Immune thrombocytopenia in the setting of acute SARS-CoV-2 infection.

Immune thrombocytopenia (ITP) is an immune-mediated event, characterised by the destruction of platelets by autoantibodies resulting in isolated thrombocytopaenia (platelets <100 x10/L). In children, most cases are preceded by a viral infection. Cases of ITP in the setting of SARS-CoV-2 infection have been described.

Transient symptomatic zinc deficiency in an exclusively breastfed infant.

A 3-month-old, full term female infant, adequate for gestational age, and exclusively breastfed, was admitted with a 10 day history of generalised scaling erythematous dermatitis, affecting the face (perinasal, nasolabial folds and periauricular), acral and intertriginous areas, with irritability and failure to thrive. Her mother had been treated with isoniazid since the third trimester because of family contact with tuberculosis. Based on a diagnosis of suspected impetiginised eczema, the infant was treated with flucloxacillin and prednisolone, and maternal isoniazid was suspended, with no improvement.

Metatarsal osteomyelitis in a healthy child.

Non-typhoidal osteomyelitis in healthy children is a very rare condition. A previously healthy 7-year-old boy presented with foot pain following a small injury. Local inflammatory signs of the foot were observed, with a normal radiograph.

Lipschütz ulcer and group A streptococcal tonsillitis.

Lipschütz ulcers (LU) are non-sexually related genital ulcers, rarely reported. We describe a healthy 11-year-old girl, who presented with fever and a painful vulvar ulcer associated with erythematous tonsillitis. Throat swab test for Group A Streptococcus (GAS) was positive.

[Infectious Mononucleosis and Cholestatic Hepatitis: A Rare Association].

Infectious mononucleosis is one of the major clinical manifestations of Epstein-Barr virus infection. In this syndrome, elevation of liver transaminase levels is common but cholestasis is rare, with few cases described in the literature. We present the case of a 14-year-old female adolescent, admitted to the Emergency Room with fever, odynophagia and cervical adenomegaly.

Epstein-Barr virus-associated cholestatic hepatitis.

Epstein-Barr virus infection is common in children, usually presenting as infectious mononucleosis, including fever, tonsillitis and lymphadenopathy associated with self-resolving increase in transaminases. Cholestasis is rare in children with only a few cases reported but it was described in up to 55% of the adult population affected. We present a case of a 6-year-old boy with fever, vomiting and choluria.

[Infective endarteritis complicating clinically silent patent ductus arteriosus].

Infective Endocarditis is caused by bacteria or fungi involving the heart or the great vessels (Endarteritis). It is a rare and potentially ominous disease, with increasing incidence. Despite technological advances it remains difficult to diagnose and treat, particularly in children below two years.