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October 2012 Volume-9 Issue-10 [Supplement 10]
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Pediatric Oncall
 
October 2012 Volume-9 Issue-10 [Supplement 10]
(ISSN - 0973-0958)
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DIAGNOSTIC DILEMMA
A 4 years old boy presented with jaundice, ascitis, hepatomegaly and multiple abscesses over sternum and back for which he was on antituberculous therapy (ATT) for past 1 month. He was treated for tuberculosis (TB) at 1 year of age for 5 months in view of fever. At 2½ years of age, he had multiple abscesses over neck, sternum, back, left thumb. At 3 years, sternum abscess was drained and he was again given ATT for 7 months. At 3½ years of age, he had icterus and ascitis. His CT chest showed osteolytic lesion in sternum with pericardial effusion, consolidation in left lower lobe of lung and right paravertebral abscess. Ascitic fluid did not grow any MTB after 6 weeks nor did the sternal pus.

Is it TB? What is other likely diagnosis?



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QUESTION OF THE DAY
My 4 years old nephew has developed varicella rash yesterday. He was not immunised. My husband and I are his close contacts. I am 26 wks pregnant, had varicella in childhood. but my husband did not have varicella nor is he immunised. Additionally he is a known case of ulcerative colitis since 1.5 yrs on tab azathioprine 100mg and sulfasalazine. What preventive measure should be taken for him not to contract varicella and a concern for me? Can he take vaccine in view of his immunosuppressed state?

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

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IMAGE GALLERY
Kalyanshettar SS, Navadgi AS, Naganoor RG,
Talikoti AB




A newborn baby presenting with pulsatile mass in the upper abdomen. Examination revealed exomphalos major with part of cardia in it. X ray showed absence of lower sternum with herniation of heart in to the sac of exomphalos. Echocardiography revealed Tetralogy of Fallot. Antenatal sonogram (level 1) done at a peripheral centre in the second trimester was reported as normal. What is the diagnosis?

Try your clinical skills in the "SPOT DIAGNOSIS" for the fortnight and the lucky winner gets a child health CD - courtesy Pediatric Oncall

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Pediatric Oncall


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