Tuberculosis (TB) remains a major public health problem worldwide. The actual magnitude of this epidemic is underestimated due to difficulties in diagnosis in children and the limited reporting of this disease. Diagnosis of childhood TB represents a challenge, since the infection in the child usually presents with nonspecific clinical manifestations and is often asymptomatic, which delays the diagnosis, leading to this age group at a high risk of disseminated infection. We describe the case of a preschool boy with meningeal tuberculosis, with a subacute clinical presentation of fever, progressive sensory disorder, and signs of endocranial hypertension. The epidemiological background allowed guiding the diagnosis and the start of antituberculous therapy. The patient's clinical evolution was torpid, he developed very serious complications, with a fatal outcome.

Tuberculosis (TB) remains a major public health problem worldwide. The actual magnitude of this epidemic is underestimated due to difficulties in diagnosis in children and the limited reporting of this disease. Diagnosis of childhood TB represents a challenge, since the infection in the child usually presents with nonspecific clinical manifestations and is often asymptomatic, which delays the diagnosis, leading to this age group at a high risk of disseminated infection. We describe the case of a preschool boy with meningeal tuberculosis, with a subacute clinical presentation of fever, progressive sensory disorder, and signs of endocranial hypertension. The epidemiological background allowed guiding the diagnosis and the start of antituberculous therapy. The patient's clinical evolution was torpid, he developed very serious complications, with a fatal outcome.

Systemic lupus erythematosus is an autoimmune disease with multisystem involvement, an alternating clinical course, and which constitutes a diagnostic challenge, with a greater disease activity in the pediatric age group, which also darkens its prognosis. In this article, we report the case of a ten year old female patient who debuted with systemic lupus erythematosus with gastrointestinal, renal and hematological involvement; the chronic course coupled with the varied clinical spectrum suggested the diagnostic possibility.

More child abuse cases are reported in Peru every year; however, there is no official report that describes the actual incidence, especially of the most vulnerable population such as infants. Signs of physical abuse generally involve brain injury and constitute shaken baby syndrome or pediatric abusive head trauma, which is a challenging diagnostic challenge. A 3-month-old infant is admitted to the emergency room for 30-minute generalized tonic-clonic seizures. On physical examination, the presence of a bony callus on the right clavicle was striking. A brain tomography and magnetic resonance imaging were performed, showing hyperintense lesions in the white matter, non-contrast enhancers, limited diffusion, and a bilateral subdural collection. Together, a bone survey was taken, which revealed multiple fractures in different areas of the body and suspecting the case of child abuse, so...

The spider bite of the genus Loxosceles is a public health problem in regions of Latin America. In Peru, it occurs more frequently in homes in the coastal region and could have serious consequences, including death in the case of cutaneous and visceral loxoscelism (CVL). The case of a pediatric patient with a suspected spider bite is presented below. The clinical picture developed with marked edema of the face and neck, without developing respiratory distress and without evidence of systemic compromise. The slow resolution of the edema and the lack of response to the treatment of choice for angioedema allowed us to guide the diagnosis to predominantly edematous cutaneous loxoscelism (CLEP), which is an infrequent form of presentation.

Systemic lupus erythematosus is an autoimmune disease with multisystem involvement, an alternating clinical course, and which constitutes a diagnostic challenge, with a greater disease activity in the pediatric age group, which also darkens its prognosis. In this article, we report the case of a ten year old female patient who debuted with systemic lupus erythematosus with gastrointestinal, renal and hematological involvement; the chronic course coupled with the varied clinical spectrum suggested the diagnostic possibility.