Genital Hair-Thread Tourniquet Syndrome.

BACKGROUND: Hair-thread tourniquet syndrome is a rare disorder that occurs when a hair or other fiber becomes wrapped around an appendage, resulting in swelling, pain, or even loss of the appendage. Some cases affecting the female genitals have been reported. CASE: The case of a 10-year-old girl with a 3-day history of genital pain is presented. During examination, a hair tourniquet was found at the base of a swollen and painful clitoris. The hair was removed under deep sedation, producing immediate relief. SUMMARY AND CONCLUSION: The most important concern in genital hair-thread tourniquet syndrome is a high index of suspicion and prompt resolution in order to save the affected tissue. It should be considered on the differential diagnosis for all girls with vulvar swelling and indication of pain.

[Hypotonic-hyporesponsive episode following acellular pertussis vaccination]. / Episodio de hipotonía-hiporreactividad posvacunación con DtPa.

The introduction of routine vaccination against whooping cough caused a drastic decline in the incidence of this disease, but remains today a public health problem even in countries with high vaccination coverage. However, with this decrease in cases, there were an emergence of neurological severe adverse events such as the "hypotonic-hyporesponsive episodes" (HHE), characterized by sudden loss of muscle tone associated with poor response to stimuli and skin pallor or cyanosis. The HHE is a rare phenomenon after administration of pertussis vaccine, but it is essential for health workers recognition of such reactions, especially in the 48 hours following vaccination. Although sometimes can become difficult to attribute a causal relationship between vaccine administration and an adverse effect, any suspicious events should be reported.

Episodio de hipotonía-hiporreactividad posvacunación con DtPa / Hypotonic-hyporesponsive episode following acellular pertussis vaccination

La introducción de la vacunación sistemática contra la tos ferina determinó un descenso drástico en la incidencia de esta patología, aunque todavía representa un problema de salud pública, incluso en los países con alta cobertura de vacunación. Sin embargo, además de la disminución de los casos por la proflaxis activa, se ha observado la emergencia de efectos adversos neurológicos graves, como los denominados "episodios de hipotonía-hiporreactividad" (HHE), caracterizados por una pérdida súbita del tono muscular asociada a escasa respuesta a los estímulos y palidez cutánea o cianosis. Los HHE son un fenómeno infrecuente después de la administración de la vacuna con un componente antitosferínico, pero es fundamental que el personal sanitario sepa reconocerlos, sobre todo en las siguientes 48 horas de la vacunación. Aunque en ocasiones es difícil establecer una relación causal entre la administración de la vacuna y un efecto adverso, debe comunicarse cualquier evento sospechoso.

The introduction of routine vaccination against whooping cough caused a drastic decline in the incidence of this disease, but remains today a public health problem even in countries with high vaccination coverage. However, with this decrease in cases, there were an emergence of neurological severe adverse events such as the "hypotonic-hyporesponsive episodes" (HHE), characterized by sudden loss of muscle tone associated with poor response to stimuli and skin pallor or cyanosis. The HHE is a rare phenomenon after administration of pertussis vaccine, but it is essential for health workers recognition of such reactions, especially in the 48 hours following vaccination. Although sometimes can become diffcult to attribute a causal relationship between vaccine administration and an adverse effect, any suspicious events should be reported.

Episodio de hipotonía-hiporreactividad posvacunación con DtPa / Hypotonic-hyporesponsive episode following acellular pertussis vaccination

La introducción de la vacunación sistemática contra la tos ferina determinó un descenso drástico en la incidencia de esta patología, aunque todavía representa un problema de salud pública, incluso en los países con alta cobertura de vacunación. Sin embargo, además de la disminución de los casos por la proflaxis activa, se ha observado la emergencia de efectos adversos neurológicos graves, como los denominados "episodios de hipotonía-hiporreactividad" (HHE), caracterizados por una pérdida súbita del tono muscular asociada a escasa respuesta a los estímulos y palidez cutánea o cianosis. Los HHE son un fenómeno infrecuente después de la administración de la vacuna con un componente antitosferínico, pero es fundamental que el personal sanitario sepa reconocerlos, sobre todo en las siguientes 48 horas de la vacunación. Aunque en ocasiones es difícil establecer una relación causal entre la administración de la vacuna y un efecto adverso, debe comunicarse cualquier evento sospechoso.(AU)

The introduction of routine vaccination against whooping cough caused a drastic decline in the incidence of this disease, but remains today a public health problem even in countries with high vaccination coverage. However, with this decrease in cases, there were an emergence of neurological severe adverse events such as the "hypotonic-hyporesponsive episodes" (HHE), characterized by sudden loss of muscle tone associated with poor response to stimuli and skin pallor or cyanosis. The HHE is a rare phenomenon after administration of pertussis vaccine, but it is essential for health workers recognition of such reactions, especially in the 48 hours following vaccination. Although sometimes can become diffcult to attribute a causal relationship between vaccine administration and an adverse effect, any suspicious events should be reported.(AU)

Episodio de hipotonía-hiporreactividad posvacunación con DtPa. / [Hypotonic-hyporesponsive episode following acellular pertussis vaccination].

The introduction of routine vaccination against whooping cough caused a drastic decline in the incidence of this disease, but remains today a public health problem even in countries with high vaccination coverage. However, with this decrease in cases, there were an emergence of neurological severe adverse events such as the "hypotonic-hyporesponsive episodes" (HHE), characterized by sudden loss of muscle tone associated with poor response to stimuli and skin pallor or cyanosis. The HHE is a rare phenomenon after administration of pertussis vaccine, but it is essential for health workers recognition of such reactions, especially in the 48 hours following vaccination. Although sometimes can become difficult to attribute a causal relationship between vaccine administration and an adverse effect, any suspicious events should be reported.

Sepsis por Leuconostoc spp. en un lactante sano / Sepsis by Leuconostoc spp. in a healthy infant

El género Leuconostoc, del grupo de bacterias ácido-lácticas, son cocos grampositivos resistentes a vancomicina, distribuidos en la naturaleza y empleados en la industria alimentaria. Clásicamente considerado inocuo para la especie humana, se lo ha implicado en diversas patologías en sujetos susceptibles; se lo aisló cada vez con más frecuencia y con un amplio perfil de patogenicidad, por lo que en la actualidad se clasifica como patógeno oportunista emergente. Los niños son especialmente vulnerables, sobre todo prematuros y afectos de patología digestiva grave. La puerta de entrada no ha sido estudiada en profundidad; las más probables son la digestiva, en intestinos alterados, y la cutánea, a través de la pérdida de su integridad.Otras formas descritas son contaminaciones de la nutrición parenteral y enteral, esta última asociada sobre todo al uso de sondas gástricas. Los aislados casos descritos en pacientes inmunocompetentes sin factores de riesgo involucran, sobre todo, a lactantes sanos, como el caso que presentamos.

Sepsis por Leuconostoc spp. en un lactante sano / Sepsis by Leuconostoc spp. in a healthy infant

El género Leuconostoc, del grupo de bacterias ácido-lácticas, son cocos grampositivos resistentes a vancomicina, distribuidos en la naturaleza y empleados en la industria alimentaria. Clásicamente considerado inocuo para la especie humana, se lo ha implicado en diversas patologías en sujetos susceptibles; se lo aisló cada vez con más frecuencia y con un amplio perfil de patogenicidad, por lo que en la actualidad se clasifica como patógeno oportunista emergente. Los niños son especialmente vulnerables, sobre todo prematuros y afectos de patología digestiva grave. La puerta de entrada no ha sido estudiada en profundidad; las más probables son la digestiva, en intestinos alterados, y la cutánea, a través de la pérdida de su integridad.Otras formas descritas son contaminaciones de la nutrición parenteral y enteral, esta última asociada sobre todo al uso de sondas gástricas. Los aislados casos descritos en pacientes inmunocompetentes sin factores de riesgo involucran, sobre todo, a lactantes sanos, como el caso que presentamos.(AU)

Sepsis por Leuconostoc spp. en un lactante sano / Sepsis by Leuconostoc spp. in a healthy infant

El género Leuconostoc, del grupo de bacterias ácido-lácticas, son cocos grampositivos resistentes a vancomicina, distribuidos en la naturaleza y empleados en la industria alimentaria. Clásicamente considerado inocuo para la especie humana, se lo ha implicado en diversas patologías en sujetos susceptibles; se lo aisló cada vez con más frecuencia y con un amplio perfil de patogenicidad, por lo que en la actualidad se clasifica como patógeno oportunista emergente. Los niños son especialmente vulnerables, sobre todo prematuros y afectos de patología digestiva grave. La puerta de entrada no ha sido estudiada en profundidad; las más probables son la digestiva, en intestinos alterados, y la cutánea, a través de la pérdida de su integridad.Otras formas descritas son contaminaciones de la nutrición parenteral y enteral, esta última asociada sobre todo al uso de sondas gástricas. Los aislados casos descritos en pacientes inmunocompetentes sin factores de riesgo involucran, sobre todo, a lactantes sanos, como el caso que presentamos.(AU)

[Sepsis by Leuconostoc spp. in a healthy infant]. / Sepsis por Leuconostoc spp. en un lactante sano.

Leuconostoc genus, belonging to the lactic acid bacteria group, are Gram-positive bacteria intrinsically resistant to vancomycin, broad distributed in nature and widely used in the food industry. Traditionally considered safe for humans, has recently been implicated in various diseases in susceptible individuals, increasingly isolated and with a broad profile of pathogenicity, and it is now classified as an emerging opportunistic pathogen. Children are particularly vulnerable, especially premature babies and those suffering from severe digestive pathology. The way of entry to the human organism has not been studied in depth. The most frequent are the altered intestine and the skin through loss of barrier integrity. Also are described contamination of parenteral and enteral nutrition, especially associated with the use of gastric tubes. Anecdotal cases reported in immunocompetent patients without underlying disease and no use of external devices have occurred in infants, as the case presented here.

Peripheral precocious puberty due to inadvertent exposure to testosterone: case report and review of the literature.

Sexual development in children due to exogenous androgen exposure is rare and sparsely reported. In this paper, we present a new case of peripheral precocious puberty of exogenous origin in an 18-month-old boy due to inadvertent exposure to a testosterone gel used by his father as hormonal replacement therapy. We also review other cases in the literature. Most of these cases are due to a secondary exposure to androgen topical preparations, such as gels or creams. We highlight the value of the knowledge of the existence of these preparations to the paediatrician, given the increasingly widespread use and production of adverse effects from inadvertent contact, especially in children.