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Chronic granulomatous disease (CGD) is a rare primary immunodeficiency disorder of phagocytes, characterized by repeated bacterial and fungal infections. We present a boy suffering from recurrent infections since infancy who was treated with various antibiotics and anti-tuberculosis medicines without any relief. All four of his brothers had recurrent respiratory tract infections and were treated empirically with anti-tuberculosis; all of them expired one after the other without any definitive diagnosis. He was diagnosed at ten years of age with pulmonary aspergillosis and CGD. This case highlights pitfalls of medical management of chronic cases in our society. Because of TB endemic area, it is a common practice among physicians to start anti-tuberculosis medicines without making a definite diagnosis. We recommend thorough investigations including testing for CGD in every patient with recurrent or persistent infections especially if other siblings also have similar manifestations. [ABSTRACT FROM AUTHOR]

Objective: To analyse the common causes of death in paediatric acute myeloid leukaemia cases at a tertiary care facility., Methodology: The retrospective study was conducted at the Paediatric Oncology Department of the Combined Military Hospital, Rawalpindi, Pakistan, and comprised newly-registered cases of acute myeloid leukaemia aged <18 years from January 1, 2012, onwards and who completed their treatment before January 31, 2019. Data was retrieved from medical records and was analysed using SPSS 23., Results: Of the 206 cases, 130(63.1%) were males and 76(36.9%) were females. Overall mean age at diagnosis was 5.96±3.57 years (range: 9 months to 15 years). Of the total, 6(2.9%) patients died before the start of treatment. Of the remaining, 43(21.5%) patients died during 1st induction chemotherapy, and 16(8%) during the post-induction period, with overall treatment-related mortality being 65(31.5%). The main cause of death during the first two weeks of induction was infection, while infection followed by multi-organ failure was the main cause of mortality in the second phase. A total of 130(63%) patients completed the treatment. Overall survival was 81(62.3%) while disease-free survival was 77 (59.2%)., Conclusions: Overall treatment-related mortality rate in paediatric acute myeloid leukaemia cases was found to be high. Pregnancies achieved by IVF/ICSI, being complicated with severe OHSS could be related to gestational hypertension.