RESUMO
This case report presents a 4 year-old-female patient with a neck mass who was diagnosed with an infected fourth branchial cleft cyst with left thyroid lobe involvement through fistulation. The case emphasizes the importance of considering uncommon etiologies, such as congenital anomalies, as a differential diagnosis when evaluating pediatric neck masses. The patient was prescribed broad-spectrum antibiotics, which led to the regression of the mass and inflammatory signs. Close follow-up in endocrinology and otorhinolaryngology appointments was maintained, and after 7 months, hypoplasia of the left lobe was observed. Thyroid function was reevaluated, and after two years, no recurrences were noted. The case highlights the significance of a comprehensive examination and assessment of corresponding clinical features, which can significantly reduce the rate of misdiagnoses and achieve an individualized diagnosis.
RESUMO
Immune thrombocytopenia (ITP) is an immune-mediated event, characterised by the destruction of platelets by autoantibodies resulting in isolated thrombocytopaenia (platelets <100 x109/L). In children, most cases are preceded by a viral infection. Cases of ITP in the setting of SARS-CoV-2 infection have been described. We describe a previously healthy boy, who presented with an extensive frontal and periorbital haematoma, petechial rash on the trunk and coryza. He had suffered a minor head trauma, 9 days before admission. Blood tests revealed a platelet count of 8000/µL. The remainder study was unremarkable, except for a positive SARS-CoV-2 PCR. Treatment comprised a single dose of intravenous immunoglobulin, with increase in platelet count and no recurrence. We made a working diagnosis of an ITP concurrent with a SARS-CoV-2 infection. Although few cases have been described, SARS-CoV-2 might be considered as a trigger for ITP.