DIAGNOSTIC DILEMMA
Pediatric Oncall
A 5 month old twin (born preterm) presents with non-resolving pneumonia, hepatosplenomegaly, pseudomonas on blood culture, normal sugar meningitis and mesenteric lymphnodes. What is the diagnosis? Read more...

Last fortnight's query of A 3½ years old boy with polyarthropathy with fever for a year, icterus with hepatomegaly and died of pulmonary edema. What is the diagnosis? Read more… Most of the readers have suggested Reye's syndrome due to aspirin. The authors have replied that the child was suspected to have Juvenile Idiopathic arthritis {JIA} and drug induced hepatitis {either due to homeopathic medicine or due to high dose aspirin}. In view of shock, bradycardia, respiratory distress with pulmonary edema and hepatitis, a dengue ELISA IgM was sent which was positive. Just prior to death, his CBC also showed thrombocytopenia..

TEACHING FILES

Ira Shah
A 6 months old boy presented with progressive distension of abdomen for 4 days associated with swelling over feet and eyes for past 2 days. He had fever with diarrhea 2 weeks ago. On looking at the child, he has anasarca. The abdomen is distended with upper quadrant appearing fuller as compared to lower quadrant. He is also well nourished. What is the cause of ascitis in this child? Read the entire teaching clinical query in the section of "TEACHING FILES" and try the correct answer.

Last month's teaching file:
Query: A 6 years old child with Dengue Shock Syndrome. How should fluids be managed in DSS?

Answer: The fluids to be given should be isotonic normal saline or ringer lactate or even colloids and the rate of infusion should be adjusted as per severity of the leak. Read more...

ORIGINAL ARTICLE

Household Community Management of the Sick Child in the Northern Part of Togo Before Implementation of the Community Component of the "Integrated Management of Childhood Illness" Strategy. Agbèrè A D, Koffi S, Chiabi A, Kouassi E K, Assih D. Read about family practices concerning appropriate home care in a sick child.

CASE REPORTS

Infantile Myofibromatosis. Holly Paugh, Yebabe Mengesha. Read about an infant who presented with multiple congenital nodules...

VIEWERS CHOICE

A Study of Neurological Abnormalities of Term Neonates and its Relationship to Adverse Obstetric and Neonatal Factors. Raktima Chakrabarti, P Dham, SP Goel

IMAGE GALLERY

Sincerely,
Pediatric Oncall

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