Pediatric Oncall

A 7 years old boy has had 12 fractures till date. He also has had recurrent infections in form of chronic diarrhea, recurrent cough with snoring and elbow infection due to K-wire at 4 years of age, gangrene of left toe at 6 years of age and osteomyelitis of tibia following fracture of tibia at 6½ years of age. HIV is negative and normal serum immunoglobulins with normal CD 3, CD 4 and CD 8. What is the likely diagnosis?

A 4 years old girl presented with recurrent watery diarrhea for the past 6 months and edema for past 15 days. Her diet is only on dal and rice with calorie intake of 400kcal, day and proteins of 7gm, day. She had history of pica. On examination, her weight was 8.5kgs Her hair was depigmented and easily pluckable. She had generalized lymphadenopathy, pallor, angular cheilitis and beading of the ribs was present. Tongue was bald. She had conjunctival xerosis. On systemic examination, she was apathetic and had hepatomegaly. Her stool examination showed ova of hookworm, Trichuris trichiura, ascariasis and cysts of e. histolytica.

What nutritional deficiencies does this child have? How should this child be managed? How should this child undergo nutritional rehabilitation? What problems will she have as she grows older?

A 7 years old boy had fever and cough for 2 days with sore throat. Throat swab done for influenza A and B antigen test was positive. The child was immediately put on oseltamivir. The child in addition had a younger brother who was 3 years old and asymptomatic. The mother was also in her 3rd month of pregnancy.

Do the contacts need to take oseltamivir?

Ira Shah
Common Variable Immunodeficiency (CVID) Read about symptoms, causes, treatment, complications, diagnosis of common variable immunodeficiency.

Ira Shah
Immunoglobulin Replacement Therapy for Primary Immunodeficiencies Read about immunoglobulins, side effects, best route of administration of immunoglobulin replacement therapy.

These are questions asked by our viewers to the experts on the panel of Pediatric Oncall.

• A 16 months old child present with tetany with carpopedal spasm. He had similar episode 2 months back. His s. calcium is 9mg%, alk. phosphatase is 572. What could be the cause?
  
  
  

Amit R Jain

A term male child appropriate for gestational age with birth weight of 2.6kg born to a primigravida unregistered 22 years old mother by normal vaginal delivery was found to have the short limbs and shortened toe-like fingers and rudimentary grape like toes. {Figure 1}.

What is the diagnosis?



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