Emphysematous pyelonephritis and cystitis associated with bilateral pelviureteric junction obstruction: a case report

Emphysematous pyelonephritis and cystitis are both rare entities that have not been reported in children. The authors report an unusual case of a baby boy presenting with bilateral emphysematous pyelonephritis and cystitis associated with bilateral pelviureteric junction obstruction and urinary tract infection.

Necrotizing fasciitis: a serious complication of omphalitis in neonates

Necrotizing fasciitis occurs when the inflammation (cellulitis) spreads beyond the umbilicus to include the subcutaneous tissue and underlying fascia. Presently, omphalitis is relatively uncommon because of aseptic delivery techniques and antimicrobial therapy. One hundred three neonates aged 7 to 28 days, with varying degrees of omphalitis, were treated on an outpatient or inpatient basis between 1989 and mid-1993. The neonates were full-term and weighed at least 2.5 kg. Patients with necrotizing fasciitis initially appear deceptively well, which results in less-than-optimum treatment at the outset, followed by a rapid and fulminating downhill course, in turn resulting in death within 24 to 72 hours. Early recognition of the condition, with aggressive resuscitation, appropriate antibiotics, and early surgery are necessary to salvage this high-risk group. The risk factors that may predict the development of necrotizing fasciitis and its early detection are discussed.

Lingual thyroglossal duct cyst presenting in infancy

Lingual thyroglossal duct cysts are a rare form of thyroglossal cysts. We present two infants, 10 and 12 weeks of age, with midline intraoral cystic swellings stretching from the base of the tongue to the thyroid cartilage. Complete excision of the cysts by Sistrunk's procedure were carried out. Both infants are well on follow-up, at 6 months postoperatively. Their unique presentation with regard to age, location, and symptomatology is discussed. Lingual thyroglossal duct cysts large enough to cause dysphagia, stridor, respiratory distress, and failure to thrive in infants have not been previously reported in the literature.