Issue 7:2

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Clinical and Radiologic Features of Fulminant Pediatric Autoimmune Encephalitis: A Case Report

Raymen Rammy Assaf, MD, MPH*^

DOI: https://doi.org/10.21980/J8JW75 Issue 7:2 No ratings yet.
The neurology service was consulted in the ED and multisequence MRI and MR angiography (MRA) of the brain were obtained without and with IV contrast. Diffusion-weighted imaging (DWI) and T2-weighted-Fluid-Attentuated Inversion Recovery (FLAIR) sequences showed multifocal small areas of diffusion signal abnormality in the brainstem and basal ganglia (red asterisks) suggestive of ischemia. Additional multifocal bilateral supra- and infratentorial foci of signal abnormality including subcortical white matter and deep grey matter were highly concerning for encephalitis or demyelinating disease. MRI was repeated on day 3 and day 7 during evolution of disease.
PediatricsInfectious DiseaseVisual EM
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Case Report of a Pelvic Kidney with Ureteral Obstruction from Inguinal Hernia Entrapment and Concurrent Cryptorchid Testis

Nathan Feil, BS*, Daniel Kwan, BA*, Cameron Fateri, BS*, Lindsey Spiegelman, MD^ and Roozbeh Houshyar, MD*

DOI: https://doi.org/10.21980/J8F345 Issue 7:2 No ratings yet.
The patient was afebrile with normal lactate and white blood cell count. Initial CT imaging showed an ectopic right pelvic kidney with entrapment of his right ureter within an indirect right inguinal hernia causing severe hydronephrosis (coronal: white arrow). Also discovered was an ovoid hypodensity in the right anterior pelvis consistent with right undescended testis (axial: orange arrow; coronal: green arrow) that was previously unknown to the patient, with a normal left scrotal testis (axial: red arrowhead; coronal: blue arrowhead). Other potential etiologies of the patient’s symptoms could include appendicitis or incarcerated inguinal hernia, though the imaging results and absence of systemic inflammatory response syndrome made these causes less likely.
Renal/ElectrolytesVisual EM