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A previously healthy 6-year-old boy presented with new onset seizure activity and altered mental status. His prehospital course included prolonged fever, vague abdominal complaints, and unusual behavior. Neurological testing was unrevealing, and his symptoms slowly improved without intervention. His primary pediatrician had ordered serum antibody titers to Bartonella henselae for testing of prolonged fever in the setting of exposure to a kitten; these were found to be positive for both immunoglobulin G and immunoglobulin M. Further examination for organ involvement revealed splenic and liver micro-abscesses. After completion of his antibiotic course, the patient returned to his cognitive and neurologic baseline with resolution of his abdominal abscesses. This case emphasizes the importance of obtaining a thorough exposure history when evaluating for infectious causes of encephalitis. [ Pediatr Ann . 2020;49(8):e359–e362.]

Background Schimke immuno-osseous dysplasia is a rare autosomal recessive disease resulting from biallelic SMARCAL1 mutations. It presents in early childhood and is characterized by short stature, nephropathy, and immunodeficiency. Approximately 50% of those affected have neurological complications including migraines, transient ischemic attacks, and strokes. Methods We present a six-year-old boy with Schimke immuno-osseous dysplasia without evidence of atherosclerosis with recurrent episodes of severe headache, fluctuating hemiparesis, and aphasia. Results Magnetic resonance imaging and angiography were normal during the initial episode; multiple areas of reversible restricted diffusion with decreased perfusion and arterial stenosis were seen with subsequent attacks. Conclusions This constellation of symptoms and imaging findings is suggestive of reversible cerebral vasoconstriction syndrome, which we propose as a mechanism for the transient ischemic attacks and infarcts seen in some patients with Schimke immuno-osseous dysplasia, as opposed to accelerated atherosclerosis alone. This new insight may provide a basis for novel preventative therapy in this rare disorder.

To investigate possible exposure to polybrominated diphenyl ethers (PBDEs) in US professional airline workers.We recruited 30 healthy US professional airline workers who lived in the Dallas, Texas, area to test their blood PBDE levels. We examined the relationship between hours worked in an airplane and total PBDE blood levels.Total PBDE blood levels from the 30 volunteers were unremarkable despite minor elevations of certain congeners in a few volunteers. No statistically significant correlations were noted between hours in airplanes in the past 1 or 5 years and levels of individual brominated diphenyl ethers congeners or total PBDEs.We hypothesized that elevated PBDE levels in commercial aviation workers could be found associated with time spent in airliners. Our findings do not support such an association.

Objectives The objectives of this study were to provide updated measurements of PBDEs in US food, to estimate possible difference in levels from differing geographical regions, and to provide an improved estimate of current dietary intake. Methods Thirty matched food samples for a total of 90 samples were collected from each of three cities (Los Angeles, California; Dallas, Texas; and Albany, New York) and were analyzed for 13 polybrominated diphenyl ether congeners (BDE 28, 47, 49, 66, 85, 99, 100, 138, 153, 154, 183, 203, and 209). Dietary intake of PBDEs was estimated by food type, age, and sex. Results In this pilot study, we did not note a statistically significant difference in total PBDE levels in food collected from the three locations. The median total PBDE levels (estimating non-detected values as half of the detection limit) in meat, dairy, eggs, and fish were 267 pg/g wet weight (ww) (range 102–3156 pg/g ww), 176 pg/g ww (range 41–954 pg/g ww), 637 pg/g ww (range 193–932 pg/g ww), and 243 pg/g ww (range 36–2161 pg/g ww). PBDE intake from food was estimated to range from 2.7 ng/kg/day for children 2 through 5 years of age to 0.8 ng/kg/day for women aged 60 years and older. This compares closely with our previous study where the intake estimate was 2.7 ng/kg/day for children 2 through 5 years of age and 0.9 ng/kg/day for women aged 60 years and older. Conclusion We did not find a decrease of PBDEs in food since our previous studies which we expected to find due to the declining use of PBDEs in the USA. These findings could be consistent with food contamination from depot sources of PBDEs. A larger, more representative sampling of the US food supply is indicated based on our findings.

This paper presents new data on the levels of polybrominated diphenyl ethers (PBDEs) in American airline workers. This pilot study did not find elevated total PBDEs in the blood of nine flight attendants and one aircraft pilot who have worked in airplanes for at least the past 5 years. These findings are not consistent with the findings of elevated blood levels of PBDEs from the 2008 Christiansson et al. publication "Polybrominated diphenyl ethers in aircraft cabins - A source of human exposure?" We agree that more research needs to be done on larger, more representative samples of airline workers to better characterize exposure of airline workers and other frequent flyers to PBDEs.