Cytomegalovirus (CMV) is frequently isolated from neonates. Symptomatic infection is only apparent in 10% of affected babies with particular predilection for the reticuloendothelial and central nervous system. Isolated respiratory system involvement is rarely encountered. We report a case of a premature 32 weeks infant who required prolonged oxygen dependency and treated for bronchopulmonary dysplasia. The diagnosis of CMV pneumonitis was only discovered after detection of CMV DNA in the bronchoalveolar lavage. A high level of clinical awareness is crucial as a definite diagnosis and treatment will significantly alter the morbidity and the cost of therapy.
Focal eventration involving the posterior segment of the
hemidiaphragm is a rare congenital anomaly. We report of a 10-
day-old infant who presented with significant respiratory
insufficiency and failure to show any responses to standard
treatment. The diagnosis of focal eventration of the diaphragm
was not anticipated until ultrasonographic examination revealed
the defect. Diaphragmatic plication resulted in complete
resolution of symptoms. A high level clinical awareness is
crucial as a relatively simple surgical procedure could avert long
term life-threatening complications.
Dapsone syndrome is a potentially fatal hypersensitivity reaction to sulphone. We report a 12-year-old girl who developed high grade fever associated with intense jaundice, exfoliative skin rash and hepatomegaly after five weeks of starting the multidrug regimen for the treatment of Hansen's disease. Laboratory investigations revealed presence of leucocytosis with eosinophilia, deranged liver enzymes and an abnormal coagulation profile. Immediate cessation of the offending drug and administration of steroid proved successful. A high level of clinical awareness is fundamental for early diagnosis of dapsone syndrome as initiation of a prompt treatment may lead to rapid recovery.