ABSTRACT
Acute ethmoiditis is a rare infection of ethmoidal cells. The pathognomonic sign is an edema of the internal corner of the eye. Imaging may be necessary to verify the absence of orbital or endocranial complications. Thrombophlebitis of the cavernous sinus is a serious complication of this infectious process. We report the case of an 11-year-old boy who presented with ethmoiditis complicated with thrombophlebitis of the cavernous sinus, with right hemiplegia and left Bell palsy sequelae. Early diagnosis of this disorder and urgent therapy are essential. Treatment is based on the antibiotic therapy.
Subject(s)
Cavernous Sinus Thrombosis/etiology , Ethmoid Sinusitis/complications , Methicillin-Resistant Staphylococcus aureus , Staphylococcal Infections/complications , Acute Disease , Cavernous Sinus/pathology , Cavernous Sinus Thrombosis/diagnosis , Cavernous Sinus Thrombosis/drug therapy , Combined Modality Therapy , Drug Therapy, Combination , Early Diagnosis , Ethmoid Sinus/pathology , Ethmoid Sinusitis/diagnosis , Ethmoid Sinusitis/drug therapy , Facial Paralysis/diagnosis , Facial Paralysis/etiology , Hemiplegia/diagnosis , Hemiplegia/etiology , Humans , Magnetic Resonance Imaging , Physical Therapy Modalities , Rifampin/therapeutic use , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Tomography, X-Ray Computed , Vancomycin/therapeutic useABSTRACT
Hemolytic and uremic syndrome (HUS) is a classical form of thrombotic microangiopathies characterized by the association of hemolytic anemia with schizocytes, thrombocytopenia, and acute renal failure. Two forms of HUS have been described: the typical form that occurs after ingestion of a strain of bacteria, usually Escherichia coli types, which expresses verotoxin (also called shiga-like toxin), typically followed by bloody diarrhea, and atypical HUS, which is rare during childhood and can also be revealed by bloody diarrhea. We report a case of a 25-month-old infant who presented with hematuria and pallor after an episode of diarrhea. Biological tests revealed anemia, thrombocytopenia, and renal failure. The diagnosis of typical HUS was made, but the causal microorganism was not identified. Progression was favorable within 5 days of plasma transfusions. Two months later, the patient presented with the same symptoms and neurological impairment without any diarrhea. Von Willebrand factor-cleaving protease activity (ADAMTS 13) was low. Therefore, the diagnosis of atypical HUS by severe deficiency of ADAMTS 13 was suggested. The treatment was based on plasma transfusions resulting in remission. Atypical HUS associated with severe ADAMTS 13 deficiency rarely occurs in childhood. The prognosis, usually threatening, has been completely transformed thanks to a better understanding of the pathogenesis and to therapeutic progress.
Subject(s)
ADAM Proteins/deficiency , Hemolytic-Uremic Syndrome/complications , von Willebrand Factor/metabolism , ADAMTS13 Protein , Acute Kidney Injury/etiology , Atypical Hemolytic Uremic Syndrome , Blood Transfusion , Child, Preschool , Follow-Up Studies , Hemolytic-Uremic Syndrome/therapy , Humans , Male , Plasma , Recurrence , Remission Induction , Retreatment , Treatment OutcomeABSTRACT
Hypoplasia of the carotid arteries is a rare congenital anomaly which, when symptomatic, presents as cerebral ischemia or hemorrhage. We report a case of hypoplasia of the carotid arteries revealed by cerebral ischemic stroke in an infant with hereditary spherocytosis. The diagnosis was confirmed by MR angiography. We describe this rare cause of stroke in children and the characteristics of its association with hereditary spherocytosis.
Subject(s)
Brain Ischemia/complications , Carotid Artery, Internal/abnormalities , Stroke/diagnosis , Stroke/etiology , Anemia, Hemolytic, Congenital/complications , Ankyrins/deficiency , Diagnosis, Differential , Female , Humans , Infant , Jaundice, Obstructive/complications , Magnetic Resonance Angiography , Severity of Illness Index , Spherocytosis, HereditaryABSTRACT
Glanzmann thrombasthenia (TG) is a congenital platelet function disorder characterized by frequent and occasionally severe bleeding events. Treatment is based on platelet transfusion at the time of bleeding. We report a case of GT revealed in the neonatal period, a severe hemorrhagic syndrome refractory to transfusions, treated at the age of 6 years. Activated recombinant factor VII (Novoseven) injections were necessary. The advantages of recombinant activated factor VII in GT patients with platelet antibodies and/or platelet transfusions refractoriness are discussed.
