The American journal of emergency medicine
-
Subgaleal hematoma is an uncommon, but potential sequela of birth trauma and instrument-assisted delivery of neonates, as well as head trauma in young children. A rare complication is an infection of the subgaleal hematoma, which typically happens due to concomitant scalp lacerations. Escherichia coli is the most common causative pathogen in peripartum cases, and Staphylococcus aureus predominates in trauma cases. ⋯ She responded well to antibiotic therapy and required no surgical intervention. Conclusion: Subgaleal hematoma infection should be suspected in a child who presents with increased hematoma swelling, irritability, fever, and local signs of infection. Early recognition and treatment with antibiotics can prevent further complications, such as abscess formation and skull osteomyelitis.
-
Recent reports have described a secondary Multisystem Inflammatory Syndrome in Children (MIS-C) after a prior COVID-19 infection that often has features of Kawasaki disease (KD). Here, we report the case of a 36-year-old woman who presented to the emergency department hypotensive and tachycardic after 1 week of fevers, abdominal pain, vomiting and diarrhea, and was found to have the classic phenotype of complete Kawasaki's Disease including nonexudative conjunctivitis, cracked lips, edema of the hands and feet, palmar erythema, a diffuse maculopapular rash, and cervical lymphadenopathy. Initial laboratory studies were significant for hyponatremia, elevated liver function tests including direct hyperbilirubinemia, and leukocytosis with neutrophilia. ⋯ It suggests that the virulent strain of SARS-CoV-2 appears to cause a post-infectious inflammatory syndrome similar to KD in adults, as well as children. Our understanding of the myriad of COVID-19 symptoms and sequelae is rapidly evolving. We recommend physicians remain vigilant for inflammatory syndromes that mimic KD/KDSS which may warrant prompt treatment with IVIG and steroids.