Ptosis, miosis and cats.

Horner's syndrome (HS) is caused by a disruption in the oculosympathetic pathway. Both congenital and acquired HS are unusual in children. Acquired HS can be caused by trauma, surgical intervention, tumours, vascular malformations or infection.We describe the case of a 6-year-old boy who was brought to our emergency department with ptosis, miosis, painful cervical lymphadenopathy and a cat scratch on a hand. The diagnosis of a cat scratch disease was confirmed by serology. A full recovery was observed on antibiotic treatment and cervical lymphadenomegaly reduction 3 weeks later.

Horner's syndrome as a co-presentation of tuberculous retropharyngeal abscess.

Tuberculosis is a disease known to affect any part of the body and to present in many interesting forms. A case of tuberculous retropharyngeal abscess is described here presenting with odynophagia and Horner's syndrome. Horner's syndrome as a presenting feature of tuberculous retropharyngeal abscess has never been reported in Pakistan.

Subclavian artery occlusion and pseudoaneurysm caused by lung apex mucormycosis: successful treatment with transcatheter embolization.

Subclavian artery pseudoaneurysm and occlusion in young patients are usually post-traumatic. We report the case of a 33-year-old diabetic woman with subclavian artery occlusion and pseudoaneurysm formation caused by pulmonary mucormycosis infection. The patient presented with diabetic ketoacidosis, Horner's syndrome, and absent left arm pulses. A cystic lesion of the left lung apex was found by imaging, was surgically resected, and was histologically diagnosed as mucormycosis infection. Magnetic resonance angiography depicted a left subclavian artery pseudoaneurysm and occlusion adjacent to the mucormycosis lesion. To protect against thromboembolic complications and rupture, the pseudoaneurysm was embolized with coils. The patient is clinically well 1 year after the intervention with no perfusion of the pseudoaneurysm.

Horner's syndrome as a complication of acute otitis media.

A seventeen-year-old girl presented with acute otitis media, unilateral miosis and ptosis (partial Horner's syndrome) and tenderness of the ipsilateral jugular vein. A culture of the otorrhoea showed Staphylococcus aureus and Streptococcus pyogenes. A CT scan revealed an infiltrate near the ipsilateral carotid artery and jugular vein. The patient was hospitalised and treated with antibiotics. Clinical signs disappeared within 6 days. This report discusses the first case with a partial Horner's syndrome as an unusual complication of acute otitis media (AOM). Imaging studies suggest extracranial lymphatic spread of the infection along the adjacent jugular vein causing pressure on the postsynaptic sympathetic fibres. Recognition of the Horner's syndrome is of importance because it may be an early sign of an extracranial complication of AOM.

Pancoast's syndrome due to pulmonary infection with Cryptococcus neoformans variety gattii.

Immunocompetent hosts usually do not require antifungal therapy for pulmonary cryptococcosis. We present a case of right lung mass and Pancoast's syndrome due to locally invasive Cryptococcus neoformans variety gattii in a normal host. Lobectomy followed by therapy with amphotericin B and flucytosine was curative.