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New-Onset Seizures in Infant With Square Facies, Hypospadias, and Hirschsprung Disease

New-Onset Seizures in Infant With Square Facies, Hypospadias, and Hirschsprung Disease

HISTORY

A 6-month-old boy with dysmorphic facial features, ear anomalies, and hypospadias brought for evaluation of elevated temperature and generalized seizure. Infant born at term to a 37-year-old mother via uncomplicated cesarean delivery. In the nursery, progressive abdominal distention and bilious vomiting developed. Barium enema revealed findings consistent with Hirschsprung disease. Infant underwent corrective surgery with colostomy and subsequent colostomy reversal. A moderate ventricular septal defect was detected during his neonatal course and confirmed by echocardiogram. CT scan of the head revealed agenesis of the corpus callosum.

PHYSICAL EXAMINATION

Square-shaped face, a prominent but narrow chin, deep-set but large eyes, hypertelorism, broad nasal bridge with rounded nasal tip, open mouth with full lower lip, posteriorly rotated ears, and large uplifted earlobes with a central depression. Infant's weight and height at the 25th percentile; head circumference at the 50th percentile. Large horizontal scar from surgery on his abdomen, and a harsh grade 3/6 systolic ejection murmur over left sternal area. Vital signs normal.

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