Lymphadenitis is a common pediatric disease associated with infection and inflammation. Acute lymphadenitis in children is usually accompanied by systemic viral illness, and subsides within a few days to two weeks. However, chronic lymphadenopathy or lymphadenitis is a rare disease, and is due to a reactive response to infections including tuberculosis, neoplasms, and noninflammatory lesions. The diagnostic evaluation of chronic lymphadenitis may be very complicated and it is important to consider chronic infectious diseases and rare malignancies as possible etiologies. We report a 13-year old boy who was eventually diagnosed with tuberculous lymphadenitis. The patient was initially admitted for enlarged cervical, axillary, and epitrochlear lymph nodes. Biopsy of a cervical lymph node showed the findings compatible with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) associated with EBV infection. During treatment with prednisolone, the enlarged lymph node decreased in size. However, the lymph node enlargement resumed and we performed a second biopsy. At this time the biopsy showed tuberculous lymphadenitis and a culture of gastric juice showed M. tuberculosis. With the initiation of antituberculous treatment, the patient improved clinically.
Adolescent ; Biopsy ; Child ; Communicable Diseases ; Epstein-Barr Virus Infections ; Gastric Juice ; Herpesvirus 4, Human* ; Humans ; Immunoblastic Lymphadenopathy ; Inflammation ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Male ; Prednisolone ; Rare Diseases ; Tuberculosis ; Tuberculosis, Lymph Node*

Lymphadenitis is a common pediatric disease associated with infection and inflammation. Acute lymphadenitis in children is usually accompanied by systemic viral illness, and subsides within a few days to two weeks. However, chronic lymphadenopathy or lymphadenitis is a rare disease, and is due to a reactive response to infections including tuberculosis, neoplasms, and noninflammatory lesions. The diagnostic evaluation of chronic lymphadenitis may be very complicated and it is important to consider chronic infectious diseases and rare malignancies as possible etiologies. We report a 13-year old boy who was eventually diagnosed with tuberculous lymphadenitis. The patient was initially admitted for enlarged cervical, axillary, and epitrochlear lymph nodes. Biopsy of a cervical lymph node showed the findings compatible with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) associated with EBV infection. During treatment with prednisolone, the enlarged lymph node decreased in size. However, the lymph node enlargement resumed and we performed a second biopsy. At this time the biopsy showed tuberculous lymphadenitis and a culture of gastric juice showed M. tuberculosis. With the initiation of antituberculous treatment, the patient improved clinically.
Adolescent ; Biopsy ; Child ; Communicable Diseases ; Epstein-Barr Virus Infections ; Gastric Juice ; Herpesvirus 4, Human* ; Humans ; Immunoblastic Lymphadenopathy ; Inflammation ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Male ; Prednisolone ; Rare Diseases ; Tuberculosis ; Tuberculosis, Lymph Node*

Ewing sarcoma/peripheral primitive neuroectodermal tumor (ES/PPNET) arises from bone or soft tissue of many sites of body, but ES/PPNET, as primary lesion, in the soft tissue of neck is very uncommon. The authors experienced a case of ES/PPNET in a 17-year-old girl, which was manifested as isolated cervical mass in the soft tissue without any other suspected primary lesion or metastasis. We report the case with a brief review of the literature.
Adolescent ; Humans ; Neck ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive ; Neuroectodermal Tumors, Primitive, Peripheral ; Sarcoma, Ewing

Purpose: Rapid sequence intubation (RSI) using sedatives and neuromuscular blocking agents (NMBAs) is recommended for pediatric emergency endotracheal intubation (ETI), but is not frequently performed in Korea. This study aimed to verify factors associated with the underuse of RSI medications. Materials and Methods: This multicenter retrospective study reviewed patients aged under 18 years who underwent an ETI within 24 hours of arrival at the emergency department between 2016 and 2019. Any cases of ETI during cardiopulmonary resuscitation were excluded. We investigated the characteristics of the patients, intubators, RSI medications, and outcomes. The study cases were classified into no-medication, sedative-only, and sedative-with-NMBA groups. Multivariable logistic regression analysis of RSI medication use was conducted. Results: A total of 334 cases with a median age of 3.4 years were included in this study. Sedatives and NMBAs were used in 63.8% and 32.9%, respectively. In comparing the no-medication (n=121), sedative-only (n=103), and sedative-with-NMBA (n=110) groups, patient age (median; 1.0 year vs. 2.8 years vs. 11.3 years; p<0.001), underlying medical conditions (77.7% vs. 56.3% vs. 36.4%; p<0.001), and pediatricians as intubators (76.9% vs. 54.4% vs. 17.3%; p<0.001) were different. The factors that influenced sedatives with NMBA use were patient age [for a year increment; adjusted odds ratio (aOR), 1.182; 95% confidence interval (CI), 1.120– 1.249], no underlying medical conditions (aOR, 2.109; 95% CI, 1.093–4.070), and intubators other than pediatricians (aOR, 5.123; 95% CI, 2.257–11.626). Conclusion RSI accounted for 32.9% of pediatric emergency ETI in Korea. The underuse of RSI medications is associated with younger patient age, underlying medical conditions, and pediatricians as intubators.