ABSTRACT
Neurotoxoplasmosis is a major cause of morbidity and mortality, especially in immunocompromised patients. Definitive diagnosis is invasive and difficult thereby requiring a therapeutic trial. We herein report a case of an 11-year-old boy who presented with a tuberculoma on computerized tomography (CT) brain and did not show any clinical improvement on anti-tuberculous drugs. Subsequently, reviewing the CT scans and with supportive serology, a diagnosis of neurotoxoplasmosis was considered. A trial of antitoxoplasmosis therapy was given to which the child fully responded in two weeks. Three weeks later, his magnetic resonance imaging showed complete resolution of the lesion. This report provides an insight into the significance of therapeutic trial in neurotoxoplasmosis.
Subject(s)
Brain Diseases/diagnostic imaging , HIV Infections/diagnosis , Toxoplasmosis, Cerebral/diagnostic imaging , Tuberculoma, Intracranial/diagnostic imaging , Antiprotozoal Agents/therapeutic use , Antiretroviral Therapy, Highly Active , Antitubercular Agents/therapeutic use , Brain Diseases/drug therapy , Diagnosis, Differential , HIV Infections/drug therapy , HIV-1 , Humans , Immunocompromised Host , Magnetic Resonance Imaging , Male , Tomography, X-Ray Computed , Toxoplasmosis, Cerebral/drug therapy , Toxoplasmosis, Cerebral/parasitology , Treatment Outcome , Tuberculoma, Intracranial/drug therapyABSTRACT
Glanzmann's thrombasthenia (GT) is an uncommon cause of bleeding in children. We diagnosed two siblings as having GT on the basis of flow cytometric studies. Both had cutaneous bleedings and epistaxis since early childhood. Hematological investigations revealed prolonged bleeding time and a normal platelet count. Both the patients had absence of aggregation of platelets with the agonist adenosine diphosphate. Absence of the GPIIb/IIIa receptor was confirmed by flow cytometry. A short review of the disorder is presented.
Subject(s)
Thrombasthenia/genetics , Child, Preschool , Diagnosis, Differential , Female , Flow Cytometry , Hemorrhagic Disorders/genetics , Humans , Male , Platelet Glycoprotein GPIIb-IIIa Complex/genetics , Thrombasthenia/diagnosisABSTRACT
Pulmonary arteriovenous malformations rarely present in childhood. Two cases are presented in this report. Both the cases presented clinically with cyanosis and clubbing without a cardiac murmur. The second case had cerebral abscess in addition. Both the cases underwent a contrast-enhanced echocardiography which suggested the presence of pulmonary arteriovenous malformations. The first case also underwent 99mTc radionuclide scan and pulmonary angiography. The cases are being reported for their characteristic clinical features and for emphasizing the role of non-invasive modalities like contrast-enhanced echocardiography and radionuclide scan in reaching the diagnosis.
Subject(s)
Arteriovenous Malformations/diagnosis , Arteriovenous Malformations/therapy , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Angiography , Arteriovenous Malformations/diagnostic imaging , Child , Child, Preschool , Echocardiography , Female , Humans , Pulmonary Artery/diagnostic imaging , Pulmonary Veins/diagnostic imagingABSTRACT
A case of parkinsonism is reported in a 5-years-old male child following prolonged use of chloroquine. The patient presented with reduced spontaneous movements and speech with an expressionless face and a parkinsonian gait but no tremors. His investigations including CT scan brain, CSF study and serum ceruloplasmin were normal. Chloroquine was discontinued and the patient was started on oral trihexyphenidyl. The patient showed gradual recovery and the drug was successfully withdrawn. The toxic manifestations were only transient and reversible.