ABSTRACT
Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe post-infectious complication of SARSCoV- 2 that seems to occur most frequently two to six weeks after infection. MIS-C can present very similarly to Kawasaki's disease (KD) with symptoms such as a skin rash in addition to a prolonged fever. Here we present a case of a 12-year-old African American/Black female with incomplete KD presenting similarly to MIS-C. The patient presented with prolonged fever, eventually worsening to shock and cardiac dysfunction. We further review the similarities and differences between incomplete KD and MIS-C. Due to their similarities, it is important to keep these diagnoses on the differential when a child presents with a prolonged fever.
Subject(s)
COVID-19 , Mucocutaneous Lymph Node Syndrome , Systemic Inflammatory Response Syndrome , Humans , Female , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/complications , Child , Systemic Inflammatory Response Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/etiology , COVID-19/complications , COVID-19/diagnosis , Diagnosis, DifferentialABSTRACT
Acute cerebellitis (AC) is often a para-infectious inflammatory process that usually presents with a variable clinical picture; often with fever, nausea, headache, altered mental status, gait abnormalities, and coordination defects. It is usually a complication of an infectious process or as a result of post-infectious autoimmune mechanisms. We report a case of a 3 year old male with influenza A who presented with an acute encephalitic picture whose course and radiologic studies demonstrate cerebellar changes strongly compatible with AC.
Subject(s)
Cerebellar Diseases , Influenza, Human , Humans , Male , Influenza, Human/complications , Influenza, Human/diagnosis , Child, Preschool , Cerebellar Diseases/diagnosis , Magnetic Resonance Imaging , Encephalitis/diagnosisABSTRACT
Background: In recent years, self-tanners have become a well-liked alternative to sun tanning and tanning bed usage, as strikingly similar results can be achieved without the harmful side effects of ultraviolet exposure. Objective: The aim of this study is to investigate the presence and prevalence of potential allergens in the most popular self-tanning products. Methods: Five major retailers in the United States were evaluated, from which 17 different brands and 44 unique self-tanning products were analyzed. The ingredients in each self-tanning product were compared with 80 and 36 notable contact allergens taken from the North American Contact Dermatitis Group and Food and Drug Administration-approved T.R.U.E (Thin-Layer Rapid Use Epicutaneous Patch Test), respectively. Results: We found that contact allergens are frequently present in self-tanning products; allergens especially common are propylene glycol, linalool, polysorbate, d-limonene, benzyl alcohol, tocopherol (vitamin E), fragrances, and other scented botanicals. On average, each self-tanner we analyzed contained 11.86 allergens. Limitations: The limitation is that commercial names could not be eliminated from the analysis, introducing potential bias. Conclusion: While self-tanning products are a safer alternative to tanning bed use or sunbathing, consumers and clinicians alike must be aware that they may cause an allergic reaction of the skin for some users.
ABSTRACT
Background: Burkitt lymphoma (BL) is a common tumor of childhood that usually arises in the abdomen or pelvis in its sporadic form. In a minority of cases, BL can present with CNS involvement, usually as a secondary site. Rarely, BL can arise primarily in the epidural space and present with back pain, or less commonly, acute myelopathy. This presentation is a surgical emergency and requires vigilant management. Case Description: We describe a case of pediatric BL arising primarily within the epidural space and presenting with progressive difficulty walking in a 3-year-old boy. Progression to complete inability to walk, absent lower extremity deep tendon reflexes, and new urinary incontinence prompted MRI of the spine, which showed a lesion extending from T5 to T10 and wrapping around the anterior and posterior portions of the spine with evidence of spinal cord compression. The patient underwent decompressive laminectomies from T5 to T10 and partial debulking of the posterior portions of the tumor. Microscopic examination showed a prominent "starry sky" pattern with abundant mitotic figures. Immunohistochemistry confirmed the diagnosis of BL. The patient is 10 months post-op and continues to undergo chemotherapy with partial neurologic improvement. He was free of recurrence 10 months post-operative. Conclusion: This appears to be the youngest described patient presenting with acute myelopathy in primary paraspinal BL. Management should include surgical decompression of the spinal cord followed by one of the various described chemotherapeutic regimens. Preoperative staging and neurologic function correlate with prognosis.
