Search

Introduction: Atypical or nontuberculous mycobacteria (NTM) are an environmental organism responsible for opportunistic infection. Rapid-growing NTM are more commonly associated with hospital-acquired infections. Many of the organisms responsible for diseases in immunocompromised patients and hospital-acquired infections originate from tap water, such as Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium gordonae, Mycobacterium simiae, Mycobacterium mucogenicum, Mycobacterium fortuitum, Mycobacterium chelonae, and Mycobacterium abscessus. NTM is a rare organism responsible for the injection abscess. Considering low incidents, not much clinical data are available for this condition. Here, we discuss such cases which can be helpful to spread awareness and provide data for future policy makers. Materials and Methods: This was a retrospective study. Data on patients with injection abscess were collected from the last 6 years. Detailed history and clinical examination findings were analyzed. Children with injection abscess were operated and their further management and outcome were studied. Results: A total of 13 cases with confirmed culture of NTM were treated over 6 years. The age ranged from 2 1/2 months to 5 3/4 years with male:female ratio of 7:6. All patients hailed from the same geographical area. All children were healthy with no history of any long-term or chronic illness, without additional symptoms and had received Bacillus Calmette-Guérin vaccination at birth. The total duration of illness varied from 1 to 5 months, with a mean of 3 months. All patients had a history of intramuscular age-appropriate vaccination as per the national immunization schedule. All patients were followed up to 6 months after intervention and none of our patients developed relapse. Conclusion: Patient who does not respond with optimum treatment should have a high suspicion of such opportunistic infection, which is crucial to their management. Hospital-acquired NTM infections often result from contaminated instruments or fluids. Adherence to strict aseptic precautions, hand hygiene and environmental precautions are the key to preventing these infections. In case of skin and soft tissue infections / abscesses, surgical intervention plays a significant role for managing the patient. [ABSTRACT FROM AUTHOR]

Ritual circumcision in children remains a trivialized procedure in some countries, especially in rural areas. It is often performed by unqualified paramedical personnel, or even by religious workers whose notions of surgery and asepsis are uncertain. Although it is thought to be a minor procedure, major complications with sexual or even life-threatening prognosis can occur. Amputation of the glans during circumcision is a rare incidence secondary to poor application of operating principles. We report the case of a 1 1/2-year-old boy who underwent a progressive amputation of the glans after a ritual circumcision by a religious worker. The child was brought 10 days after the procedure with totally amputated, nonsalvageable glans. A urethral meatoplasty was performed to enable proper voiding and prevent meatal stenosis. The child has been in follow-up for the past 6 months without any urinary symptoms. [ABSTRACT FROM AUTHOR]

Micturating cystourethrography (MCUG) is a very commonly performed diagnostic procedure in pediatric urology. Although considered to be simple, safe, and cost-effective, it can incur some complications. Bladder rupture during MCUG is a very rare complication and only a handful of cases have been reported in world literature. We report the case of a 2.5-month-old boy who had intraperitoneal bladder rupture during an MCUG needing surgical repair. At operation, the child had a bladder tear at the dome of the bladder which was repaired successfully. The postoperative recovery was uneventful and the child is doing well in follow-up. Although individual management of bladder rupture may differ, a majority of infants need surgery for the same. Thorough vigil and attention to the technique are a must to prevent such incidents in children. [ABSTRACT FROM AUTHOR]

Laparoscopic repair of Morgagni hernia has been described in adults and children. In the published reports, the crux of the repair consists of suturing the posterior part of the diaphragmatic defect to the undersurface of the sternum or the posterior rectus sheath. The tissue on the undersurface of the sternum is variable is in its nature and may be inadequate for suturing, hence compromising the strength of the repair. A technique that circumvents this problem and offers a strong anatomical repair is described. A Morgagni hernia was diagnosed in a 2-year-old girl with trisomy 21, who presented with recurrent chest infections. She underwent laparoscopic repair of the hernia using three ports. The tissue on the undersurface of the sternum was inadequate for a conventional repair. The procedure was modified as follows: a small transverse incision was made over the lower end of the sternum. Three nonabsorbable mattress sutures were inserted through the sternum, the anterior edge of the diaphragmatic defect, and back through the sternum and tied with extracorporeal knots. The child was discharged home on the second postoperative day. At 6-month follow up, the child was asymptomatic, and had been infection free. A chest radiograph was normal. This is a simple, novel, noninvasive method, which offers a secure anatomical repair and it is not dependent on the adequacy of the tissue on the undersurface of the sternum.

Juvenile dermatomyositis classically manifests as necrotising vasculitis in multiple organs. It mainly involves the vessels of skin and muscle and is associated with subcutaneous deposits of calcium. Ureteric involvement in dermatomyositis is extremely rare. The authors present a case of a 14-year-old girl with juvenile dermatomyositis with intramural ureteric calcification mimicking pelviureteric junction (PUJ) obstruction.

Context: Postoperative fever is known to occur after all surgical procedures irrespective of the type of anesthesia. Thermometry devices that work without touching or disturbing the child seem to be appreciated more than the conventional skin contact thermometers. However, whether this technology is reliable to be adapted for routine pediatric surgical care is debatable. Aims: The aim of this study was to study the accuracy of infrared nonskin contact digital thermometer (IRT) compared to the skin contact digital thermometer (DT) and mercury in glass thermometer (MT). Settings and Design: A prospective cross-sectional study was done in postoperative patients at a pediatric surgical center over a period of 3 months. Subjects and Methods: The forehead temperature was recorded with IRT. This was followed by recording the temperature in one armpit by DT and the other armpit by MT. Readings were promptly documented. Statistical Analysis Used: A sample t-test was done which gave the P value and mean. Linear regression analysis was carried out to find correlation coefficients. Bland–Altman test was used to access the concordance between all readings. Results: We found a strong correlation between temperature readings taken by DT (mean = −0.03, r = 0.07, slope = −0.04) and IRT (mean = 0.89, r = 0.091, slope = −0.14). However, on comparison of results with the MT, there are wider limits of agreement with the IRT (−0.31–2.09) in comparison to DT (−0.66–0.59). Conclusion: Skin contact digital thermometer are more accurate and suitable for checking body temperature as compared to infrared nonskin contact digital thermometer in postoperative pediatric patients. [ABSTRACT FROM AUTHOR]

Generalized lymphangioma of tongue is a rare cause of macroglossia in children. It causes mechanical discomfort and functional and psychological disturbances. We report a case of macroglossia due to generalized lymphangioma in a 10 year old where partial glossectomy was done to achieve symptomatic relief. [ABSTRACT FROM AUTHOR]

Segmental dilatation of the intestine is a rare disease and mostly involves the ileal segment. It commonly presents in the neonatal period and early infancy with symptoms of partial or total obstruction. We report a rare case of an isolated jejunal segmental dilatation in a 7-year-old girl. The child presented with malnutrition and signs of subacute obstruction. The diagnosis was confirmed intraoperatively, and the dilated segment was resected. Although the etiology remains unknown, we discuss its clinical aspects and relevant literature. [ABSTRACT FROM AUTHOR]

Littoral cell angioma is a rare primary splenic vascular tumor, originating from the littoral cells lining the red pulp sinuses of the spleen, with variable presentation. Here, we present the case of a 2-year-old male child presenting with chronic thrombocytopenia which resolved after splenectomy. [ABSTRACT FROM AUTHOR]

Primary chylopericardium is a rare entity in the pediatric population, which is characterized by chyle accumulation in the pericardial sac. Treatment of this rare problem is a management dilemma as no definitive treatment has been found to be curative. We share our experience of treating chylopericardium with minimally invasive surgery. [ABSTRACT FROM AUTHOR]