Rectal adenocarcinoma in an 9 year old girl. A case report

Rectal adenocarcinoma is rare in children. The patient described here is a 9-year-old girl who presented with rectorrhagia. Her problem started 3 months ago and she had been treated for infectious diarrhea. A colonoscopy was performed 3 months after the onset of symptoms and a non-pedunculated polyp in the rectum was noted and resected. After the colonoscopy signs and symptoms of peritonitis developed and in laparotomy a rectal perforation was noted and a biopsy from rectal mucosa was taken. The result of biopsy was adenocarcinoma. Then a low anterior resection of rectum with protective ileostomy followed by adjuvant chemotherapy was performed. During a 15 month follow-up the patient had no problems and no clinical, radiological or laboratory signs or symptoms of recurrence was found. However rectal adenocarcinoma is rare but it should be considered in the differentialdiagnosis of intestinal problems

Recent Emergence and Re-Emergence of Crimean Congo Hemorrhagic Fever and Q Fever Zoonotic Diseases: Major yet Ignored Infectious Diseases Worldwide

The continuing emergence or re-emergence of vector-borne zoonotic Q fever (caused by Coxiella burnetii) and Crimean Congo hemorrhagic fever (CCHF, caused by Orthonairovirus) include indispensable extraordinary threat around the world. Low infectious dose and long-term environmental residence are major risks. Wildlife and domestic livestock act as hosts or reservoirs of the CCHF virus and ticks are carriers. The disease also poses a threat to public health services owing to its epidemic potential, high case fatality ratio (up to 40%) as well as difficulties in treatment, prevention, and control. Q fever is another zoonotic febrile disease mainly affecting workers involved in farming livestock. The causative agent of Q fever causes abortion in livestock. The pathogen is shed in large numbers in the waste of infected animals (amniotic fluids and placenta during parturition) and is transmitted by inhalation of contaminated aerosols. Vaccination is the most effective way of protecting against Q fever. The main way to prevent Q fever is to avoid contact with animals, especially while animals are giving birth, or consumption of unpasteurized milk and contaminated dairy products. Due to the increasing importation of livestock to meet the growing demand for dairy and meat products, new diseases are likely to be introduced. In our growing globalized world, where trade between countries increases, it is necessary to conduct more research on zoonotic diseases and to monitor any possible disease introduction to new areas. A continuing surveillance program and pathogen testing are important in tracking the emergence of new pathogens

A 15-Month-Old Boy With Respiratory Distress and Parapharyngeal Abscess: A Case Report

Parapharyngeal abscess is a life-threatening disease. Upper respiratory tract infection is the main cause in children. We present a 15-month-old boy admitted to the emergency ward with the chief complaint of difficulty in breathing caused by parapharyngealabscess. His condition deteriorated gradually, and he transferred to the operation theater quickly for abscess drainage and because of the difficulty in orotracheal intubation; a tracheostomy was performed. His respiratory condition deteriorated 2 days after PICU admission, and the medical team noticed an unexplainable respiratory distress. A chest x ray obtained and showed a right side pneumothorax and subcutaneous emphysema around theneck area. The case presented here, had not been diagnosed at the first examination; however, there were enough clinical clues (such as respiratory distress, drooling, torticollis, bulging of theneck, previous viral respiratory infection, possible pharyngeal trauma). The story of this case reminds us the importance of the precise physical exam and history taking which could be life-saving

A Case Report of Congenital Myasthenia Gravis Presenting With Respiratory Distress

Congenital Myasthenic Syndromes (CMS) are rare inherited disorders characterized by dysfunction of neuromuscular transmission at the neuromuscular junction. Most patients with congenital myasthenic syndromes present in the infancy. Major symptoms of affected individuals include weakness and fatigue during the first years of life. Patients may show hypotonia, facial weakness, swallowing difficulties, respiratory dysfunction, ptosis and ophthalmoparesis. Here we report a 6 month old boy congenital myasthenia gravis due to homozygous mutation in COLQ gene. The patient presented with several episodes of apnea and didn’t have ptosis until 6 months of age, and even at this time it started as just left eye ptosis and after a few days became bilateral. He had been misdiagnosed with several other causes of episodic apnea. Later by using electrophysiology he was diagnosed as congenital myasthenia gravis and mutation analysis of the patient revealed the presence of mutation of COLQ gene and was treated successfully