Suppurative complications following BCG vaccine in 2 Nepalese children.

Background: The Bacillus Calmette-Guérin (BCG) vaccine is one of the most common vaccines administered worldwide and awareness regarding its usual and adverse reactions is important. Local and systemic complications require accurate identification for timely therapy. We hereby report two patients with rare suppurative local complications of BCG. Case presentation: Case 1: A nine-month-old boy presented with swelling over the right deltoid for one month with low-grade fever and purulent discharge for two days. The active discharge occurred from the same site of previous BCG inoculation, the regression of which was achieved conservatively. Case 2: The second case was a 14-month-old boy who presented with a swelling over the lower part of the right axilla for one year, later diagnosed as a tuberculous lymph nodal abscess. Needle aspiration was done and anti-tubercular therapy was started based on positive Gene Xpert reports. Both the cases resolved completely without complications. Conclusion: Pharmacovigilance surveillance of BCG scar reactions and occurrence of suppurative complications should be known by clinicians for correct identification and management.

Pneumothorax in a Preterm Neonate: A Case Report.

A pneumothorax is an abnormal collection of air in the pleural space between the lung and chest wall. Although this condition commonly occurs in adults, it can also present as complication in neonates requiring assisted ventilation and has high morbidity and mortality. Chest tube placement and needle drainage are some common approaches in management. A late preterm infant born at 35+2 weeks of gestation was admitted in Neonatal Intensive Care Unit for the management of respiratory distress. He was kept on mechanical Continuous Positive Airway Pressure owing to worsening respiratory distress. Chest X-ray revealed pneumothorax that was successfully managed with venous catheter drainage on second intercostal space with underwater seal. He was discharge on 10th day of Neonatal Intensive Care Unit admission with stable vitals and normal breathing pattern.

Multiple Neonatal Teeth in a Preterm Neonate: A Case Report.

Prematurity and low birth weight are significantly associated with delayed dentition. Few cases of the eruption of a tooth immediately at or after birth in preterm neonates have been reported in the literature, although this is a rare presentation. The aetiology of this rare biological aberration is yet to be established but has been associated with hereditary predilection, nutritional factor, endocrine causes, infection, and some syndromes. Here, we present a case of a preterm male neonate at 28 weeks of gestation with very low birth weight and respiratory distress who presented with three neonatal teeth, two maxillary central incisors, and one mandibular central incisor and its subsequent management.

Diagnosis of Achondroplasia at Birth: A Case Report.

Autosomal dominant mutations in fibroblast growth factor receptor 3 cause achondroplasia, the most common form of dwarfism in humans. Achondroplasia is a genetic disorder causing rhizomelic shortening of limbs. Head is often large with prominent forehead causing vaginal delivery difficult. A twenty-one years old multipara mother gave birth to a baby with achondroplasia via spontaneous vaginal delivery with episiotomy without any complication. Achondroplasia, in this case, was diagnosed on the basis of antenatal ultrasonography finding, clinical features and radiological finding of the baby. He was admitted in the special baby care unit for observation and discharged on the next day as no complications were noted. Keywords: achondroplasia; dwarfism; ultrasonography.

Rare manifestations of Potter Sequence: A Case Report.

Potter sequence is a rare congenital malformation that primarily affects male fetuses and is characterized by pulmonary hypoplasia, skeletal malformation, and kidney abnormalities. The pressure of the uterine wall due to oligohydramnios leads to an unusual facial appearance, abnormal limbsor limbs in abnormal positions or contractures. The fetus generally dies soon after birth due to respiratory insufficiency. We presented a male baby of 35 wks gestation with birth weight 1200gms delivered by primi mother. She had severe oligohydramnios and virtually there was no liquor during birth. The baby had severe perinatal depression at birth requiring resuscitation. Multiple congenital anomalies like absence of left eye, congenital cataract on the right eye, right-sided choanal atresia, micrognathia, low set ears, beaked nose, bilateral clubbed foot with hip deformity were noted. After 2 hours of life,baby developed fast breathing and cyanosis and died due to respiratory failure.