Acute lymphoblastic leukemia presenting as bilateral renal enlargement in a child

To report a case with early presentation of acute lymphoblastic leukemia [ALL] as bilateral renal masses and renal failure. Clinical Presentation and Intervention: A 6-year-old boy was admitted with bilaterally enlarged kidneys and severe renal impairment. Magnetic resonance imaging [MRI] showed bilateral renal enlargement with features suggestive of an infiltrative lesion. Accordingly, bone marrow examination was performed, and diagnosis of ALL was made. The patient developed acute renal failure after initiation of chemotherapy, so he received hemodialysis. His renal function normalized and kidney enlargement regressed. This case demonstrates an unusual early renal involvement in ALL in a child. MRI is a valuable imaging modality in the evaluation of renal masses

[Lung abscess revealing a congenital cystic adenomatoid lung malformation]

Congenital cystic adenomatoid lung malformations [CCAM] are, todays, more frequently diagnosed during the pregnancy thanks to progresses in ultrasonographic explorations. On occasion, CCAM may remain asymptomatic and be discovered after being complicated by infection. This was the case of our patient. Amani _ was delivered by spontaneous vaginal delivery at term after a well-controlled pregnancy. She had good staturo-ponderal and psychomotor developments. When she was eight-year-old, she was treated for right pneumonia. Three years later, she was admitted in a general pediatrie unit because of right lower lobe abscess. Thoracic computed tomography, indicated since the infection was recurrent in the same lobe and after the constatation of a persistent cystic feature on chest radiograph, revealed multiple cystic lesions compatible with CCAM. The anatomopathological study of the surgically removed lobe concludes for a cystic adenomatoid lung malformation type I. Cystic adenomatoid lung malformations are frequently revealed by recurrent infections in old children. Thoracic computed tomography is very interesting for the diagnosis when pneumonia relapses in the same site

[Canavan disease or n-acetyl aspartic aciduria [one case]]

Canavan's disease [CD] or N-Acetylaspartic aciduria, is an autosomal recessive leukodystrophy characterized by spongy degeneration of brain. The disease is an inborn error of metabolism caused by aspartoacylase deficiency resulting from accumulation of N- acetylaspartic acid in the brain. The authors report a case in a ten-month old boy who presented with developmental delay and megalencephaly noticeable afterfour months of age. Magnetic resonance imaging of the brain show diffuse white matter degeneration. The diagnosis of CD was confirmed by nuclear magnetic resonance spectroscopy and gas chromatography-mass spectrometry

[Cerebral peduncle hydatid cyst.]

The cerebral trunk localization of the hydatid cyst is exceptional. We report the case of a 3-year old girl who has a primary localization of the hydatid cyst on the level of cerebral [peduncle]. Our patient has been admitted with signs of intracranial hypertension. The initial CT scan reveals a triventricular hydrocephaly without an obvious [obstacle] and the magnetic resonance imaging showed a cystic lesion measuring 10 mm located in the mesencephale. This lesion obstructs the Sylvius's aqueduct hence, leading to the hydrocephaly. The patient has benefited from a ventriculo-peritoneal derivation. After 4 months she presented the same symptoms. the magnetic resonance imaging and the scan revealed a lesion measuring 36mm.the patient underwent a new operation and the diagnosis of intracranial hydatid cyst was confirmed with the histopathological examination. Our patient didn't have any other localization and her hydatid serology was negative, too

[Glucose transporteur type 1 deficiency: a mild form]

Glucose transporter type 1 deficiency is a rare but curable disease whose real frequency is probably under estimated. This defect is responsible df reduced glucose brain supply across the blood-brain barrier. We report a mild form of GLUT1 deficiency suspected in al 9 months old boy when low cerebrospinal fluid rate glucose had persisted several months after recovery from presumed viral meningitis. GLUT 1 deficiency should be evoked in any child with delayed milestones development or seizures of unclear cause. The sole effective treatment is based on ketogenic diet

[Listeria monocytogenes meningitis in immunocompetent children. [a case report]]

Introduction: Listeria monocytogenes is, increasingly, recognised as a cause of life-threatening disease mainly in immunocompromised persons, but it is an uncommon cause of bacterial meningitis beyond the newborn period in healthy subjects

Report: We present the case of a 10-year-old previously healthy child who was admitted at a general pediatric unit for high fever, impaired consciousness and intra cranial hypertension syndrome. Cerebrospinal fluid examination revealed 980 cells/mm3 in mixed formula [neutrophils = 50 per cent, lymphocytes = 50 per cent], decreased glycorrachia [1.5 mmol/l], increased albuminorrachia [2g/l] and normal chlorurachia. Gram's stain was negative. initial parenteral antibiotics combining cefotaxime and vancomycin didn't lead to clinical improvement. In fact, after 48 hours, the temperature was usually high and the patient remained obnubilated and, also, developed bilateral convergent strabismus. The second cerebrospinal fluid sample showed lymphocytic meningitis [125 cells/mm3, neutrophils = 5 per cent, lymphocytes = 95 per cent], decreased glycorrachia [0.5 mmol/l], increased albuminorrachia [1.2 g/l], normal chlorurachia and negative soluble antigens. Gram's stain showed Gram positive bacilli. Subsequent culture yielded Listeria monocytogenes. The patient was so treated with parenteral ampicillin for fifteen days and showed uneventful recovery. No immunocompromised conditions were identified in this patient

Discussion: In its most severe form, listeriosis is an invasive disease that affects not only immunocompromised but also immunocompetent persons in whom the neuromeningeal form is the most frequent

Conclusion: L. monocytogenes should be considered among the aetiologies of bacterial meningitis in children who do not respond initially to conventional antimicrobial treatment or who deteriorate rapidly even if they are immunocompetent and non-neonates

[Kaposi-juliusberg's syndrome complicating atopic dermatitis]

Kaposi-Juliusberg dermatitis is a severe infection of the skin caused by herpes simplex virus. It occurs, most often, in the presence of another skin disease such as eczema. We report the case of a 12 month old boy who was previously examined for atopic dermatitis treated by topic steroids. He was admitted in a general pediatric unit for a diffuse vesicular and ulcero-necrotic eruption which was extremely severe and hemorrhagic in the face. Buccal mucosis was also ill. The lesions were accompanied by high fever and wirse general state. Kaposi's dermatitis was highly suspected and the boy was so treated with parenteral Zovirax and topic product for three weeks. An uneventful recovery within one month

Heart in typhoid fever

Serial clinical and electrocardiographic examinations were made on sixty four cases as typhoid fever. In nineteen cases [29.7%] the ECG's demonstrated significantly deviations from the normal. Spontaneous gradual return to normal ECG pattern observed in most patients while recovering from the disease process. During the whole period of observation all the cases remained asymptomatic with the exception of one who manifested features suggestive of myocarditis. There was no relationship between clinical toxicity, electrolyte and enzyme alterations and ECG changes. Prognosis found to be independent to the ECG abnormalities. No fatalities occurred in this series of cases

Risk profile of young military personnel with myocardial infarction

In order to determine whether the development of myocardial infarction among young military personnel is associated with different coronary risk factors, 67 men between the age of 21 and 40 years has been investigated in a prospective case - control study for the coronary risk factors: cigarette smoking, hypertension diabetes mellitus, obesity, a positive family history of ischemic heart disease and a positive family history of diabetes mellitus. The most common risks operating seemed to be cigarette smoking 75% [p < 0.005], a positive family history of 1. H. D 28% [P <0. 02], and hypertension 21% [P < 0.001]. Although obesity was observed in 36% of the patients it showed no significant value. The prevalence of diabetes mellitus was trivial in the myocardial infarction group and the control sample, however a positive family history of diabetes mellitus was demonstrated in 24% of the myocardial infarction group but without significance The prevalence of a single significant risk factor in the myocardial infarction group is not materially different from that in the control sample, but the prevalence of two or more of these is significantly greater in the myocardial infarction group. The absence of all the three risk factors is commoner in the control sample. Our data supported the current view relating the occurrence of myocardial infarction in men of younger age range to multiple causal factors and that no single factor is a etiologic