Journal of Pediatric Infectious Diseases - Volume 3, issue 1

Authors: Agrawal, Amit | Pratap, Akshay | Agrawal, Chandra S. | Singh, Satya N.

Article Type: Research Article

Abstract: We report a case of 14-year-old female who was admitted with a rare retroorbital subperiosteal hematoma manifested as sudden orbital pain, progressive proptosis and diminution of vision. Cranial computed tomography showed a biconvex high density mass in the superolateral part of the right orbit, which was recognized to be a subperiosteal hematoma intraoperatively. Infection extending into the orbit was important in causing the hemorrhage.

Keywords: Retrorbital, subperiosteal hematoma, frontal abscess

Citation: Journal of Pediatric Infectious Diseases, vol. 3, no. 1, pp. 59-61, 2008

Authors: Nandi, Madhumita | Mondal, Rakesh | Datta, Supratim | Chowdhury, Abhijit

Article Type: Research Article

Abstract: Hepatitis A virus infection may remain asymptomatic, especially in children, or it may cause acute self- limiting hepatitis of few weeks duration. Rarely, it may also cause fulminant hepatitis or relapsing hepatitis or prolonged cholestasis of few months duration. We describe five children admitted to a tertiary care centre with features of acute severe hepatitis due to hepatitis A virus infection who on follow up for 6 months showed persistent biochemical abnormalities. We also review the …existing literature on prolonged hepatitis A virus infection. Show more

Keywords: Hepatitis A virus, infection, prolonged hepatitis, children

Citation: Journal of Pediatric Infectious Diseases, vol. 3, no. 1, pp. 63-67, 2008

Authors: Campos, Santiago | de la Cerda, Pablo | Rivera, Alfonso

Article Type: Research Article

Abstract: A 5-year-old boy from a malaria endemic region of our country was admitted to our unit after being diagnosed of Plasmodium vivax malaria and treated with rectal artesunate at a dose of 200 mg bid for 4 days (total dose 1,600 mg; 88 mg/kg/day). After a period of improvement, at the fifth day of treatment he developed unconsciousness, seizures, jaundice and gastrointestinal hemorrhage. New tests for Plasmodium were negative (blood smear, bone marrow examination and two …rapid diagnostic tests for Plasmodium falciparum). Blood, urine and cerebrospinal fluid bacterial cultures were negative as well as viral tests for central nervous system and liver infections. A computerized tomography scan of the brain demonstrated a diffuse brain swelling. Despite intensive treatment, the clinical condition worsened to status epilepticus, unresponsive hemodynamic collapse, pancytopenia, liver failure, coagulopathy, renal insufficiency and finally death 6 days after admission and 13 days after the first dose of artesunate. The Institutional Review Board waived the need for consent. The safety profile of artemisinin derivatives has been questioned because of their potential neurotoxic effects. In this case, the particular pharmacokinetic profile of artesunate suppositories and prescription error at a dose at seven fold higher than the maximum recommended for the drug, could have caused a protracted central nervous system exposure to very high levels of artesunate leading to toxicity especially to the brain stem, which explains the unresponsive hemodynamic collapse responsible for the death of our patient. To our knowledge, this could be the first reported case of artesunate intoxication in humans. Children are particularly vulnerable to inadvertent prescribing errors. We caution against using adult preparations for pediatric treatment and suggest that hospitals should update their prescribing formulary for pediatric treatment of malaria. Show more

Keywords: Artesunate, artemisinin, neurotoxicity, malaria, Plasmodium, child

Citation: Journal of Pediatric Infectious Diseases, vol. 3, no. 1, pp. 69-75, 2008

Article Type: Other

Citation: Journal of Pediatric Infectious Diseases, vol. 3, no. 1, pp. 77-78, 2008