hamza hokoumi

For more than 25 years, honey has been employed to facilitate the healing of complex wounds with excellent results. Here, we report the case of a two-and-a-half-year-old agammaglobulinemia patient admitted in our unit for severe sepsis with extensive skin necrosis in the groin, penis and scrotum. An Ecthyma Gangrenosum was corroborated by the isolation of Pseudomonas aeruginosa in wound swab culture. The child was treated by broad-spectrum antibiotics. Following resuscitation, the prognosis of external genitalia remained reserved. An extended necrosectomy was performed on the groin, leaving a large and deep wound. No improvement occurred with standard local therapy; moreover, the striking particularity of the present immunosuppressed case was that necrosis extended and engaged the genitalia. Such condition left us with no alternative except to try honey dressings without much conviction, which, surprisingly, resulted in an improvement in the wound, until total healing was achieved. Honey seems to be the local treatment of choice for ecthyma gangrenosum.

Ventriculoperitoneal shunt (VPS) is the most commonly used procedure for treatment of hydrocephalus in children. Abdominal cerebrospinal fluid pseudocyst is a rare complication but potentially fatal. The pathogenesis of this complication remains unclear. This complication should be considered during differential diagnosis of an abdominal mass. Our aim is to report how large and giant an abdominal cerebrospinal fluid pseudocyst can develop, and how severe the neurological damage can be.
A 6 year-old girl known to have a ventriculoperitoneal shunt presented with abdominal distension and signs of increased Intracranial Pressure (ICP). Ultrasonography revealed a hypoechoic intraperitoneal fluid containing cyst with a well-defined margin and septations. Abdominal computerized tomography revealed a huge cyst in the abdomen and the distal part of the peritoneal shunt tube located within the cyst. Laparotomy revealed a huge cyst extending from the upper right side of the abdomen to the pelvis. The whole cyst was excised and the catheter repositioned.
Early diagnosis of abdominal Cerebrospinal Fluid (CSF) pseudocyst is only possible through close and periodic examination of patients after the procedure.