RESUMO
We found substantial dysplasia of fingernails and toenails in each of four siblings demonstrating other features consistent with a diagnosis of fetal alcohol syndrome (FAS). This aspect of examination is frequently overlooked in routine physical assessments. All four affected teenagers of this heteropaternal sibship demonstrated common features of FAS, including moderate mental retardation, maxillary hypoplasia, an elongated philtrum, and narrow palpebral fissures, as well as absence or dysplasia of two or more nails. Although nail hypoplasia has been previously reported as a minor finding in FAS, a literature review confirmed that nail dysplasia is found in more than 20% of individuals with FAS.
Assuntos
Transtornos do Espectro Alcoólico Fetal/genética , Unhas Malformadas/genética , Adolescente , Face/anormalidades , Feminino , Transtornos do Espectro Alcoólico Fetal/complicações , Humanos , Deficiência Intelectual/complicações , Masculino , Unhas Malformadas/complicações , GravidezRESUMO
Endocarditis in a 2-year-old child was caused by a penicillin-resistant Streptococcus constellatus. Viridans streptococci in general and those associated with endocarditis in particular are usually believed to be penicillin sensitive. Although the patient did not receive prophylactic antibiotics, the child had recently been treated with an oral penicillin. Penicillin-resistant viridans streptococci are usually sensitive to the synergistic effects of penicillin and an aminoglycoside, but this organism was not. Clindamycin was ultimately shown to demonstrate admirable bactericidal activity against this patient's S constellatus.
