Pediatric pneumonia - A clinico-pathological study.

CONTEXT: Numerous pathogens (bacteria, viruses, or fungi) can cause childhood pneumonia. The clinical presentations of viral and bacterial pneumonia can be similar. Though viruses are a more common cause as compared to bacteria, antibiotics remain the first line of treatment for pneumonia. AIMS: This study was planned to describe the pulmonary histopathological patterns in cases of pediatric pneumonia (age <12 years) at autopsy and aimed to identify the probable etiology and correlate with clinical presentations. MATERIAL AND METHODS: This is a single-center 3-year retrospective descriptive autopsy study. Relevant clinical data was correlated with the postmortem findings. The cases were assigned to one of the following categories based on probable etiology: viral, bacterial, mixed, or others. RESULTS: There were 89 cases with a postmortem diagnosis of pneumonia among 262 autopsied children (34%). Most patients had histological patterns that suggested viral and bacterial etiology in 46 (51.7%) and 27 (30.3%), respectively. A total of 35 out of 46 patients received antibiotics. Twelve cases had mixed viral and bacterial patterns. Antibiotics were also given in the remaining four children (4.5%) with a similar clinical presentation, where a diagnosis of tuberculosis (03 cases) and invasive aspergillosis (01) was made at autopsy. CONCLUSION: Neither clinical features nor investigations reliably differentiate between viral and bacterial pneumonia. Autopsy has an important role in providing insights into the pathogenesis of pneumonia and suggests inappropriate antibiotic exposure. No prior Indian studies have been performed to compare the clinical and postmortem findings of pneumonia in children.

Intraosseous Hemangioma with unusual presentation.

Intrabony vascular lesions are extremely rare conditions. The lesions include 0.5% to 1% of all intraosseous tumors. Females are more predilected than males with a female: male ratio of 2:1, usually affecting the second decade of life. Most common sites of occurrence of these lesions are in the vertebral column and skull, jaws are the rare location with the mandible being the quite rare location. The origin of hemangiomas is still doubtful. Many of the authors believe it as hamartoma but as per World Health Organization, it as a true benign neoplasm of vascular origin. The clinical presentation of hemangiomas is variable with atypical radiographic presentations. Due to the varied presentations of this lesion, the diagnosis becomes very difficult. But diagnosing central hemangiomas early is essential for preventing uncontrollable hemorrhage and even death during any surgical intervention. We present a case of intraosseous cavernous hemangioma which presented as periapical radiolucency with specks of calcification, quiet a rare presentation. The case was managed by embolization followed by surgical resection of the body of the mandible.