Search

A dental abscess, most often caused by inadequate oral hygiene, can be easily treated if timely diagnosed. However, delay in treatment can lead to bacterial dissemination and serious complications, such as development of a cerebral abscess. Authors retrospectively analyzed a case of a 15-year-old boy admitted to our pediatrics department with a cerebral abscess due to a dental abscess. A 15-year-old patient presented with supra-orbital swelling which due to previous delay in dental treatment had caused dental, orbital and cerebral abscess formation. After extraction of the affected tooth and six weeks of IV antibiotics the size of the cerebral abscess was practically unchanged. An epidural drainage and further treatment with IV antibiotics were needed to eliminate the cerebral abscess. The urgency of dental treatment to inhibit further microbial spread is of great importance and delay can have serious consequences.

A boy aged 8 years, 10 months presented with refractory anemia. Bone marrow investigation revealed monolobular megakaryocytes. Cytogenetic analysis showed a clonal abnormality: 46, XY, del(5)(q14q32). This is the youngest individual ever reported with this disorder. A year after diagnosis, while on treatment with human recombinant erythropoietin, the bone marrow showed an excess of blasts. No bone marrow donor could be found. Transformation to acute myelomonocytic leukemia occurred 3 months later. In spite of intensive chemotherapy, the child died of progressive disease with massive splenomegaly and jaundice. The case illustrates that the 5q- syndrome can occur de novo in children. The outcome in this child was poor, which may reflect a difference from the adult 5q- syndrome or may possibly be related to the erythropoietin the child received.