Background: Sepsis still causes morbidity and mortality in children admitted to the pediatric intensive care unit (PICU). Sepsis induces myocardial dysfunction and causes a reversible decline in ejection fraction (EF) of ventricles. Many biomarkers have been described for diagnosing sepsis, including serum ferritin and C-reactive protein (CRP). Objectives: This study was conducted to assess the relationship of cardiac dysfunction evaluated using echocardiogram, ferritin, and CRP with negative outcomes of sepsis in the PICU. Methods: A cross-sectional study was conducted on 80 patients aged between one month and six years who fulfilled the following criteria: (1) confirmed diagnosis of sepsis according to the American College of Critical Care Medicine; (2) receiving ventilation for 48 h and/or vasoactive medicines. The CRP and ferritin levels were recorded on the first day (D1) and third day (D3) of hospitalization in the PICU. Participants underwent an echocardiography study to investigate the ejection fraction on D1 and D3. All outcomes were evaluated. Results: Our results showed a highly statistically significant difference between D1 and D3 in ejection fraction (P = 0.001). The serum ferritin level and CRP enhanced significantly from D1 to D3 (P < 0.001). Low left ventricular ejection fraction, and high serum ferritin were associated with unfavorable outcomes (P values < 0.001 and 0.021, respectively), but there was no significant difference in the outcomes regarding CRP. Conclusions: Cardiac dysfunction and high serum ferritin were associated with unfavorable outcomes in children with sepsis admitted to the PICU.

Pseudolipoma, also known as pseudolipoma of the Glisson's capsule, is an encapsulated lesion that contains degenerated fat and is enveloped by the liver capsule. In this report, we discuss a 37-year-old male presenting with dysuria and microscopic hematuria who revealed an incidental finding of a pseudolipoma on a CT scan of the abdomen.

Objective: This study aimed to evaluate the association of Cardiac dysfunction assessed by Echocardiogram study, ferritin, c-reactive protein, and leukocyte count with unfavorable outcomes in pediatric sepsis within the pediatric intensive care unit.Methods: A prospective cohort study was carried out from September 2019 to April 2020, with 40 patients admitted to a pediatric intensive care unit(PICU) at Minia University Children and Maternal hospital, aged between 28 days and 15 years. Inclusion criteria where patients diagnosed with sepsis, need for mechanical ventilation for quite 48h, and vasoactive drugs. Serum levels of C-reactive protein, ferritin, and leukocyte count were collected within 24 h of admission (D1), and 72 h (D3) after admission to PICU. Patients underwent echocardiography study to figure out the ejection fraction of the ventricle on D1 and D3. The outcomes measured through length of stay at hospital and at the pediatric intensive care unit, mechanical ventilation(MV) duration, free hours of VM, duration of use of inotropic agents, maximum inotropic score, and mortality.Results: Patients with elevated ferritin levels on D1 had less ventilator-free time and higher maximum inotropic score. Patients with cardiac dysfunction by echocardiogram on D1 had longer hospital stay pediatric intensive care unit, stay longer duration of mechanical ventilation higher maximum inotropic score, and fewer ventilator-free hoursConclusion: Cardiac dysfunction by echocardiography study and serum ferritin value was significantly related to unfavorable outcomes in pediatric patients requiring admission to PICU with sepsis.