RESUMO
Appendicitis is the most common cause for abdominal surgery in children. It is usually caused by Escherichia coli and Streptococcus species and is generally polymicrobial. However, Streptococcus pneumoniae is a rare cause of appendicitis. We report a rare case of pneumococcal appendicitis in a 7-year-old child with no underlying conditions, in association with E. coli and group F ß-hemolytic Streptococcus. The isolated pneumococcal strain was sensible to all tested antibiotics. The patient had a full recovery after surgery and antibiotics. This case emphasizes that S. pneumoniae can cause a variety of unusual infections like appendicitis, in patients with or without underlying conditions. Thus, even though being a rare entity, physicians should always be aware of S. pneumoniae as a possible causative agent.
RESUMO
MYCN protooncogene status was assessed for the first time in Morocco in peripheral neuroblastic tumors, including neuroblastoma, ganglioneuroblastoma, and ganglioneuroma. Correlations with age at diagnosis, stage, mitosis-karyorrhexis index, differentiation, and Shimada histology were evaluated. Thirty-six formalin-fixed, paraffin-embedded peripheral neuroblastic tumor tissue specimens collected between 2007 and 2010 from the Pathology Department were assessed for MYCN amplification using fluorescence in situ hybridization. MYCN amplification was found in 27.8% of cases. An association of MYCN amplification with unfavorable Shimada grading, higher mitosis-karyorrhexis index, and undifferentiated morphologic phenotype was found. We found no correlation with older age, advanced stage, or the presence of metastasis. Our results suggested that the presence of MYCN amplification is a strong biological indicator of a poor outcome and aggressive disease in neuroblastoma and nodular ganglioneuroblastoma.
