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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intracranial arteriovenous fistula (AVF) is rare. Of the 320 arteriovenous malformations (AVMs) treated by Halbach over the past ten years, only five (1.6%) had a single arteriovenous connection. In the present study, a male infant developed focal seizure and intracranial hemorrhage without cardiac decompensation at the age of 42 days. When he was 3 years and 4 months old, status epileptics occurred, and AVF was discovered via CT scan and cerebral angiographic examination. The AVF was fed by a middle cerebral artery and drained into a huge cortical vein over the left parietooccipital area. Endovascular therapy and/or surgery were suggested, but the family refused. Though seizures occurred occasionally, the patient's consciousness level had become more clear, and he was discharged after three weeks' hospitalization. The patient was noted to be lethargic and only could roll over partially at the age of 3 year and 8 months, in the latest follow-up.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:Intracerebral arteriovenous fistula: report of one case. 151 13

From January 1981 to December 1988, we collected 11 cases of neonatal meningitis caused by Flavobacterium meningosepticum. The 6 male and 5 female newborns ranged from 3 days to 20 days old. Birth body weight varied from 1100 gm to 3600 gm. Seven cases were premature or small for date. Nosocomial infection was noted in 7 of these 11 cases. Clinically, lethargy and poor activity were the most common symptoms. Cyanosis, fever and convulsion were the next. There were 9 cases showing pleocytosis, increased protein and decreased glucose level in the cerebrospinal fluid examination. The organisms isolated in all 11 cases were susceptible to piperacillin, resistant to ampicillin, aminoglycosides and cephalosporin. Five patients were treated with antibiotics other than piperacillin for 5 to 18 days. Three patients died; hydrocephalus was the cause of death in 2 of them. Two patients were discharged against advice. Among the remaining 6 cases we gave piperacillin for 3 weeks, one case developed hydrocephalus but eventually succumbed to K. pneumoniae sepsis. Out of five surviving cases, 3 developed hydrocephalus (VP shunt performed in two). The other two patients were discharged without neurological deficit. In conclusion, neonatal Flavobacterium meningosepticum meningitis was more frequent in premature or small for date babies, and it usually appeared in nosocomial infection. The prognosis was poor and piperacillin was proved to be the drug of choice.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:[Clinical observation of neonatal meningitis caused by flavobacterium meningosepticum]. 177 41

Four cases of diabetic ketoacidosis presenting with abdominal pain are reported. Case 1: a 14-year-old boy suffered from sudden onset of mid-abdominal pain, then migrating to the right lower quadrant. Nausea and vomiting occurred subsequently. Appendectomy was performed under the impression of acute appendicitis in an outside surgical clinic. The patient became comatose the next day and then was transferred to our hospital. Diabetic ketoacidosis was diagnosed after the detection of hyperglycemia, glycosuria, and ketonuria on the day of admission. Unfortunately, he expired on the same day in spite of vigorous resuscitation. Case 2: a 9-year-old boy complained of abdominal pain for 10 days. There was no specific finding in the physical examination. Diabetic ketoacidosis was confirmed four days later when conscious disturbance, dehydration, and tachypnea were noticed. Case 3: a 10-year-old girl presented with a history of intermittent abdominal pain for one month. The character of the abdominal pain was nonspecific. Glycosuria was detected in a pediatric clinic. Diabetic ketoacidosis was confirmed after her referral to our hospital. Case 4: a 5-year-old girl suffered from acute abdominal pain for four hours. She was found to have tachypnea, lethargy, and ill-looking. Diabetic ketoacidosis was diagnosed after serial examinations. The abdominal pain in diabetic ketoacidosis may lead the pediatrician into diagnostic error. Therefore, when a child presented with non-specific abdominal pain, a routine urine sugar should be checked in order not to miss the possibility of diabetic ketoacidosis.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:[Abdominal pain in diabetic ketoacidosis: report of four cases]. 212 98

Septic arthritis in infants who are less than two months of age is a rare condition. During a recent seven-year period, eighteen cases of infantile septic arthritis were diagnosed at Mackay Memorial Hospital. The ratio of males to females was 1.6:1. The most common symptoms were crying during diaper change, and an immobile and swollen joint. Nonspecific symptoms such as fever, poor appetite and lethargy were uncommon. The hip was the most commonly affected joint with the knee taking second place. Ten cases (55%) demonstrated concomitant osteomyelitis. A bacterial etiology was established in 16 cases (88%). The predominant pathogens were S. aureus (5 cases) followed by group B streptococcus (4 cases). Total parenteral nutrition was the predisposing factor of infection in 4 of the 5 S. aureus arthritis cases. The duration of treatment ranged from 21 to 44 days. Two patients developed sequelae: namely discrepancies in leg length, and a limping gait. Early diagnosis and prompt antibiotic treatment are crucial elements in the prevention of disabling and catastrophic sequelae in young infants who have septic arthritis. In addition, open drainage is highly recommended in hip and shoulder arthritis.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:Septic arthritis in early infancy. 227 68

This report describes the clinical, roentgenologic, pathologic, and virologic findings in a 2 years and ten months old girl who died from a severe pneumonia. Initially, the patient presented with fever and cough for 2 days. Physically, the patient appeared lethargic, and breathing sounds revealed diffuse rales and wheezing. Hemogram showed mild leukocytosis and lymphocyte predominant. Chest X ray revealed diffuse interstitial infiltration of the right upper lung, left upper and left lower lung field. Bacteria infection was first impressed. Although treated with several antibiotics (ampicillin, cefuroxime, amikacin, penicillin, cephazolin, imipenem and vancomycin) in three different hospitals, the patient's condition went downhill and the patient died 2 weeks later. Finally, adenoviurs type 3 was isolated from sputum specimen taken before death and necropsy lung tissue. The lung pathology showed diffuse necrotizing inflammation with fibrinopurulent exudate, and eosinophilic intranuclear inclusion bodies were also noted in the alveolar cells. These data proved the diagnosis of adenovirus pneumonia. This case adds to the evidence that adenovirus type 3 infection during childhood may cause fatal disease.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:A fatal case of viral pneumonia in a child infected with adenovirus type 3. 227 28

Tyrosinemia is one of the disorders of aromatic amino acid metabolism. The report describes a male newborn who presented with tachypnea, lethargy, diarrhea and metabolic acidosis at 12 days old, with an elevated level of lactic acid. Tyrosinemia was impressed according to elevated plasma tyrosine level and specific metabolites of tyrosine detected by gas chromatography/mass spectrometry (GC/MS) study. The symptoms/signs subsided within one month after supportive treatment and protein restriction. Transient tyrosinemia of the newborn is indicative of delayed maturation of the liver enzyme systems (i.e. p-hydroxyphenylpyruvate dioxygenase), and is not a true inborn error of metabolism. Lactic acidosis is a rare associated findings in this condition.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:Transient tyrosinemia presenting as lactic acidosis in a term baby: report of one case. 761 75

Adenoviral pneumonia, while most common in infancy and young childhood, is rare in school childhood. Here, we report one case, a 13 years old otherwise healthy girl, suffered from fulminating pneumonia caused by adenovirus infection. She had dry cough, pharyngitis, lethargy, myalgia and fever in the beginning. Four days later, the patient became tachypneic, dyspneic and drowsy, and developed hypoxemia and diffuse bilateral infiltrates on chest radiographs. The laboratory data revealed elevated SGOT, CPK and LDH. Adenovirus was isolated from patient's endotracheal suction tube tips. Fortunately, weaning from mechanical ventilation was accomplished on the fifth day of hospitalization, despite of the high fatality rate of adenoviral pneumonia in this age group. The clinical characteristics and therapeutic management of our case are discussed and literatures reviewed.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:[Fulminating adenovirus pneumonia: report of one case]. 794 37

From Nov. 1988 to Nov. 1991, forty-five newborns, who were admitted due to bilious vomiting within the first 7 days of life followed prospectively. Twenty-three (51.1%) required surgical intervention, and the remaining twenty-two (48.9%) had nonsurgical conditions. Clinical findings of green vomitus, abdominal distension, lethargy, irritability and abdominal tenderness are more likely to indicate the need for surgery. But the onset of vomiting and time of first stool passage are not helpful in detecting the need for surgery situation. Initial routine plain abdominal roentgenogram is helpful in distinguishing infants with surgical or nonsurgical problems. Sixteen infants with normal plain abdominal roentgenograms had nonsurgical conditions. Specific findings on the plain abdominal roentgenogram were noted in 23 infants, and 19 (82.6%) of these needed surgical intervention. Contrast studies were indicated for those without signs of complete obstruction, perforation or peritonitis, but the plain abdominal roentgenogram was abnormal and clinical condition did not improved.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:Bilious vomiting during the first week of life. 804 3