Superimposed Mongolian spots.

We report four Chinese infants with a darker pigmented Mongolian spot superimposed on another Mongolian spot. The presence of a superimposed Mongolian spot has not been previously reported. Mongolian spots can look similar to a bruise and awareness of these lesions is important to avoid unjustified consideration of injury or child abuse.

Urinary bladder calculi in a sliding vesical-inguinal-scrotal hernia diagnosed preoperatively by plain abdominal radiography.

A sliding inguinal hernia is usually diagnosed during a surgical procedure rather than preoperatively. This report describes a 77-year-old man with a sliding vesicalinguinal-scrotal hernia. The preoperative diagnosis was established by a plain radiograph of the abdomen, which showed bladder calculi within the pelvic cavity and in the right groin area.

Pertussis in adolescents.

Pertussis is a highly communicable respiratory infection caused by Bordetella pertussis. In spite of the widespread availability of effective vaccines and high levels of vaccination coverage, a significant resurgence in pertussis has been observed during the past 2 decades. The increase in reported cases is due in large part to infection in adolescents and adults, and waning immunity plays an important role.

Penile and oral angioedema associated with peanut ingestion.

Angioedema is characterized by transient, episodic, nonpruritic, nonpitting and well-defined edema that involves the subcutaneous or submucosal tissue, and most commonly develops in the head and neck region. Angioedema is caused by extravasation of plasma into the interstitial space of the affected tissue. We describe a six-year-old boy who developed oral and penile angioedema subsequent to the ingestion of peanuts.

Hypospadias: an update.

Hypospadias is the most common congenital anomaly of the penis. The problem usually develops sporadically and without an obvious underlying cause. The ectopically positioned urethral meatus lies proximal to the normal site and on the ventral aspect of the penis, and in severe cases opens onto the scrotum or perineum.

Recurrent panniculitis in an adolescent boy with Prader-Willi syndrome.

We describe recurrent panniculitis in a 15-year-old boy with Prader-Willi syndrome. To our knowledge, this association has not been previously reported.

Traveler's diarrhea.

Travelers' diarrhea is common. Between 8% and 50% of travelers develop diarrhea; incidence depends on the country visited. The attack rate is highest for travelers from a developed country who visit a developing country.

Natal teeth: a review.

The incidence of natal teeth is approximately 1:2,000 to 1:3,000 live births. The most commonly affected teeth are the lower primary central incisors. Natal teeth usually occur in pairs.

Successful alpha-1 receptor blockade therapy in a toddler with infrequent and difficult voiding.

A 3-year-old neurologically intact and behaviorally normal boy developed infrequent and difficult voiding subsequent to a soft tissue injury to the glans penis. Symptoms persisted for at least 9 months, and the course was complicated by diagnostic imaging evidence of a "markedly distended" bladder and a voiding diary that suggested elevated bladder volumes. Treatment with an alpha-1 receptor blocker normalized voiding within 24 hours.

Penile dog bite in an adolescent.

Dog bites to the external genitalia are rare. In this case, a 16-year-old boy suffered a dog bite wound to the penis. The wound was cleansed with copious amounts of sterile normal saline by means of high-pressure syringe irrigation.

Urinary tract infection due to Salmonella stanleyville in an otherwise healthy child.

A healthy four-year-old boy developed a febrile urinary tract infection (UTI) due to Salmonella stanleyville. The UTI developed following an episode of enteritis due to the same organism. Salmonella UTI is uncommon and is reported more often in patients with a predisposing factor, such as immune deficiency or a structural abnormality, in the urinary tract.