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Congenital Hydrocephalus

 This child was born by c-section. The mother was brought to the hospital in second stage and there was no way a head that big could be delivered vaginally. Notice the pathognomonic ‘setting-sun’ sign clearly seen in both pictures. Many doctors believe that an elective craniotomy should be done if the pregnancy has progressed to term. What are your views on this? Do leave comments. Thanks.

What do you think?

This child was brought with a history of skin lesions which became pustular and gave rise to these ulcers with punched out edges. The child was in sepsis and passed away the next day. I am clueless as to what this could have been. Differentials on first impression by various doctors included varicella with secondary infection, and ulcers related to some kind of vasculitis among others. Please leave your comments as to what you think this could be. Thanks.

Macrodactyly

  This is a picture of the foot of a baby a few months old. Macrodactyly is an uncommon congenital condition. A lot of theories have been put forward regarding the cause of this illness. Some of these include problems with nerves, blood vessels and  an AV malformation. But nobody  knows for sure what the cause is.

More here:

http://www.childrenshospital.org/az/Site1093/mainpageS1093P0.html

http://www.wheelessonline.com/ortho/macrodactyly

http://rlbatesmd.blogspot.com/2009/07/macrodactyly.html

Newborn with severe dehydration

This baby was brought to the hospital with complaints of lethargy and weak cry. The baby had sepsis and couldn't feed well. Skin turgor test is a quick way of assessing dehydration. Also notice the tied umbilical cord stump and the fungal skin infection at the right  groin flexure.

Injection Abscess

  

This was a child who had been vaccinated against DTP, if I remember right  just a few days before presenting with a swelling at the injection site – lateral thigh, probably a bit anterior. The baby was unable to move the right leg due to pain. Post vaccination abscesses are common in rural India, may be because of the large number of children vaccinated in under staffed settings.

Read more here:

 http://www.cdc.gov/mmwr/preview/mmwrhtml/00001165.htm

http://www.fetp.edu.sa/bulletin/bulletin03_3.pdf

http://www.ncbi.nlm.nih.gov/pubmed/8327295

Face Presentation

In face presentation, the presenting part is obviously not the vertex. Since difficult delivery can produce a caput on the vertex, it does no less damage to the face. This baby was delivered vaginally, as are most of the babies with face presentation in rural India. I can’t but imagine the pain and agony it has to go through not just during the delivery, but also during the first few days of life.