ABSTRACT
An 11-year-old boy was brought to the emergency department with a week-long history of widespread pain in his upper abdomen that worsened with deep breathing and eating, sialorrhea, food impaction sensation, and a recent fever. Ten months prior, he had similar symptoms and was diagnosed with a pharyngeal phlegmon. He was treated with antibiotics and dexamethasone. In the current episode, he presented with mild elevation of inflammatory markers, a slight deviation of the trachea on chest X-ray, and a tubular esophageal duplication was identified on a thoracic CT, with its opening observed during the endoscopic study. The patient was admitted for further treatment with fluids, analgesia, and antibiotics, and showed improvement over the next seven days with no significant incidents. Esophageal duplications are a rare congenital anomaly and their exact cause is unknown. Typically found in the posterior mediastinum and lower esophagus, they can cause symptoms such as pain, dysphagia, regurgitation, and malnutrition. Surgical or endoscopic resection can be a treatment option for these malformations.
Subject(s)
Humans , Male , Child, Preschool , Respiratory Tract Infections , Leukocytosis , Metapneumovirus , HypoxiaSubject(s)
Arteriovenous Malformations , Pulmonary Artery , Pulmonary Veins , Humans , Male , Pulmonary Artery/abnormalities , Pulmonary Artery/diagnostic imaging , Pulmonary Veins/abnormalities , Pulmonary Veins/diagnostic imaging , Infant , Arteriovenous Malformations/diagnostic imaging , Arteriovenous Malformations/diagnosisABSTRACT
Several cases of paediatric acute hepatitis of an unknown aetiology have been described in these last few months and in several countries worldwide. We present two patients, a 7-month-old girl and an 8-year-old boy, with gastrointestinal symptoms and lethargy, associated with elevation of transaminase levels. Serologies for hepatitis A-E virus and PCR test to SARS-CoV-2 were all negative. In the first case, an adenovirus serotype C could be isolated in a respiratory sample as well as cytomegalovirus (CMV) in the blood (100 copies/mL). In both children, there was a progressive decrease in the hepatic markers and symptomatic resolution, compatible with a good prognosis, also seen globally in most cases. To date, infection remains the most plausible cause to consider, especially when it is presumed to be linked to adenovirus. Other potential agents and causes are still being evaluated, thus emphasizing the importance of continuous epidemiological surveillance, notification, and detailed study of all hepatitis cases.