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RN&C: Ano de 2025

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  • Specific learning disorders – the role of the pediatrician in a multidisciplinary approach
    Gandra, Inês; Freitas, Catarina; Castro, Carolina; Maio, Inês; Gonçalves, Cláudia
    The main specific learning disorders are addressed, with regard to their definition, screening, diagnosis and general therapeutic guidance strategies. Particular attention is given to the role of the Pediatrician in early identification of risk factors and clinical manifestations, timely referencing for evaluation by appropriate subspecialists - contributing to a timely diagnosis and early intervention - and overall coordination of the multidisciplinary team.
  • Right aortic arch: the value of the upper mediastinum view in fetal echocardiography
    Ferreira, Beatriz Sousa; Almeida, Francisca Ferreira de; Correia, Ana Isabel
    The prenatal diagnosis of a right aortic arch consists of the visualization of a malposition of the aorta crossing the upper mediastinum to the right side of the trachea. The detection rate of this anatomic abnormality has improved with the introduction of the upper mediastinum views in routine fetal ultrasonographic evaluation. The following casereport demonstrates a fetus affected by an isolated right aortic arch emphasizing the importance of the five Yagel views of the fetal heart.
  • Dermatologic clinical case
    Santos, Raquel; Quintela, Carolina; Silva, Joana Azevedo; Peralta, Lígia; Sá, Aida
    Phytophotodermatosis (PPD) is a skin reaction caused by contact with furocoumarins, photosensitizing substances present in certain plants, followed by exposure to ultraviolet radiation. Herein we report a case of a 17-year-old teenager who developed a cutaneous reaction after using rue (Ruta graveolens) as a homemade treatment for acne. The condition presented with a characteristic inflammatory phase, followed by a hyperpigmentation phase. A diagnosis of PPD due to rue was established, and with rue eviction there was a full resolution. The authors aim to raise awareness about this condition which requires a high level of clinical suspicion for identifying the etiological agent. Prompt recognition and intervention are crucial in preventing the worsening and recurrence of the reaction.
  • Pollen-food syndrome during pediatric age: a case series
    Cunha, Francisca; Rodrigues dos Santos, Filipa; Cunha, Leonor; Falcão, Helena
    Introduction: Pollen-food syndrome (PFS) is an immunoglobulin E-mediated reaction, caused by cross-reactivity between pollen and antigens of foods such as those in fruits, vegetables, and/or nuts, in patients with pollinosis. Aims and Methods: The aim of this study was to present clinical manifestations of PFS, using a case series of six pediatric patients with PFS and pollen allergy referred to our Allergy and Clinical Immunology Department. Results: The age at diagnosis ranged between 10 and 17 years old, and three of the patients were male. All patients reported experiencing oral allergy syndrome. The main foods reported as triggers were apple, peach, pear, kiwi and banana. The allergic diagnostic workup revealed sensitisation to PR-10 and profilins, the main proteins involved in PFS. Currently, all patients remain asymptomatic after the fresh fruits’ eviction. Conclusion: We emphasize the importance of recognition of this entity to provide an adequate management.
  • Lipschütz ulcer: a diagnosis to remember in acute genital ulceration in adolescents
    Sampaio, Margarida Camanho de; Martins, Cátia; Pereira, Patrícia; Hipólito, Elsa; Flores, Maria Manuel
    Lipschütz ulcer (LU) is a rare cause of acute genital ulceration, usually in a mirror pattern, that mainly affects adolescents without previous sexual contact. The aetiology is unclear, but infectious and idiopathic causes have been associated with its onset. LU can cause significant pain but is self-limited and typically resolves within two to six weeks. A case report of a 12-year-old girl with LU is presented, who was initially misdiagnosed with genital herpes. After excluding other causes of genital ulceration, she was ultimately diagnosed with LU and treated with symptomatic medication for pain control and healing optimization.. The patient fully recovered after five weeks and remained asymptomatic after one year.LU is a rare cause of vaginal ulceration in non-sexually active adolescents that can be easily overlooked in the differential diagnosis. The disease is self-limited, but in some cases may require hospitalization for pain management.
  • Severe back pain in an adolescent - what to suspect?
    Esteves, Catarina Schrempp; Costa, Ricardo Craveiro; Brissos, João; Flores, Pedro; Faria, Hugo Castro
    We present a case involving an adolescent who visited our emergency department with a two-day history of debilitating lower back pain affecting daily activities. The pain’s intensity and presence of fever raised concerns, prompting a bone scintigraphy that led to an osteomyelitis diagnosis. Timely identification of osteomyelitis is crucial due to its potential life-threatening nature. Staphylococcus aureus infection, prevalent in skin and deep tissue infections, is the most common etiology across all age groups. Swift diagnosis and treatment play a pivotal role in achieving positive outcomes.
  • Campylobacter spp Gastroenteritis in Paediatric Patients of a Portuguese Hospital: Impact of the COVID-19 Pandemic
    De Beir, Joana; Caniço, Joana; Mesquita, Marta; Almeida, Sílvia
    Introduction: Campylobacter spp is the main cause of acute bacterial gastroenteritis. This study aims to characterise cases of Campylobacter spp acute gastroenteritis (CAG) over the past 10 years in a Portuguese hospital setting and to assess the impact of the COVID-19 pandemic on the incidence and management of these infections. Methods Observational descriptive study of CAG in a Portuguese Paediatrics Department, from 01. June.2013 to 31. December.2023. Diagnosis was established by stool culture/molecular methods. Results: Among 3391 stool samples analysed, 766 tested positive, and Campylobacter spp was isolated in 582 of them. A total of 502 CAG were diagnosed: 89% caused by C. jejuni, 63% were male, and the median age was 2 years. Co-infections were found in 12% of the cases. The incidence of CAG increased over the years, mainly after the emergence of the COVID-19 pandemic. Conclusions: Over the last 10 years, there has been an increase of CAG, mainly affecting young children and boys. After COVID-19, the incidence of campylobacteriosis increased, for reasons that remain to be clarified. Although the clinical course was mostly benign, the acute complications raised after the pandemic.
  • Purpuric rash in an adolescent
    Melo, Joana; Margalha Miranda, Ana; Pereira Fernandes Garcês, Sónia
    A previously healthy 17-year-old girl presented to the emergency department with a 14-day history of fever, sore throat, and a generalized reddish-purple pruritic rash. The rash, initially erythematous and maculopapular, worsened and became coalescent and purpuric. She had been treated with azithromycin for three days starting on the third day of illness. Physical examination revealed a good general condition, pharyngeal erythema with exudate, and a purpuric rash covering the body, including the face, palms, and soles, without other systemic signs. Serological tests confirmed a diagnosis of acute infectious mononucleosis. The patient was managed conservatively and had fully recovery at re-evaluation, 50 days after symptom onset. Acute infectious mononucleosis typically presents with fever, cervical lymphadenopathy, and tonsillitis/ pharyngitis, with spontaneous exanthema occurring in 3-15% of cases. This case highlights the importance of considering acute infectious mononucleosis in adolescents presenting with purpuric exanthema and the potential for antibiotic-associated rash including azithromycin, emphasizing the need for thorough clinical and serological evaluation.
  • Ulcerative skin lesions – what is the diagnosis?
    Foles, Ana; Carvalho, Rita; Moreira, Biana; Cachão, Joana
    Ecthyma is an ulcerative skin infection, usually caused by group A beta-hemolytic Streptococcus. High temperatures and humidity facilitate the development of the disease, which is particularly common among travelers returning from tropical countries. Early diagnosis and adequate treatment, with systemic antibiotics and local intervention, is essential to minimize the risk of complications. The authors present the case of an 11-year-old boy with exuberant ecthyma lesions conditioning severe pain, which prevented walking.
  • Feeding difficulties in the offspring of mothers with an eating disorder - a case report
    Carvalho e Marques, Pedro; Sá, Teresa; Martins, Vânia
    Background: One of the main risk factors for eating disorders (ED) in early childhood is maternal ED. Mothers with a history of ED have difficulties in their approach to feeding their children, with mealtimes being perceived as stressful, with controlling behavior and intrusiveness. Case presentation: An 11-month-old female infant was evaluated at a Child Psychiatry Consultation for feeding difficulties. Her mother had a history of Restrictive Anorexia Nervosa. Mother-child psychotherapy was performed due to a pattern of insecure attachment and an ongoing conflict over control and autonomy between the caregiver-child. After the intervention, mealtimes became more natural and less conflictual. Discussion and conclusion: The authors aim to shed light on the transgenerational transmission of ED. Feeding interactions between mothers with ED and their offspring are less harmonious, with greater conflict, controlling behaviors, negative affect and decreased emotional availability to the child. Clinicians must be aware of a potential parental history of ED when dealing with children with feeding problems.