ABSTRACT
Buruli ulcer, caused by Mycobacterium ulcerans, is a chronic ulcerative skin disease, found predominantly in central and west Africa and Australia. A boy of 2.5 years of age from Angola was admitted to our hospital with severe kwashiokor and a large ulcer with undermined edges on the left side of the thorax. Further examination revealed anaemia, hypoproteinaemia, bacterial superinfection of the ulcer and intestinal parasites. Histological analysis showed acid-fast bacilli and histopathological changes typical of Buruli ulcer. M. ulcerans was detected by PCR and culture. The patient was treated by surgical excision of diseased skin, followed by split-skin grafting. He also received antibiotic therapy (ciprofloxacin, clarithromycin, rifabutin, and dapsone). After six months, the child was discharged from hospital in good condition. This is the first published case of Buruli ulcer from Angola.
Subject(s)
Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/therapy , Mycobacterium ulcerans/isolation & purification , Thorax , Angola , Child, Preschool , Humans , Male , Polymerase Chain ReactionABSTRACT
The clinical disease pattern of an "acute abdomen" is by no means rare in newborn and very young infants and always signals an emergency situation. Besides inflammatory causes, congenital anomalies are among the most prominent reasons responsible for this condition. The example of 3 own patients serves to illustrate the disease pattern of Hirschsprung's disease, which is discussed with special reference to neonatology.
Subject(s)
Hirschsprung Disease/diagnosis , Abdomen, Acute/etiology , Colonic Diseases/complications , Colonic Diseases/diagnosis , Colonic Diseases/surgery , Diagnosis, Differential , Female , Hirschsprung Disease/complications , Hirschsprung Disease/surgery , Humans , Ileostomy , Infant , Infant, Newborn , Intestinal Obstruction/complications , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Intestinal Perforation/complications , Intestinal Perforation/diagnosis , Intestinal Perforation/surgery , ReoperationABSTRACT
The most common surgical diseases in childhood that need a planned operation, are described--especially the indications and the timing of operation. Inguinal hernia, hydrocele, cryptorchism, umbilical hernia and phimosis are presented.
Subject(s)
Cryptorchidism/surgery , Hernia, Inguinal/surgery , Hernia, Umbilical/surgery , Phimosis/surgery , Testicular Hydrocele/surgery , Age Factors , Child, Preschool , Cryptorchidism/diagnosis , Female , Hernia, Inguinal/diagnosis , Hernia, Umbilical/diagnosis , Humans , Infant , Male , Phimosis/diagnosis , Recurrence , Testicular Hydrocele/diagnosisABSTRACT
A perforation of the stomach is relatively seldom during the newborn period and the first year of life. A wide spectrum of causes has to be considered. The prognosis is determined by prematurity, basic illnesses and combined injuries and essentially by the time of an operation. We report on a mature newborn. At the fourth day a stomach perforation was closed by an operation. A serious diffuse peritonitis and a partial suture insufficiency complicated the postoperative course and necessitated a four-weekly respirator therapy, complete parenteral nutrition for 30 days as well as chemotherapy for several weeks. Altogether a programmed peritoneal lavage has been carried out for 10 times. After 62 days the child could be discharged home in a good condition.
