RESUMO
We report the case of a 15-year-old girl who presented with a history of recurrent bitemporal headaches for the last 2 months. In the prior few days, she complained of neck pain, emesis, phonophobia and photophobia, but no fever. Additional symptoms included polydipsia, polyuria and weight gain in the last year. Magnetic resonance imaging (MRI) of the brain demonstrated a cystic sellar and suprasellar mass with peripheral enhancement. Cerebrospinal fluid studies showed pleocytosis. Serum hormone levels were consistent with panhypopituitarism. Transnasal sphenoidotomy was performed, and 2 mL of purulent material was drained, confirming the diagnosis of pituitary abscess. The patient completed 6 weeks of parenteral antibiotics. She improved but continued to require home hormonal replacement therapy. A repeated MRI 3 months later showed abscess resolution. In addition to tumors, pituitary abscess should be considered in children who present with headache and panhypopituitarism, particularly in those who present with signs of meningeal inflammation. Prolonged parenteral antibiotics and surgical drainage are effective.
Assuntos
Abscesso Encefálico/diagnóstico , Doenças da Hipófise/diagnóstico , Adolescente , Abscesso Encefálico/microbiologia , Abscesso Encefálico/terapia , Infecções por Corynebacterium/complicações , Infecções por Corynebacterium/diagnóstico , Infecções por Corynebacterium/tratamento farmacológico , Feminino , Humanos , Imageamento por Ressonância Magnética , Doenças da Hipófise/microbiologia , Doenças da Hipófise/terapia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Estreptococos Viridans/isolamento & purificaçãoAssuntos
Dermatomicoses/diagnóstico , Fusariose/diagnóstico , Fusarium/isolamento & purificação , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/diagnóstico , Úlcera Cutânea/diagnóstico , Úlcera Cutânea/patologia , Adolescente , Dermatomicoses/etiologia , Dermatomicoses/patologia , Fusariose/etiologia , Fusariose/patologia , Humanos , Joelho/patologia , Leucemia Mieloide Aguda/patologia , Masculino , Necrose/patologia , Úlcera Cutânea/etiologiaRESUMO
A preterm neonate was noted to have diffuse blanching erythema around the mouth followed by appearance of bullous lesions on the upper back, lower neck and right scapular areas at 23 h of life. The bullae subsequently ruptured leaving an extremely tender, erythematous, denuded area of the skin, which extended over next few hours to involve most of the upper back and right shoulder regions. Nikolsky sign was positive. Clinical diagnosis of staphylococcal scalded skin syndrome was made. The throat, blood, urine and cerebrospinal fluid cultures did not yield any growth, but wound culture was positive for Staphylococcus aureus. Treatment included administration of intravenous fluids and vancomycin for 10 days. The wound area was covered with vaseline and sterile gauge dressings. On day 5 of life, epithelialisation began and was complete on the seventh day of life. She was discharged home with intact skin, without scars, on day 12 of life.
