Acute scrotum in Henoch-Schönlein purpura.

Henoch-Schönlein purpura (HSP) is a systemic vasculitis with manifestations usually involving the skin, gastrointestinal tract, kidney and joints. Epididymitis is rarely seen as a complication of HSP. It is easily misdiagnosed as testicular torsion, causing the patient to undergo unnecessary surgery, because the patient may have complained of severe scrotal pain and swelling. We report a 5-year-old boy who was suffering from HSP associated with acute scrotal pain and swelling of the left testicle. No gastrointestinal signs were noted but severe joint pain, swelling and palpable skin lesions in the lower limbs and the buttocks were found. Prednisolone was prescribed and the boy recovered without surgical intervention.

Descending mesocolon defect herniation: case report.

Internal hernia, herniation of the internal organs through defects in the intraabdominal cavity, is rare. Due to the rarity of this pathology and lack of the specific symptoms and signs, early diagnosis and treatment are always stressful to the clinician and misdiagnoses may occur in the emergency room. The prognosis of a patient with uncomplicated internal hernia is excellent. We report a 21-year-old Chinese man with internal herniation through a defect of mesocolon, presented as an impalpable abdominal mass which was shown only on imaging studies. In addition to the typical whirlpool pattern, a huge solid mass between the pancreatic tail and stomach was found under computed tomography (CT) scan. The major symptoms were intermittent epigastralgia and abdominal fullness that had bothered him for years. Physical examination results showed only mild epigastric tenderness. Computed tomography scans and exploratory laparotomy of the abdomen played vital roles during diagnosis. The herniated organ was a portion of jejunum with partial small intestinal obstruction.

Pyomyositis in childhood: a case report.

Pyomyositis is a primary infection of skeletal muscle. We report the case of a previously healthy six-year-old who suffered from pyomyositis in the right lower back. He presented with lower back pain and low-grade fever for one week. After a series of laboratory and imaging studies, the diagnosis of right multifidus muscle pyomyositis with abscess formation was made. The patient recovered rapidly after incision and drainage therapy, accompanied by antibiotic treatment. Methicillin-resistant Staphylococcus aureus was cultured from the abscess discharge. It was strongly suspected that herbal medicines and common cold medication the patient had been prescribed before admission to our hospital produced a masking effect that delayed the diagnosis.

Neonatal intracardiac rhabdomyomatosis: a case report.

Intracardiac tumors are rare in neonates. Most of these lesions are rhabdomyomas and they occur almost exclusively during infancy. Rhabdomyomas are commonly associated with tuberous sclerosis and often involve the brain, kidneys and pancreas; they are frequently multiple and originate most commonly from the ventricular septum. Surgical intervention is indicated for rhabdomyoma with either mechanical cardiac obstruction or dysrhythmias resulting in symptoms or sudden death. A newborn with diffuse rhabdomyomatosis over the right atrium, right ventricle and left ventricle of the heart complicated with congestive heart failure and intractable supraventricular tachycardia is reported herein. No tuberous sclerosis or other organ involvement was noted. The tumor was resected.

Group A streptococcal septicemia with retropharyngeal abscess: a case report.

Group A streptococcal (GAS) septicemia is rare in occurrence but has a significant morbidity and mortality, whereas retropharyngeal abscess (RPA) is infrequent and it is most commonly found in children under the age of 6 years, with half of the cases occurring in children between 6 and 12 months old. This report concerns a case of GAS septicemia complicated with RPA. The patient, a five-year-old boy, was referred from a local medical department under the impression of meningitis. However, blood and throat cultures were both found to be positive for group A streptococci. Widening of the retropharyngeal space was noted in lateral neck roentgenography. RPA was confirmed by computed tomography (CT) of the neck. Ampicillin was prescribed for a period of four weeks. The patient was then discharged and oral form ampicillin was continued for four more weeks. No surgical incision and drainage was performed. Complete disappearance of the abscesses were noted via CT of the neck at an Outpatient Department follow-up.

Cockayne syndrome with tetralogy of Fallot: a case report.

Cockayne syndrome (CS) is a rare autosomal recessive disorder characterized by growth retardation, senile-like appearance, loss of subcutaneous adipose tissue, photosensitive dermatitis, microcephaly, deafness, pigmentary degeneration of retina, disproportionately long limbs, skeletal malformations with knee contractures and neurologic abnormalities. This is a description of a three-year-old boy with typical features of Cockayne syndrome complicated with tetralogy of Fallot, pneumonia and hepato-splenomegaly. He had been suffering from frequent attacks of pneumonia and had been hospitalized for several times since birth. Tetralogy of Fallot was diagnosed under echocardiography study and he died suddenly in hospital during a mydriatic procedure in the Ophthalmologic Clinic.