ABSTRACT
Patients with infantile spasms, an intractable epileptic disorder, often are treated with adrenocorticotropic hormone. Legionella pneumophila is a rare cause of pneumonia in children. We describe 2 infants with Legionella pneumonia whose infection occurred within 1 month after starting adrenocorticotropic hormone.
Subject(s)
Adrenocorticotropic Hormone/adverse effects , Hormones/adverse effects , Legionella pneumophila , Legionnaires' Disease/diagnosis , Legionnaires' Disease/etiology , Pneumonia, Bacterial/diagnosis , Female , Humans , Infant , Legionnaires' Disease/therapy , Male , Pneumonia, Bacterial/etiology , Pneumonia, Bacterial/therapy , Spasms, Infantile/drug therapyABSTRACT
Primary cutaneous nocardiosis is an infrequent infection among children, generally affecting immunocompromised hosts. It is caused by Gram positive bacteria, partially alcohol and acid resistant which are saprophytes of the soil, water and organic matter. In most cases the causal agent enters through inhalation, and hematogenous dissemination may occur mainly among the immune compromised patients. Direct cutaneous inoculation is less frequent, especially among children. We report an 8-year old female who lives in an urban house with a small garden, who presented with an ulcer on her right shin accompanied by surrounding cellulitis, pain, swelling and fever. The patient's medical history was unremarkable, with no exposure to animals or travelling, except for rafting on the Jordan River the previous week. Culture from the ulcer grew Nocardia brasiliensis, and she recovered after 8 weeks of therapy with trimethoprim-sulphamethoxazole.