Lymphomatoid granulomatosis with upper airway obstruction: a case report.

A case of lymphomatoid granulomatosis in a previously healthy 13-year-old Thai girl presenting with right sixth cranial nerve palsy and severe upper airway obstruction was reported. Cranial nerve palsy later disappeared spontaneously but the patient developed multiple pulmonary nodules and cavity leading to pulmonary insufficiency. Her course was complicated with septicemia which limited the use of corticosteroid and cytotoxic drugs. She finally expired with pseudomonas sepsis in addition to pulmonary and liver involvement. This is the first case of lymphomatoid granulomatosis in a child ever reported in Thailand. Lymphomatoid granulomatosis should be included in the differential diagnosis of upper airway obstruction with pulmonary nodules and cavity and multi-organ involvement in children.

Group A beta-hemolytic streptococcal type M11 sepsis and empyema: a case report.

A case of serious suppurative disease caused by GABHS in a previously well 2-month-old Thai female presenting with clinical features of sepsis and right pleural effusion was reported. Treatment was initially with cloxacillin and a right side intercostal drainage. When subsequent cultures of blood and pleural fluid grew GABHS; intravenous penicillin was substituted. She made an uneventful recovery. Typing of the GABHS revealed non typable T-antigen and M-protein 11 GABHS, although very sensitive to penicillin, can cause severe and rapidly progressive disease in a very young infant. This is the first case of GABHS type M11 causing pleural effusion and sepsis in an infant ever reported in Thailand. Epidemiologic study might be indicated if an epidemic should occur.

Afebrile pneumonia associated with chlamydial infection in infants less than 6 months of age: initial results of a three year prospective study.

During the year 1986-1988, 112 infants younger than 6 months of age with the diagnosis of afebrile pneumonia were studied at Chulalongkorn Hospital, Bangkok, Thailand. Thirty cases (26.78%) were caused by Chlamydia trachomatis. The clinical and laboratory findings which differed significantly from pneumonia caused by other organisms included longer duration of symptoms (greater than 1 week), younger age of onset (less than 12 weeks), history of conjunctivitis after birth, no wheezing detected, white blood cell count greater than or equal to 10,000 cells/microliters with eosinophilic count greater than or equal to 300 cells/microliters and reticulonodular infiltration on the chest x-ray.