ABSTRACT
Craniotomy is a common surgery used to expose the brain by removing a part of the bone from the skull. During surgery, bone flaps can be fixed by using variety of materials that can migrate in the long term. A 7-year-old boy presented several years after the craniotomy and subdural peritoneal (SP) shunt surgeries. It was decided to remove the shunt catheter, and during the diagnostic tests, we saw that a loosened titanium screw has migrated along the SP shunt catheter from the skull into the abdominal wall. To the best of our knowledge, this is the first case in the reported electronic literature for a pediatric patient with a subcutaneous migration of a screw along the shunt catheter.
ABSTRACT
A 6-year-old boy was referred to the paediatric infectious disease clinic with a 2-month history of enlarged, erythematous, painless cervical lymph nodes. He initially presented to his paediatrician with a painless lesion. At that time, he was treated empirically with clindamycin and azithromycin due to a history of cat exposure. Despite treatment, the lesion evolved into a non-healing linear ulcer with painless, ascending cervical lymphadenopathy. Serologies were negative for Bartonella henselae antibodies. Additional laboratory studies revealed eosinophilia and negative Toxoplasma gondii antibodies. After no improvement following a course of trimethoprim-sulfamethoxazole, further questioning revealed that the patient had fallen into a haystack 1 month before the initial cervical lesion. The patient's parents opted to treat the infection empirically for sporotrichosis with itraconazole rather than undergo lymph node biopsy. At the 2-week follow-up, his lymphadenopathy had resolved and had returned to baseline activity.
