MRI findings of metronidazole neurotoxicity in a pediatric patient with chronic diarrhea.

Neurotoxicity is a rare side effect of metronidazole therapy. Shown here are findings of metronidazole toxicity in a patient, who received chronic metronidazole as prophylaxis for pseudomembranous colitis following bowel resection as an infant. Findings depicted include increased T2 signal in the dentate nuclei and brainstem. Discontinuing the medication resulted in reversal of the findings.

MRI findings of hypomyelination in adenylosuccinate lyase deficiency.

Adenylosuccinate lyase deficiency is a rare genetic disorder with few reported cases in the United States. Magnetic resonance imaging findings in the brain include hypomyelination and low generalized parenchymal volume. Presented here is a case in a 3-month-old male who presented with hypotonia and seizures and was subsequently diagnosed with adenylosuccinate lyase deficiency. Given the rarity of this diagnosis, findings demonstrated in this case may prompt ordering physicians to broaden their approach to genetic testing in the setting of hypomyelination. Comparison is also made to more common hypomyelinating leukodystrophies.

Asymptomatic endophthalmitis following strabismus correction in a pediatric patient.

Endophthalmitis is most commonly seen in adults shortly after cataract surgery. It is rare in the pediatric population. Presented here is a case of endophthalmitis following strabismus repair in a 9-month-old patient with Trisomy 21. Leukocoria was observed 15 days after surgery, but the child did not exhibit symptoms of infection, and the ordering clinician requested an MRI of the brain and orbits to assess the possibility of retinoblastoma. This case highlights the importance of MRI in the evaluation of leukocoria and displays typical MRI findings of this infrequently-encountered condition in the pediatric population.