Tuberous sclerosis is a multisystemic disorder inherited in autosomal dominant pattern. It can be diagnosed as early as intra-uterine period of life but clinically may remain asymptomatic until late childhood or adulthood. We here report a case of TSC with cardiac rhabdomyoma presenting as unresponsive tonic seizures in a 10-year-old with behaviour abnormality.

Background: The upper respiratory infections cause considerable morbidity mainly in children due to the fact that they mainly affect children. Accordingly, a study was conducted on antibiotics to compare the effectiveness of clarithromycin, cefuroxime, and levofloxacin for treating upper respiratory tract infections (URTI) in children. Methods: A prospective observational study for a period of 6 months was conducted in the pediatrics department of RVM hospital. Outpatients under the age of 14 years given antibiotics for the treatment of URTI were included in the study. A total of 99 study subjects were included in the study, divided into three groups each containing 33 sample sizes (clarithromycin, cefuroxime, and levofloxacin). Patient data was collected using a form and verbal consent was obtained from patients/patient representatives, and drugs were given using the lottery method. Follow-up was done and noted for the 3rd, 5th, 7th day through telephonic calls, and the collected data were evaluated using statistical analysis. Results: Pool data from 99 patients shows that many patients belong to 0–5 years age groups (age distribution), and males were more than female (gender distribution). Clarithromycin (cure rate 3 days) and cefuroxime (cure rate 5 days) showed an equal rate of cure percentage (94%), while levofloxacin for 3–5 days with a 3% failure rate. A significant difference of p<0.05 (p=0.000) was observed and no adverse events were noted. Conclusion: The study findings showed, out of 3 drugs, clarithromycin and cefuroxime showed an equal efficacy rate of 94%, but clarithromycin showed shorter duration of outcome, i.e., 3 days. Hence, clarithromycin is effective than the other two drugs in the treatment of URTI.

The lymph nodes, particularly cervical nodes are affected in many infectious, autoimmune, metabolic and malignant diseases because they are the first drainage stations especially among children and can represent an early and subtle clinical sign. A careful choice of diagnostic procedures must be made to permit appropriate treatment. The spectrum of differential diagnoses vary from simple upper respiratory infections to malignant diseases. One such rare condi-tion is Sinus Histiocytosis which is associated with fever, massive bilateral lymphadenopathy. It is known to be associated with SLE or can mimic SLE. The condition commonly present in the first two decades of life. In our case of fever of unknown origin, diagnosis of Sinus Histiocytosis was made by lymph node biopsy but immunological profile was suggestive of mixed connective disorder. The case left a grey area unexplored whether MCTD can mimic or be associated with sinus histiocytosis.