Partial facial duplication (diprosopus): a case report and review of the literature.

BACKGROUND: Diprosopus, or craniofacial duplication, is a rare entity that occurs in approximately 1 in 180,000 to 15 million live births. The degree of duplication varies from complete facial duplication to small facial structure duplication like the nose and eye. The cause of diprosopus is unknown though there are proposed factors. CASE PRESENTATION: Our African patient was a term 72 hours old female neonate who was referred to our center with impression of lower facial duplication with two oral cavity that are located side to side separated by large soft tissue, she also had flat nasal bridge with widely separated nostrils and widely spaced eyes. Besides the facial malformation she had multiple episodes of vomiting with aspiration. Her blood tests were normal. Precontract brain computed tomography (CT) scan confirmed partially duplicated mandible and maxilla, two oral cavity separated by large fatty tissue, brain tissue were well formed and the only abnormality was corpus callosum agenesis and interhemispheric lipoma. In her stay at hospital nasogastric tube (NG) tube feed was initiated and started with antibiotics for aspiration pneumonia. After 25th day the neonatal passed away with possible cause of death being respiratory failure. CONCLUSION: Craniofacial duplication is a very rare anomaly with only a few cases reported. Most of these patients are stillborn, even if they survive the prognosis is often poor. Early prenatal diagnosis is very important as termination of pregnancy can sometimes be considered an option.

A First Report on Experience in Managing Infants with Congenital Toxoplasmosis in Ethiopia: Case Reports and a Review of Evaluation and Treatment.

Background. Congenital toxoplasmosis is a major sequela of untreated primary maternal infection. With or without symptoms, untreated infections eventually lead to multiple neurologic complications. Despite the high Toxoplasma gondii seroprevalence in the Ethiopian population, there are no reports of newborns diagnosed and treated for congenital toxoplasmosis. Presentation of Cases. The clinical presentation, evaluation, and management of three infants with congenital toxoplasmosis are described. Two were symptomatic at birth. All three had confirmed diagnoses using Toxoplasma serologic tests. Two completed their treatment with one infant developing complications of strabismus and seizure disorder. Discussion and Conclusions. There is little experience in managing congenital toxoplasmosis in Ethiopia due to constraints in diagnostics and therapy. The description of this first such report underscores the need for risk assessment and evaluation during antenatal care to obtain favorable fetal outcomes.