Eosinophilic granuloma with acute epidural hematoma: a case report.

The most common symptoms of eosinophilic granuloma are local tenderness and an enlarged skull mass. The presence of epidural hematoma is a very rare symptom of eosinophilic granuloma. To our knowledge, this is only the second reported case of eosinophilic granuloma with epidural hematoma. A 2-year-old boy with a soft tumor on the occipital scalp, palpable at the age of 3 months, yet with no obvious history of trauma, was admitted due to a sudden onset of loss of consciousness. A brain computed tomography scan showed a lytic lesion on the occipital skull with a large epidural and subcutaneous hematoma, causing brain compression. He underwent an emergency craniectomy with removal of both the tumor and hematoma. The patient regained consciousness and had no residual neurological damage. Pathological reports showed abnormal proliferation of Langerhans' cells, eosinophilic cells and multinucleated cells. A whole-body bone nuclide scan revealed no other bone lesions. The patient was discharged uneventfully. The causes of hematomas are not very clear. They may be due to tumor necrosis or minor trauma. In our presented case, the cause of the epidural hematoma may have been tumor bleeding which ruptured into the epidural space. A solitary eosinophilic granuloma of the skull with acute epidural hematoma and loss of consciousness is extremely uncommon. Craniectomy with removal of the tumor and hematoma decompression may produce good results.     

Vaginal hemangioma revealed by bleeding in a girl: a case report]

We report on the case of a 9-year-old girl who presented vaginal bleeding which led to the diagnosis of vaginal hemangioma. Such localisation is rare, and requires a clinical follow-up by vaginoscopy. A spontaneous regression can be expected but, at this time, the progress of puberty and future fertility are unknown.     

Eosinophilic fasciitis--progression to linear scleroderma: a case report

Eosinophilic fasciitis is a rare disease in children. Although changes similar to linear scleroderma have been reported, the outcome is usually good. In this report, a 10-year-old boy who developed eosinophilic fasciitis without a good response to steroids is presented. He progressed to linear scleroderma within months. Our case reinforces the hypothesis that eosinophilic fasciitis may be an early manifestation or a variant of localized scleroderma similar to the other cases in the literature.     

Eosinophilic granuloma of the skull: a retrospective analysis

BACKGROUND: The authors describe 9 cases of children with eosinophilic granuloma (EG) of the skull and report on their clinical manifestations, treatment, and prognosis. METHOD: Nine consecutive patients were diagnosed as EG of the skull and confirmed pathologically between 1996 and 2005. In the present study, multi- and single-system Langerhans' cell histiocytosis without skull involvement were excluded. Patients with EG of the skull were divided into two groups: (1) those with only a single bone lesion and those with (2) multiple bone lesions. Surgical removal was performed between 2 and 10 years of age (mean, 4.2 years). RESULTS: Eight (88.9%) of the study subjects were found to have a single bone lesion at diagnosis, and 1 had multiple bone lesions. Seven patients had a painless skull mass and 2 patients had a painful skull mass. Total removal was performed in all 9 patients. Eight patients received postoperative chemotherapy or indomethacin as adjuvant therapy. Of the 8 patients who received adjuvant therapy, 4 were treated with indomethacin and the remaining 4 received methotrexate-based chemotherapy. Eight patients did not experience EG recurrence, however, 1 patient developed additional lesions 2 years after surgical excision. CONCLUSIONS: EG of the skull is a clinicopathological entity with a good outcome. However, therapies and prognoses are dependent on age at diagnosis and the number of bony involvements.     

嗜酸性粒细胞性胃肠炎并腹膜炎1例报告

患儿 ,男 ,1 3岁 ,因腹泻黄稀水样便 1 0ｄ,发现腹水 4ｄ入院。患儿于入院前 1 0ｄ无明显诱因出现腹泻 ,为黄稀水样便 ,其内有少许粘液 ,但无脓血。每日 5～ 6次 ,量较多。伴间断腹痛 ,排便后可缓解。无发热及其他伴随症状。起病第 6天自觉腹胀且发现其腹部逐渐膨隆增大 ,同时腹泻加重至每日 1 0余次 ,并出现非喷射状呕吐 ,为胃内容物 ,影响进食、进水 ,尿量减少。病后以“急性胃肠炎”在外院给予抗感染、对症及灌肠治疗 ,病情未愈且日渐加重 ,故以“腹水待查 ,急性腹泻病”收入我院。既往无过敏性鼻炎、支气管哮喘等病史 ,半年前曾患“乙型…     

嗜酸细胞性膀胱炎一例

患儿男,8岁,因尿频半年、B超发现膀胱壁包块1 d入院.既往无过敏史.入院查体:一般情况良好,全身皮肤浅表淋巴结未触及肿大,腹部平软,未触及明显增大的膀胱,膀胱区无明显压痛.检查尿白细胞(离心尿)0～4个/高倍镜视野(HPF),尿蛋白(+),血常规WBC 12.85×109/L,嗜酸性粒细胞计数4.19×109/L,嗜酸性粒细胞百分率32.61%;B超显示:膀胱前壁及右侧壁探及环形不规则异常光团,呈基本均匀稍低回声.膀胱逆行造影检查见膀胱呈三角形偏小的形态充盈,密度均匀,边缘光整.清洁中段尿培养(4 d)未见细菌生长.     

Eosinophilic meningitis--a case report and literature review

A case of eosinophilic meningitis in a young boy from Indonesia is reported. Clinically, he had a subacute meningitis with eosinophilic pleocytosis in the cerebrospinal fluid. The clinical and laboratory findings strongly suggest Angiostrongylus cantonensis as the aetiologic agent although the parasite was not found. The other most likely causes in the region are also considered and the life-cycle of Angiostrongylus cantonensis and the epidemiology of its infection are briefly reviewed.     

Retinoblastoma, eosinophilic granuloma, and malignant melanoma: a case report

The case history of a patient treated for unilateral hereditary retinoblastoma who subsequently developed malignant melanoma and eosinophilic granuloma is presented. Although the association between retinoblastoma and second malignancies including malignant melanoma is established, we have found no reports of third malignancies occurring in such individuals.     

Pyogenic granuloma, a cause of congenital nasal mass: case report

This is a case report of a 45-day-old Nigerian boy who presented with obstruction of the left nasal cavity since birth caused by a pyogenic granuloma which was successfully removed.     

Johanson-Blizzard syndrome: a case report]

The Johanson-Blizzard syndrome is a rare autosomal recessive syndrome. This syndrome includes congenital aplasia of the cutis, aplasia of the alae nasi, bilateral hearing loss, dental malformations and pancreatic insufficiency. CASE REPORT: We report a sporadic case male infant from nonconsanguineous parents. He presented aplasia of the cutis and high anorectal malformation, associated with exocrine pancreatic insufficiency. A colostomy was performed at birth and anorectal atresia was corrected surgically at two months. Exocrine pancreatic insufficiency required immediate enzyme supplementation.     

Fibroblastic rheumatism: a case report]

Fibroblastic rheumatism is a rare entity. Nineteen cases were reported in the literature, and among them, only one in a child. CASE REPORT: Cam. (born August 19, 1988) had an onset of disease in October 1996 with nodules on the MCP and PIP, elbows and tibia, with partial improvement after three months. In April 1997, she suffered from arthralgia and stiffness of both wrists, and then of the big toes. X-rays showed destructive and erosive lesions on both wrists and on the PIP of the second and third fingers and the big toes. Laboratory investigations disclosed normal values for ESR and CRP and negative results for ANA and RF. The diagnosis of fibroblastic rheumatism was based on the typical histologic pattern of a nodule. The treatment associated colchicin and rehabilitation. In August 1998, the wrists' stiffness began to improve, though the big toes remained totally stiff. The radiologic erosive lesions did not show progress. COMMENTS: The diagnosis of fibroblastic rheumatism is based on the histologic pattern of the nodules. The erosive evolution of the arthropathies is infrequent (8/15 cases in adults). Juvenile onset is very rare; only one case has been reported, in a 10-year-old boy. The mechanism of the disease remains unknown. As it is very rare, the therapeutic strategies are not well established. CONCLUSION: This disease should be considered among the causes of juvenile arthritis with erosion.     

Tay-Sachs disease: a case report]

After an infection of the respiratory tract at the age of one a male infant showed progressive mental and physical retardation. Outstanding signs (e.g. baby doll face, startle reaction and frog position) as well as results of special investigations (cherry red spots of the maculae, short tubular bones) were suspicious for the presence of a lipidstorage disease, that could be identified as Tay-Sachs disease because of absent hexosaminidase A-activity in the patient's serum. Inspite the very low incidence of Tay-Sachs disease in our population, compared with a frequency of 1: 1200 in Ashkenzi Jews, the importance of establishing a diagnosis, based on typical clinical features and biochemical results, has to be emphasized. Genetic consultation is the only point of influence in positive family history, for attempts of causal therapy are not successful at present.     

Benign paroxysmal torticollis of infancy. A case report

Benign paroxysmal torticollis of infancy is a benign, rare, probably under-recognised disorder, characterized by recurrent episodes of head tilting. The diagnosis is primarily one of pattern recognition and exclusion of alternatives conditions; other symptoms, such as vomiting, pallor and eyes' rotation, may be associated with or rapidly follow the attack, leading to misdiagnosis of this disease. The exact pathogenesis of benign paroxysmal torticollis is not clear, but a close relationship with childhood periodic syndromes is supposed. Due to the difficulty in defining the disease, this event has implications with respect to the training and education of practice providers and emergency physicians. We describe the case of a 7-month-old infant with benign paroxysmal torticollis recently observed, discuss the clinical presentation and review the literature.     

面中线恶性肉芽肿一例

患儿男,6个月。因发热15天,右鼻腔渗脓血12天,声音嘶哑8天入院。15天前开始发热,体温高达40。c。于当地卫生院输液治疗,病后3天于鼻腔滴入退热剂,随即该侧鼻腔红肿,渗脓血液。病后8天右耳道渗液,哭声嘶哑,吸吮无力。体检：T39．2℃,P132次／min,体重6kg。发育正常,精神萎靡,面色苍白。浅在淋巴结无肿大,无呼吸困难,