Chiritoiu Gabriela and Cristian Cazac
Carol Davila University, Romania
Scientific Tracks Abstracts: Health Care: Current Reviews
A two year old male child was hospitalized in the Pediatric Emergency department of Constanta, Romania, for fever, edema and necrosis of nasal wings, and erythematous maculopapular rash on the upper and lower limbs. Physical examination also revealed a necrotic lesion in the palatine raphe. The patient√?¬Ę√?¬?√?¬?s medical history was significant for recurrent upper respiratory tract infections (more than 8 per year) and persistent fever of unknown origin. Nasal cultures were obtained which revealed the presence of Pseudomonas aeruginosa. Due to the extent of the lesions, the patient was transferred to the Emergency Children√?¬Ę√?¬?√?¬?s Hospital in Bucharest with a suspected diagnosis of Steven Johnson√?¬Ę√?¬?√?¬?s syndrome and unknown immunodeficiency. The lesions progressed and evolved into Ecthyma Gangrenosum. An immunogram was performed and suspicion was raised for a diagnosis of immunodeficiency. The patient was subsequently transferred to the Institute for Mother and Child Health for further investigation and specialized treatment. Flow cytometry and genetic testing was performed which confirmed the diagnosis of Bruton Agammaglobulinemia. The patient was treated with intravenous immunoglobulins and antibiotics for the Pseudomonas aeruginosa infection. It was concluded that the patient did not have Stevens Johnson√?¬Ę√?¬?√?¬?s syndrome but that the maculopapular rash and necrosis was due to the Pseudomonas aeruginosa infection in an immunodeficient child. Upon 4 months follow up, the patient reports no recurrent infections or associated disability. It is important to include Bruton agammaglobulinemia in the differential diagnosis of a pediatric male patient with recurrent infections and other immunodeficiency-related symptoms.
Chiritoiu Gabriela is a 5th year Medical student at the Carol Davila University, Bucharest, Romania. She has participated in 2 national medical congresses and 4 medical conferences. She has also participated in numerous medical school activities, has been a Member of the Medical Student Society of Bucharest, and is the Coordinator of the Medical Project titled “Together for the refugees”.
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