Severe disseminated tuberculosis in a 4-month-old infant initially presenting with multiform cutaneous lesions.

A 4-month-old female infant presented with 1 month history of horizontal nystagmus and discrete multiform skin lesions. The patient was initially diagnosed with congenital nystagmus and staphylococcal skin infection not responding to antimicrobial agents. The development of severe systemic symptoms led to extensive investigations and the diagnosis of disseminated tuberculosis. Mycobacterium tuberculosis (MTB) was isolated from the skin and cerebrospinal fluid. The patient was treated with isoniazid, rifampicin, pyrizinamide, streptomycin and dexamethasone. Skin lesions resolved completely but severe neurological deficits persisted.

Simultaneous presentation of Henoch Schonlein purpura in monozygotic twins.

Henoch Schonlein purpura is a relatively common and well recognized paediatric condition. We report a case of 2 monozygotic twins that presented with typical Henoch Schonlein symptoms, starting simultaneously. Both children had positive throat cultures for Streptococcus pyogenes and skin biopsies typical for HS disease. Their genotype was determined and compared with studies suggesting predisposition according to HLA typing.