The pathogenesis of Mycoplasma pneumoniae encephalitis is not established. We report, for the first time, the case of a patient with severe Bickerstaff brain stem encephalitis in whom we detected intrathecal production of M. pneumoniae-specific antibodies, contrasting the findings in another patient with less severe encephalitis in whom we detected intrathecal M. pneumoniae DNA but no specific antibodies. Our observations suggest that intrathecal M. pneumoniae-specific antibody responses may contribute to a more severe course of M. pneumoniae encephalitis.

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Objective: We aimed to evaluate the impact of a low-dose whole-body computed tomography (WBCT) protocol on radiation doses in pediatric major trauma patients. Methods: Retrospective cohort study of pediatric trauma patients (<16 years) at a national level 1 pediatric trauma center (PTC) over a 6-year period prior and post introduction of a low-dose WBCT protocol (2014–2019). Demographic data, patient characteristics, CT device, and exposure information including scan range, dose-length product (DLP), and volume computed tomography dose index (CTDIvol) were collected. Effective dose (ED) and exposure parameters were compared before and after protocol introduction. Results: Forty-eight patients underwent WBCT during the study period. Prior to introduction of the low-dose protocol (n =18), the ED was 20.6 mSv (median 20.1 ± 5.3 mSv [range 12.5-30.7]). After introduction of the low-dose WBCT protocol (n = 30), mean ED was 4.8 mSv (median 2.6 ± 5.0 [range: 0.8–19.1]). This resulted in a reduction of 77% in mean ED (p value <0.001). Conclusions: Significant radiation dose reduction of 77% can be achieved with low-dose WBCT protocols in pediatric trauma centers

Calcifying fibrous tumor (CFT) is a benign tumor entity which can present in a variety of different sites. Till date, eight cases with a mediastinal manifestation have been published in literature. Surgical removal is the treatment of choice for this often incidentally detected tumor. Surgery of thoracic CFT may be challenging due to its localization within the mediastinum. A 10-year old boy with a right-sided thoracic pectus carinatum-like deformity was referred for further evaluation, incidentally, revealing a mediastinal mass in computed tomography (CT). Laboratory results were all within normal range. Magnetic resonance imaging (MRI) showed a large tumor in the upper anterior mediastinum suggesting expansive but not infiltrative character. The tumor was displacing surrounding structures like the heart and the diaphragm. Lower venous stasis with dilation of the inferior cava vein could be demonstrated. The tumor was considered to be of benign dignity and surgical removal was indicated. Complete tumor resection could be achieved through a sternotomy approach, along with thymectomy. A partial resection of both the pericardium and diaphragm was required due to adhesion with soft tissue at those sites. The specimen's size was 320 mm × 145 mm × 100 mm, histologically confirmed as CFT. The patient showed no residual tumor at 3- and 9-month follow-up. This case is a report on a large mediastinal CFT which underwent successful complete surgical removal. Following tumor resection, prognosis is considered to be good; however, key issue is complete resection to avoid local tumor recurrence.

Angeborene Fehlbildungen der Niere und des Ureters sind einer der häufigsten Erkrankungen bei Kindern. Das Erkrankungsspektrum des Harntraktes reicht hierbei von transienter Hydronephrose bis zur renalen Dysplasie und Agenesie. Die hochauflösende Bildgebung des Harntraktes ist hierbei die Grundlage für das weitere Procedere bei jedem dieser Kinder, um postnatal abzuklären, wer eine chirurgische Intervention bedarf und wer auch ohne Chirurgie eine günstige Prognose in Bezug auf die Nierenfunktion hat.