All the children recovered well with routine anti failure measures and treatment of arrhythmias and 2 children needed steroid therapy. At the end of follow up of 6 months to 1 year there has been complete reversal of ECHO changes to normal. Viral Myocarditis can manifest in varied ways in children and if treated adequately may lead to complete recovery.

Trichinosis: A recent outbreak in Northern Thailand.

During April, 1973, and outbreak of trichinosis occurred in Mae Sruay District, Chiang Rai Province, about 900 kilometers north of Bangkok, Thailand. Thirty-one persons were involved, of whom 27 (20 males, and 7 females), ranging in age from 9 to 72 years, were questioned. One adult female died before being brought to hospital. All subjects gave a history of having consumed raw pork in the form of "lahb" and "nahm", favourite dishes of the northern Thai. Beginning the third week after exposure, all developed fever and myalgia. Other less common complaints were diarrhoea and oedema of extremities and palpebral skin. Leucocytosis was revealed in 37% and 55% had eosinophilia exceeding 20%. Nineteen patients had hookworm and Opisthorchis infections. About 63% were skin test positive with Trichinella antigen. Eight patients were admitted to hospital; muscle biopsy was done on one serious case and trichina larvae were detected.