Clinical Pediatrics

doi: 10.1177/000992288902800911pmid: N/A

Ray, Melinda S.; Feldman, Sandor

doi: 10.1177/000992288902800912pmid: 2766647

This is a report of a twelve-year-old black male who presents a history of left neck pain, left shoulder pain, weight loss and minimal fever. The admission diagnosis was a malignancy, supported by radiographic findings of consolidation of left lower and left upper lobes and periosteal new bone formation along the inferior aspects of the left second, third and fourth ribs. Open biopsy of the chest wall revealed a large abscess cavity. Subsequent cultures on anaerobic blood agar plates grew Actinomyces and Fusobacterium. The patient was treated with penicillin and improved clinically. This case emphasizes the need to culture tissue specimens for a wide array of organisms, including those not commonly seen today. A high index of suspicion is required for the diagnosis of anaerobic infections. Mixed anaerobic infections, including actinomyces, although uncommon in children, should be considered in the etiology of an intrathoracic mass.

doi: 10.1177/000992288902800913pmid: N/A

Guttenplan, Michael D.; Wetmore, Ralph F.

doi: 10.1177/000992288902800914pmid: 2766648

The relationship between cystic fibrosis, nasal polyposis and chronic sinusitis is clearly defined. Mucoceles of the paranasal sinuses, however, are a well-described complication of chronic sinusitis in adults; but they rarely occur in the pediatric age group. We report a three-year-old who presented with epiphora and fullness at the right medial canthus. Computed tomography confirmed a right ethmoid mucocele which was surgically drained, with resolution of symptoms.Approximately 12 other cases of mucoceles have been reported in the pediatric age group. Although many of these patients had recognized cystic fibrosis, some were previously undiagnosed. Only after presentation with a mucocele, did sweat testing reveal their underlying pathology. No pediatric patients in the literature were found with mucoceles and normal sweat tests. Paranasal sinus mucoceles may be diagnostic of cystic fibrosis and may be the presenting sign in some patients.

doi: 10.1177/000992288902800915pmid: N/A