Pyoderma Gangrenosum with Pure Red Cell Aplasia.

Pyoderma gangrenosum is an inflammatory condition of the skin commonly associated with inflammatory bowel disease and rheumatoid arthritis, but also associated with various hematological malignancies. We describe its association with pure red cell aplasia in a four year old boy who presented with progressive skin lesions, fever and pallor, and improved with corticosteroid therapy.

Serum ALT: LDH Ratio in Typhoid Fever and Acute Viral Hepatitis.

In 100 consecutive children aged below 18 years with confirmed typhoid fever, 29 had moderate hepatitis. Serum alanine amino transferase: lactate dehydrogenase (ALT: LDH) ratios of these 29 children at the time of hospitalization were compared with that of 29 children with acute viral hepatitis. The serum ALT: LDH ratio levels (expressed in multiples of upper limit of normal) was found to be less than 9 in typhoid hepatitis and more than 9 in acute viral hepatitis. Serum ALT: LDH ratio helps to differentiate typhoid hepatitis from acute viral hepatitis.

Pachyonychia congenita with unusual features.

Pachyonychia congenita is a rare hereditary disorder characterized by gross thickening of all finger and toenails. We report an infant who had clinical features consistent with pachyonychia congenita type II, with unusual features of microcephaly, seizures, electroencephalogram abnormalities, failure to thrive, and heterochromia iridis.

Tuberculous gluteal abscess in infancy.

Primary tuberculous gluteal abscess without bone involvement has not been reported in infancy. We report 3 infants with isolated tuberculous gluteal abscess who presented with gluteal swelling of 2 weeks, 1 month and 6 months duration, respectively. Tuberculin test was positive in all cases. Pus cultures from the gluteal abscess grew Mycobacterium tuberculosis in all 3 infants.

Tuberculosis associated hemophagocytic syndrome in infancy.

An infant presented with prolonged fever, generalized lymphadenopathy, splenohepatomegaly, anemia and seborrheic dermatitis. Investigations including bone marrow findings confirmed the diagnosis of hemo-phagocytic syndrome (HPS) and the infant succumbed. Liver biopsy features of epithelioid granuloma and positive AFB culture of gastric aspirate confirmed the diagnosis of tuberculosis (TB). This rare association of HPS and tuberculosis in infancy is reported.