Journal of Pediatric Infectious Diseases - Volume 8, issue 1
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Journal of Pediatric Infectious Diseases is a peer-reviewed medical journal, publishing articles in the field of child infectious diseases. The journal provides an in-depth update on new subjects and current comprehensive coverage of the latest techniques in diagnosis and treatment of childhood infectious diseases.
The following articles will be considered for publication: editorials, original and review articles, rapid communications, case reports, letters to the editor and book reviews.
The aim of the
Journal of Pediatric Infectious Diseases is to share and disseminate knowledge between all disciplines that work in the field of pediatric infectious diseases.
Abstract: Infections caused by Bordetella pertussis (B. Pertusis), have recently been reported increasingly even in highly immunized populations. This is a population-based, descriptive study. Nasopharyngeal sampling was performed in school children between 6–14 years old with coughing for two weeks or more but without any proved underlying diseases. The specimens were examined for B. Pertusis and Bordetella parapertussis (B. parapertusis) by Polymerase chain reaction and culture. Out of 6601 students, 21 (6.40%) children were found to…be positive by polymerase chain reaction assay for B. Pertusis and 6 (2.43%) children had this test positive for B. parapertusis. B. Pertusis was detected in the culture of 4 (1.22%) specimens (all culture positive cases were positive for Polymerase chain reaction too) and B. parapertusis culture was not found positive at all. The estimated incidence of pertussis in this age group was 318/100000 and for B. parapertusis was 2/100000. Pertussis has to be considered as one of the etiologies of prolonged cough in children and adolescents in Iran.
Abstract: Breastfeeding is usually the best way to feed infants, yet the advent of HIV has complicated this practice. There is enough evidence that exclusively breastfed infants are more protected against childhood morbidity and mortality from malnutrition, respiratory and gastrointestinal infections than those exclusively formula-fed. The aim of the study was to determine the infant feeding practices and factors influencing them among Prevention of Mother to Child Transmission of HIV (PMTCT) mothers at Gulu and Lacor hospitals…in Uganda. A descriptive cross-sectional study using both qualitative and quantitative methods of data collection was used. 200 HIV-positive mothers with infants aged 0–12 months were enrolled between July and August 2007. Focus group discussions for mothers and fathers and key informant interviews were conducted. Data entry and analysis were done using EPI Data 3.1 and SPSS 11.0 respectively. Qualitative data was analyzed in themes with direct quotations given. Replacement feeding was practiced by 155 (77.5%) of the mothers. The most important predictors of replacement feeding were: infant feed preparation demonstration by the health workers (OR 25.1 95% CI 7.56–83.60, p value < 0.001); HIV test done on infant (OR 8.65 95% CI 2.25–33.22, p value 0.002); HIV serostatus disclosure to the spouse (OR 5.1 95% CI 1.51–17.24, p value 0.005) and spouse support towards feeding practice (OR 4.9 95% CI 1.62–14.83, p value 0.003). Factors from qualitative data which were negatively associated with replacement feeding included: poverty, lack of serostatus disclosure and spouse support, while need for PMTCT was positively associated with replacement feeding. Replacement feeding was the predominant feeding practice among the study population and was influenced by demonstration of feed preparation, HIV test done on the infant and spouse support. A supportive spouse, male involvement, health education and HIV status disclosure is key to successful replacement-feeding practice according to WHO and country infant feeding recommendations prior to the new recommendations of 2009.
Keywords: PMTCT, replacement feeding, HIV positive mothers, infants
Abstract: Pediatric human immunodeficiency virus (HIV) infection can have varied presentations but these manifestations usually are non-specific. Probability of HIV infection in a given clinical manifestation has been examined in a very few studies including a study conducted at Bloemfontein, South Africa. This study evaluated the usefulness of world health organization (WHO) case definition to screen HIV positive children and proposed a new case definition, which was said to be more sensitive than WHO case definition (63.2…vs 14.5%). This study aims to assess the usefulness of South African (SA) Criteria for screening of HIV in hospitalized children in Indian setup and to compare its sensitivity with that of the WHO case definition. Design: Prospective investigational study. Setting: A tertiary care teaching institution of central India. Total 110 hospitalized patients aged 18 months to 14 years were included who fulfilled either SA or WHO criteria. HIV Enzyme-Linked ImmunoSorbent Assay (ELISA) test was performed on recruited patients. Intervention: None. Out of total 110 cases, 52 (47.27%) cases fulfilled WHO criteria while 58 (52.73%) cases fulfilled SA criteria. Total 9 cases were HIV positive, 3 cases were of WHO group while 6 cases were in SA group. Sensitivity of WHO and South African criteria was 33.33% and 66.67% respectively. Although South African criteria seemed to be more accurate as it was less subjective and its seropositivity rate was higher than that of WHO criteria (10.34% vs 5.77%), it was not found to be statistically significant (p > 0.05) in our setup.
Keywords: HIV, AIDS, Pediatrics, WHO clinical case definition
Abstract: The study has been conducted in neonatal intensive care unit of Sher-i-Kashmir Institute of Medical Sciences, which is a tertiary care hospital. Thrombocytopenia and other hematological abnormalities are very commonly observed in neonatal infections. The objective of the study is to determine the frequency and severity of thrombocytopenia and other hematological abnormalities in neonatal sepsis of different microbiological origins, and their impact on morbidity and mortality. During a period of five years…we studied all the newborn babies admitted, with the diagnosis of sepsis, in neonatal intensive care unit. In every sepsis positive patient we observed neutrophil count, micro ESR, C-reactive protein, severity and duration of thrombocy-topenia and their relation with the patient's hospital course, morbidity and mortality. Of 194 Culture positive cases 49 (25.25% cases had leucopenia with 100% mortality; 93 (47.93%) had thrombocytopenia with mortality directly proportional to severity of thrombocytopenia. In neonates with fungal and Gram-negative sepsis thrombocytopenia was comparatively severe and prolonged. Different pathogens causing sepsis have different effects on hematologic parameters. Neonatal sepsis is frequently associated with thrombocytopenia. Neonatal sepsis with neutropenia or with thrombocytopenia is associated with higher mortality. These hematological parameters constitute a simple and cost effective diagnostic tool for neonatal sepsis and guide antibiotic therapy, platelet transfusion, blood transfusion and other modalities of treatment.
Abstract: The hyper-IgE syndrome (HIES) is a relatively rare primary immunodeficiency syndrome characterized by recurrent severe staphylococcal abscesses of skin, lungs, and other viscera as well as sinusitis, mastoiditis, eczema, markedly elevated levels of serum IgE and distinctive musculoskeletal features. High index of suspicion is required in children who present with recurrent pyogenic infections (especially staphylococcal) to diagnose this rare condition. We report four cases of HIES with different infectious presentations in whom…diagnosis was established clinically and supported by elevated IgE levels and hyper-IgE score. The management includes use of intravenous antibiotics and early surgical intervention (in whom required) which resulted in resolution of symptoms in all patients. These patients were discharged on antibiotic prophylaxis and are well on follow-up.
Abstract: Brain abscesses in infants are extremely rare and occur as an uncommon complication of bacterial meningitis or sepsis. This case is of a 29 week male premature infant with a diagnosis of a brain abscess at 63 days of life secondary to methicillin-resistant staphylococcus aureus bacteria (MRSA) which evolved after a fairly unremarkable neonatal intensive care unit course. Cultures of the cerebrospinal fluid and blood yielded no growth. He was found to be colonized with methicillin-resistant…staphylococcus aureus on routine surveillance cultures after transfer from an outside hospital. The infant required a temporary external ventricular drain for hydrocephalus and compression of the brainstem secondary to the mass effect. He is currently developing favorably at 14 months after undergoing prolonged treatment with Vancomycin and Rifampin.
Abstract: Fungal arthritis is a relatively rare complication, which occurs in patients with hematological disease and cancer. Recently non-albicans Candida species have emerged as clinically important agents; however, Candida krusei (C. krusei) arthritis is still rare. We report a 6-year-old boy who developed C. krusei arthritis associated with acute lymphoblastic leukemia. He was given oral fluconazole and broad-spectrum antibiotics prophylactically, but nevertheless, he developed fungemia with C. krusei and subsequently developed arthritis in…his right hip. He was successfully treated with liposomal amphotericin B and micafungin combined with surgical drainage. This is the youngest case with C. krusei arthritis.
Abstract: Meropenem is not licensed in infants below three months of age. Off-label use in this age group is common for sepsis, intraabdominal and cerebral infections. We report the case of a 9-week-old infant with an intracerebral Enterobacter cloacae abscess, who developed neutropenia after 19 days of treatment with meropenem. A literature search revealed only one other case report of meropenem-associated bone marrow aplasia in a 3-year old child. An additional search using the World Health Organization…Global Individual Case Safety Report database from the Collaborating Centre for International Drug Monitoring showed eight reports of haematological adverse events in children between 2 and 9 years of age. Severe neutropenia or agranulocytosis is a rare but serious and potentially life-threatening adverse event of meropenem and should be considered in children at any age who present with leucopenia or agranulocytosis.