A Child with Unilateral Pulmonary Edema due to Mitral Valve Rupture Following Blunt Trauma.

A 7-year-old boy was admitted with a history of cough and tachypnea for 1 day. There was a history of a fall from a motorcycle with some abrasions over the left arm. The child was found to have tachypnea and tachycardia and was started on noninvasive ventilation. Auscultation revealed a pansystolic murmur over the precordium. Chest X-ray revealed unilateral pulmonary edema on the right side. Echocardiography showed severe mitral regurgitation (MR) with the tear of the anterior leaflet. The child improved with diuretics and supportive care. After 3 months, he underwent surgical repair of the mitral valve. Traumatic mitral valve tear is quite rare in children. Unilateral pulmonary edema is a feature of MR with eccentric jet and is frequently misinterpreted. How to cite this article: Mukherjee S, Ravikumar K, Kapalavai SK, Ramachandran B. A Child with Unilateral Pulmonary Edema due to Mitral Valve Rupture Following Blunt Trauma. Indian J Crit Care Med 2021; 25(6):729-731.

Tuberculosis and Acute Deep Vein Thrombosis in a Paediatric Case.

Deep vein thrombosis (DVT) may be associated with tuberculosis infection. DVT in tuberculosis (TB) is implicated to the release of inflammatory cytokines, decrease synthesis of anti-coagulant proteins and increased fibrinogen levels. Drugs may also predispose to the hyper-coaguability. DVT may correlate with the severity of mycobacterium infection. We report a case of DVT in an 11-year-old child with sputum positive pulmonary tuberculosis. The patient was put on low molecular weight heparin after Doppler documentation of thrombosis of left femoral vein. She was then put on oral warfarin with complete resolution of the thrombosis. A clinician should be aware of this rare but dangerous association of tuberculosis and must not delay in early diagnosis and intervention.

Acute hemorrhagic edema of infancy.

The authors report an 11-mo-old child presenting with acute onset appearance of large, erythematous, palpable purpuric lesions involving face, extremities and trunk. Skin biopsy from the margin of the lesions showed leukocytoclastic vasculitis suggesting a diagnosis of acute hemorrhagic edema of infancy. This rare type of cutaneous vasculitis, despite its grave presentation is a benign condition with self-limiting course.

Measuring new born foot length to identify small babies in need of extra care: a cross-sectional hospital based study.

OBJECTIVE: The neonatal mortality rate (NMR) continues to remain quite high, one important cause being preterm deliveries. The main obstacle in the pathway towards decreasing NMR is identification of babies in need of extra care. To analyze the utility of newborn foot length as a proxy measure for birth weight and gestational age. METHODS: A cross-sectional study done in a hospital of eastern India with 351 babies during 4 months. Right foot length of each recorded using a plastic, stiff ruler. FINDINGS: 48.1% babies were preterm, 51.8% low birth weight (LBW) and 33.3% very low birth weight (VLBW). Foot length less than 7.75 cm has 92.3% sensitivity and 86.3% specificity for identification of preterm neonates. For identification of LBW babies (<2500 gm) a foot length less than 7.85cm has 100% sensitivity and 95.3% specificity. Foot length less than 6.85 cm has 100% sensitivity and 94.9% specifity for identification of VLBW babies (<1500 gm). CONCLUSION: Foot length may be used in the identification of LBW and preterm babies who are in need of extra care.