An unusual parasagittal tumour with acute blindness and response to cerebrospinal fluid shunting.

We report a seven-year-old girl who presented with a sudden tumor apoplexy due to a parasagittal hemangiopericytoma. Following tumor excision, the child was noted to have bilateral optic nerve dysfunction and progressive papilledema, despite rapid overall neurological improvement. Based on the clinical features, we feel that this case represents an unusual form of visual deterioration related to impaired CSF absorption somehow precipitated by the acute tumour apoplexy. This unusual case of blindness responded significantly to CSF shunting. Several reports exist describing raised intracranial pressure with papilledema caused by nonthrombotic sinus occlusion due to tumors in proximity to the posterior superior sagittal sinus, torcular herophili and the jugular outlet. Communicating hydrocephalus, pseudotumor syndrome or intracranial venous sinus obstruction should be considered when otherwise inexplicable visual loss coexists with optic nerve dysfunction and papilledema. We emphasize the importance of a thorough search for the cause of visual loss.     

T and B lymphocytes in patients with enteric fever.

Estimation of T and B lymphocytes was done in 50 patients of enteric fever, 50 duration matched non enteric fever patients and 50 normal healthy individuals. The difference in both early and late rosette forming T lymphocytes was found to be statistically significant in enteric versus non-enteric patients. Significant difference was also observed in enteric versus normal individuals in case of late rosette forming T lymphocytes.     

Sweeteners, flavorings, and dyes in antibiotic preparations

Even though a variety of adverse effects caused by sweeteners, flavorings, and dyes in susceptible individuals have been reported, there is no good single reference with information about these substances in pediatric antimicrobials. Data on sweeteners, flavorings, and dyes in 91 antimicrobial preparations were collected. Sucrose was present in 74 (85%) of 87 preparations, followed by saccharin in 30 (34%) preparations. Mannitol, lactose, and sorbitol were each present in 7 preparations. None of the preparations were free of sweeteners. Thirty-four (37%) of 91 preparations did not specify the flavoring content. While cherry was the most common flavoring used, there were 25 other flavorings. Thirteen different dyes and coloring agents were used in these antimicrobials. Red dye no. 40 was present in 45% of preparations. Tables detailing sweeteners, flavorings, and dyes in different groups of antimicrobials (amoxicillin, ampicillin, cephalosporins, erythromycin, penicillins, sulfonamides, and others) and adverse effects reported with these inert ingredients are presented. These tables should be helpful to physicians in selecting an antimicrobial containing a different sweetener and/or dye when an adverse reaction occurs.