Zinner syndrome: a radiological journey through a little known condition.

Zinner syndrome is a rare congenital urological entity, secondary to an alteration in embryogenesis between 4th and 13th weeks of gestation, specifically because of abnormalities in the development of the distal mesonephric duct. It is characterized by the triad of unilateral renal agenesis, cystic dilatation of the ipsilateral seminal vesicle and ipsilateral ejaculatory duct obstruction. The aim of this article is to provide the reader with all the necessary information to be able to suspect the presence of this syndrome, reviewing its physiopathology, clinical manifestations and the imaging techniques that enable its diagnosis, emphasizing those radiological findings by MRI that should lead us to think about it. This work is illustrated with representative radiological images of cases belonging to our institution, including patients with different variants of Zinner syndrome. We also include an overview of the embryology of the male urogenital system, to remember the role of the mesonephric duct and the ureteral bud in the formation of the different urogenital structures, as well as a differential diagnosis that allows us to differentiate seminal vesicle cysts from other pelvic cystic lesions.

Postpartum obstetric complications: a guide for radiologists.

The puerperium refers to the 6-8 weeks following delivery, and is a dynamic period in which maternal anatomy and physiology are restored to their prepregnant state. Postpartum complications can be divided into non-obstetric and obstetric. The latter are the topic of this article and can be further classified as infectious, thrombotic, hemorrhagic or cesarean-related. Transvaginal US is often the initial modality in the evaluation of puerperal disorders. CT is probably the most valuable imaging technique when life-threatening conditions are suspected. Pelvic MRI is being increasingly used in cases of inconclusive findings or if further characterization is needed, especially in the setting of postsurgical complications or placental disorders. Diagnostic and interventional radiologists play a pivotal role in the evaluation and management of a variety of puerperal complications. Many of these conditions pose a diagnostic challenge, as imaging findings often overlap with normal postpartum changes, so keeping in mind the patient's clinical information is key.

[Community-onset Staphylococcus aureus infection in neonates]. / Infecciones neonatales por Staphylococcus aureus de inicio en la comunidad.

INTRODUCTION: Staphylococcus aureus is a major cause of neonatal community-onset infections. The emergence of methicillin-resistant S. aureus infections in this age group has been reported in USA in the last few years; however there are no studies in Spain. The aim of this study is to describe the epidemiological, clinical and microbiological characteristics of S. aureus community-onset infections in neonates. METHODS: We prospectively reviewed the S. aureus infections in neonates over a three year period (2007-2009) in the Pediatric Emergency Department of Hospital 12 de Octubre in Madrid (Spain). RESULTS: We recorded 30 cases of neonatal S. aureus community-onset infections. Only one isolated (3.3%) was resistant to methicillin, and two (6.7%) were PVL(+). CONCLUSIONS: Despite the emergence of MRSA outside the hospital in pediatric population in Spain, CA-MRSA and SA PVL(+) infections are not frequent in neonates.

Staphylococcus aureus abscesses: methicillin-resistance or Panton-Valentine leukocidin presence?

INTRODUCTION: Panton-Valentine leukocidin (PVL) is a toxin associated with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) worldwide and also occurs in community-associated methicillin-susceptible S aureus (CA-MSSA) strains. The aims of the study were to determine the prevalence of PVL in community-onset S aureus skin and soft-tissue infections (SSTIs) and to analyse the influence of methicillin resistance and PVL presence on the clinical characteristics of these infections. PATIENTS AND METHODS: We prospectively enrolled all children with S aureus community-onset SSTIs attending the emergency department of a tertiary hospital between 2007 and 2009. Results A total of 142 S aureus SSTIs were identified, 46 (32%) were PVL positive. The proportion of subjects in each group was: 89 (63%) PVL-MSSA, 33 (23%) PVL+MSSA, 13 (9%) PVL+MRSA and 7 (5%) PVL-MRSA. PVL+infections were more frequently abscesses (63% vs 39%, p<0.01), and more often required incision and drainage (p<0.01) and hospital admission (46% vs 26%, p=0.02). MRSA infections were also more frequently associated with abscesses but in a multivariable analysis only PVL remained independently related (OR 2.33; 95% CI 1.10 to 4.90). CONCLUSIONS: Our study found a high prevalence of PVL presence in community-onset S aureus SSTIs in children in Spain. This toxin is associated with more abscess formation, regardless of methicillin resistance.

[Burkitt's lymphoma presenting as an intermittent limp]. / Cojera como forma de debut de un linfoma Burkitt.

Musculoskeletal pain is a frequent complaint in pediatrics usually related to benign conditions. However, it may also represent the initial symptom of serious diseases such as infections, malignancies or orthopedic emergencies. We present the case of a child diagnosed with Burkitt's lymphoma whose initial presentation was a limp. This is, to the best of our knowledge, the first case reported in the literature with this type of debut. This case illustrates the importance of including neoplasms in the differential diagnosis of atypical musculoskeletal pain, since early diagnosis can significantly improve their prognosis.

Infecciones neonatales por Staphylococcus aureus de inicio en la comunidad / Community-onset Staphylococcus aureus infection in neonates

Introducción Staphylococcus aureus es una causa importante de infecciones neonatales de inicio en la comunidad. En los últimos años se ha notificado en Estados Unidos la emergencia de infecciones por cepas resistentes a la meticilina en este grupo de edad, aunque existen pocos estudios en España. El objetivo de este estudio es describir las características epidemiológicas, clínicas y microbiológicas de las infecciones por S. aureus de inicio en la comunidad en neonatos. Métodos Estudio prospectivo de las infecciones neonatales por S. aureus de inicio en la comunidad realizado durante 3 años (2007-2009) en el Servicio de Urgencias Pediátricas del Hospital 12 de Octubre de Madrid (España).Resultado sSe registraron 30 casos de los que solo un aislado (3,3%) fue resistente a la meticilina y 2 (6,7%) fueron LPV(+).Conclusiones A pesar de la emergencia de SARM y/o productor de LPV fuera del ambiente hospitalario en población pediátrica en España, dichas infecciones son todavía poco frecuentes en neonatos (AU)

Introduction Staphylococcus aureus is a major cause of neonatal community-onset infections. The emergence of methicillin-resistant S. aureus infections in this age group has been reported in USA in the last few years; however there are no studies in Spain. The aim of this study is to describe the epidemiological, clinical and microbiological characteristics of S. aureus community-onset infections in neonates. Methods We prospectively reviewed the S. aureus infections in neonates over a three year period (2007-2009) in the Pediatric Emergency Department of Hospital 12 de Octubre in Madrid (Spain).ResultsWe recorded 30 cases of neonatal S. aureus community-onset infections. Only one isolated (3.3%) was resistant to methicillin, and two (6.7%) were PVL(+).Conclusions Despite the emergence of MRSA outside the hospital in pediatric population in Spain, CA-MRSA and SA PVL(+) infections are not frequent in neonates (AU)

Cojera como forma de debut de un linfoma Burkitt / Burkitt's lymphoma presenting as an intermittent limp

Los dolores musculoesqueléticos son un motivo de consulta frecuente en Pediatría. En la mayoría de las ocasiones se trata de síntomas inespecíficos sin relación con enfermedades graves, aunque pueden representar el síntoma inicial de procesos que requieran una atención inmediata como son infecciones, neoplasias o urgencias ortopédicas. Este caso clínico ilustra la importancia de incluir en el diagnóstico diferencial del dolor musculoesquelético de evolución atípica a las neoplasias, dado que un diagnóstico precoz puede mejorar significativamente su pronóstico(AU)

Musculoskeletal pain is a frequent complaint in pediatrics usually related to benign conditions. However, it may also represent the initial symptom of serious diseases such as infections, malignancies or orthopedic emergencies. We present the case of a child diagnosed with Burkitt's lymphoma whose initial presentation was a limp. This is, to the best of our knowledge, the first case reported in the literature with this type of debut. This case illustrates the importance of including neoplasms in the differential diagnosis of atypical musculoskeletal pain, since early diagnosis can significantly improve their prognosis(AU)