ABSTRACT
This report describes a case in which diplopia was developed as a finding of postinfectious anti- N -methyl- d -aspartate receptor encephalitis. Infectious encephalitis, especially herpes simplex virus, is essential as it is one of the triggers of autoimmune encephalitis. Even if the cases present unexpected clinical findings, we should be vigilant in terms of autoimmune processes, such as diplopia seen in our case.
Subject(s)
Anti-N-Methyl-D-Aspartate Receptor Encephalitis , Encephalitis, Herpes Simplex , Herpesvirus 1, Human , Humans , Autoimmunity , Encephalitis, Herpes Simplex/complications , Encephalitis, Herpes Simplex/diagnosis , Diplopia/diagnosis , Diplopia/etiology , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/complications , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/diagnosisABSTRACT
Since the COVID-19 pandemic began, various severe acute respiratory syndrome coronavirus 2 variants have been identified with different characteristics than the nonvariant strain. We retrospectively evaluated the demographic and clinical differences in the cohort of hospitalized COVID-19 children (1 month-18 years old) between March 11, 2020, and September 31, 2022, by the time the variants identified in our country predominate. Bonferroni post hoc analysis was performed to compare the differences between the periods. Of the 283 children in this study, 142 (50.2%) were females. The median age was 36 (interquartile range [IQR]: 7-132) months. Sixty-three (22.2%) patients were hospitalized in the nonvariant period, 24 (8.5%) in the Alpha period, 93 (32.9%) in the Delta period, and 103 (36.4%) in the Omicron period. Fever was the most common symptom in all groups, with no statistically significant differences (p = 0.25). In the Omicron period, respiratory and gastrointestinal symptoms decreased, and neurological symptoms increased significantly compared to other periods: [respiratory symptoms; nonvariant (65.1%) vs. Omicron (41.7%), (p = 0.024)], [gastrointestinal symptoms; Delta (41.9%) vs. Omicron (22.3%), (p = 0.018), [neurological symptoms; Delta (14.5%) vs. Omicron (31.1%), (p = 0.03]. Altered mental status and seizures were more common during the Omicron period compared to the pre-Omicron (nonvariant, Alpha, and Delta) period (p = 0.017 and p = 0.005, respectively). Although the main symptoms in children with COVID-19 were fever and respiratory symptoms, an increase in severe neurological manifestations was seen throughout the Omicron variant period.
Subject(s)
COVID-19 , SARS-CoV-2 , Female , Humans , Child , Infant , Child, Preschool , Male , Pandemics , Retrospective Studies , FeverABSTRACT
Lyme disease is an illness caused by species of Borrelia spirochetes. Early diagnosis of lyme disease depends on the recognition of skin findings, which are seen in almost 80% of all cases. Erythema migrans is the most common skin lesion. Serologic tests can be used to support the clinical diagnosis. In this article, we report a six-year-old girl who was diagnosed as having early localized lyme disease, who presented with a rash on her right shoulder. The lesion was found consistent with erythema migrans. She had a history of tick bite seven days before the onset of the rash. Serologic test results were also consistent with lyme disease. Her skin lesion disappeared with cefuroxime treatment, and no additional symptoms or pathologic findings were observed on follow-up. Recognizing early signs is important for prompt diagnosis and treatment to prevent long-term complications because the diagnosis and treatment of late-stage lyme disease can be challenging.
