Pediatric Cerebral Venous Sinus Thrombosis: A Case Report.

Cerebral venous sinus thrombosis (CVST) in infants is a rare vascular disorder that presents with nonspecific symptoms leading to a delay in diagnosis and treatment. Thrombus formation in the cerebral sinuses prevents blood from draining out of the brain leading to local and systemic complications. Here, we present an 11-week-old patient who presented to the emergency department (ED) with three days of lethargy, multiple episodes of projectile emesis, increased fussiness, and downward gaze. A CT scan demonstrated intraventricular hemorrhage (IVH) with acute hydrocephalus. A CT venogram of the cranial vault with contrast showed a large intraluminal thrombus occupying the right transverse sinus and torcula with proximal extension into the left transverse sinus confirming the diagnosis of CVST.

A Rare Case of Community-Acquired Pneumonia Only Presenting With Diarrhea, Abdominal Pain, and Fever: A Case Report.

Legionnaires' disease is an atypical pneumonia caused by Legionella pneumophila (L. pneumophila) pneumonia that features slow onset, nonproductive cough, fatigue, headache, sore throat, myalgias, and malaise. It can be difficult to diagnose, as it presents with extrapulmonary symptoms, and delay in treatment can be fatal. Here, we present the case of a previously healthy 32-year-old Caucasian male with Legionnaires disease who only presented to the clinic with abdominal pain and diarrhea. The patient did not have any pulmonary symptoms at the initial presentation. This presentation did not fit the diagnostic tools available for Legionnaires' disease, including a validated clinical prediction rule, which ruled out L. pneumophila infection with a sensitivity of 97% and a negative predictive value of 99.4%. Due to the complaint of abdominal pain, a flat/upright abdominal X-ray was ordered, which includes a chest X-ray. Upon analyzing the chest X-ray, a right lower lobe consolidation was identified, prompting an L. pneumophila urinary test to be added to the lab orders. This case represents the difficulties in diagnosing Legionnaires' disease due to the diverse clinical complexities of presentations, which may solely involve abdominal complaints.