Turkish J Pediatr
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Case Reports
A rare metabolic complication of acute lymphoblastic leukemia in childhood: lactic acidosis.
A 13-year-old boy presented with nausea, fatigue, weight loss, and bone pain for two months. Complete blood count and serum renal and liver function tests were all normal. Blood gas analysis revealed severe metabolic acidosis with high anion gap. ⋯ Metabolic acidosis dissolved as soon as chemotherapy was begun. Lactic acidosis at the presentation of acute lymphoblastic leukemia--especially with low tumor burden--is a very rare and almost always fatal complication. Our patient is still alive and in remission, which is a point of interest in this child.
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Drug-induced dystonic reactions are a common presentation to the emergency department and typically occur with drugs like chlorpromazine, haloperidol and metoclopramide. There are no reports in the literature of dystonic reaction caused by albendazole. ⋯ Even though dystonia side effects of albendazole are rare, it can induce an alarming dystonia in some sensitive children. The mechanism of dystonia is unclear.
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Subglottic cysts are rare causes of stridor in infancy and should be suspected in the case of intubation. A 15-month-old male presented with recurrent stridor and respiratory distress. Prematurity and intubation were present in his history. ⋯ The cysts were ruptured by flexible bronchoscopy. The child's stridor and other symptoms disappeared thereafter. Early diagnosis of subglottic cysts is important since the obstruction can be relieved by rupturing the cysts with bronchoscope, whereas development of a fibrotic stenosis may require a tracheotomy, with its attending morbidity.
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Case Reports
Suppurative cervical adenopathy and pharyngeal mass due to tularemia unresponsive to medical treatment.
Tularemia is a zoonotic disease caused by Francisella tularensis. Tularemia presents with various clinical forms, such as ulceroglandular, glandular, oculoglandular, oropharyngeal, pneumonic, and typhoidal tularemia forms. ⋯ Herein, we describe a girl with tularemia who presented with right cervical lymphadenopathy and left nasopharyngeal mass. To the best of our knowledge, this is the first reported case of tularemia with deep neck infection and also the first tularemia case from Corum, a city in the central Anatolian region of Turkey.