Journal of Pediatric Infectious Diseases - Volume 8, issue 3

Authors: Yellanthoor, Ramesh Bhat | Shah, Vishal Kumar Bharath | Elangovan, Deepak

Article Type: Research Article

Abstract: The epidemiologic features, clinical presentations and severity of malaria influence effective treatment and control strategies. We aimed to study clinical presentations, complications and fever resolution time (FRT) following chloroquine in childhood malaria. Children hospitalised with fever without any obvious cause in whom rapid diagnostic test confirmed malaria were enrolled for a prospective observational study. Continued fever beyond 96 hours following chloroquine was considered as treatment failure. Of total 113 children with malaria, …76.9% had Plasmodium vivax, 22.1% had Plasmodium falciparum and one had mixed infection. Children from endemic areas constituted 46.1% of cases. Mean duration of fever prior to admission was significantly less among children from endemic than non-endemic areas (p ⩽ 0.001). Headache, vomiting, cough and convulsions were present in 42.5%, 31.9%, 20.4% and 1.8% respectively; splenomegaly, hepatomegaly and anemia were observed in 80.5%, 10.6% and 9.7%. Fever resolved in 92.9% with mean FRT of 31.1 ± 17.5 hours. Complications occurred in 11.5%. P. vivax caused malaria usually responded to chloroquine; treatment failure was significantly higher in P. falciparum infections (p < 0.001). The FRT is likely to be of clinical value in resource poor settings. Show more

Keywords: Children, chloroquine, clinical studies, malaria

DOI: 10.3233/JPI-130389

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 111-115, 2013

Authors: Dondi, Arianna | Bellini, Federica | Ricci, Giampaolo | Giannetti, Arianna | Piccinno, Valentina | Pession, Andrea

Article Type: Research Article

Abstract: We investigated whether differences in the immunization status of adoptees might be related to their region of origin. 151 internationally-adopted children (35.1% from Latin America; 32.4% from Eastern Europe and ex-Soviet Union countries; 21.2% from South-east Asia and 11.3% from Africa; mean age 4.5 years) were assessed with 45 days of arrival in Italy. 26.5% of patients had invalid, or no, documentation of previous immunizations. Valid records were available for 88.7% and 87.8% of children from …Latin America and Eastern Europe respectively, but in only 43.8% and 41.2% of children from South-east Asia and Africa. 76/131 (58.0%) of children tested had protective anti-HBs antibody titres. Protective titres of anti-tetanus, -diphtheria and -pertussis antibodies were found in 59.7%, 80.4% and 41.5% of children, respectively. Antibodies against measles, mumps and rubella were found in 77.1%, 53.4% and 76.7% respectively among children older than 12 months. Considerable differences in immunization status exist between adoptees coming from different regions. Evaluation of their immune status is necessary so that they can be properly immunized as a result of differences in immunization schedule and concerns about vaccination records and effectiveness of vaccines received. Show more

Keywords: International adoptions, vaccine-preventable diseases, immunization

DOI: 10.3233/JPI-130390

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 117-123, 2013

Authors: Stephen, Selvaraj | Kandhakumari, Gandhi | Vinithra, Shanmugam Manohar | Pradeep, Jothimani | Venkatesh, Chandrasekaran | Namachivayam, Venkatachalam

Article Type: Research Article

Abstract: Contrary to the earlier view that Scrub Typhus (ST) is a disease of the Far East, it is now known to be more widely prevalent. In India, ST has now been reported from several areas where it was previously unknown. An outbreak of ST involving 40 children in a small hamlet in Southern India during five cooler months, November, 2011 to March, 2012 is described in this paper. The clinical suspicion was based on fever along with features such as …presence of an eschar, hepatomegaly, thrombocytopenia, raised hepatic enzymes, etc. A presumptive diagnosis of ST was made when the rapid immunochromatography test (RICT) for ST IgM/IgG/IgA was positive. All but two samples (95%) were later found positive by conventional ELISA for ST IgM, with many showing agglutinins for Proteus OXK antigen with varying titers. Children responded well to treatment with azithromycin (37) or doxycycline (3) with defervescence within one to three days. Most children were in the age group of 0–5 years (47.5%) and boys (67.5%) outnumbered girls. We recommend that ST has to be considered in the differential diagnosis when investigating outbreaks of unexplained fever in children in India. Show more

Keywords: Scrub Typhus, Orientia tsutsugamushi, R. orientalis

DOI: 10.3233/JPI-130392

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 125-129, 2013

Authors: Kuti, Bankole Peter | Adegoke, Samuel Ademola | Ebruke, Benard Ese | Howie, Stephen | Oyelami, Oyeku Akibu | Ota, Martin O.C.

Article Type: Research Article

Abstract: Pneumonia is a major killer of children worldwide. It is responsible for 19% of under-five-year-old mortality, of which 70% occurs in sub-Saharan Africa and South East Asia. A substantial proportion of deaths attributed to pneumonia is caused by failure to recognise factors at presentation that affect prognosis. The present study was aimed to assess for factors at presentation that determine mortality among children with WHO ARI defined severe pneumonia. This was a prospective observational study of …consecutive children aged 2 to 59 months admitted with severe pneumonia at a major health centre in rural Gambia to determine the risk factors for mortality using logistic regression analysis. Four hundred and twenty (27.6%) out of the 1517 under- five admissions during the study period fulfilled the criteria of severe pneumonia using the WHO ARI criteria. Fifteen of the 420 cases died giving case fatality of 36 per 1000 admissions, with pneumonia accounting for 21.4% of all 70 deaths during the period. Although age ranges 12–23 months and 36–47 months, overcrowding, hypothermia at presentation, oedematous PEM, severe wasting, grunting respiration, convulsion, somnolence and hypoxaemia were significantly associated with mortality (p < 0.05); only convulsions (OR=16.64, 95% CI 1.028–1.033) and severe wasting (OR=5.05, 95% CI 1.459–20.484,) were independent determinants of mortality. We conclude that children with severe pneumonia who in addition have severe wasting and convulsion are at increased risks of dying and should be managed in better equipped secondary or tertiary health facilities. Show more

Keywords: Childhood, Gambia, mortality, pneumonia, risk factors

DOI: 10.3233/JPI-130394

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 131-138, 2013

Authors: Jalal, Zakaria | Camou, Fabrice | Roubertie, François | Iriart, Xavier | Thambo, Jean-Benoit

Article Type: Research Article

Abstract: We report a case of a 12 year old child with a ventricular septal defect (VSD) and right-sided MRSA endocarditis complicated by pulmonary septic emboli. The patients was treated successfully with daptomycin in combination with gentamicin and rifampin, followed by surgery to excise the vegetation and close the VSD.

Keywords: Endocarditis, daptomycin, MRSA, congenital heart disease

DOI: 10.3233/JPI-130391

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 139-142, 2013

Authors: Foglio, Elsie Jazmin | Sykes, Joseph A. | Espiritu-Fuller, Maria | Spektor, Vadim | D'Cruz, Cyril | El-Khashab, Mostafa | Salam, Misbah | Chan, Trini A.

Article Type: Research Article

Abstract: Ustilago species is a pathogenic fungus that causes a fungal corn disease called "corn smut". Airborne-spores may cause hypersensitivity pneumonitis in humans with atopy. It has been identified as a rare pathogen in central line blood infections in immunocompromised patients. Ustilago has not been reported as a cause of brain abscess in an immunocompetent person. We report a case of multifocal brain abscesses in a previously healthy immunocompetent boy caused by Ustilago sp. Excision biopsy established …the diagnosis. The child fully recovered without any residual neurological defects. Show more

Keywords: Ustilago species, pediatric brain abscess, fungal brain abscess

DOI: 10.3233/JPI-130393

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 143-148, 2013

Authors: Cortés, Araceli Ferrari | Feria, Pilar Rojas | García, Elisa García | Sánchez, Antonio Pérez

Article Type: Research Article

Abstract: Moraxella osloensis is an aerobic, gram-negative coccobacillus infrequently isolated from clinical specimens. There is little published related to risk factors and treatment of Moraxella osloensis infections in the paediatric population. We report the first case of Moraxella bacteremia in a preterm newborn infant successfully treated and a review of bacteremia cases in children.

Keywords: Moraxella osloensis, preterm, newborn

DOI: 10.3233/JPI-130395

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 149-151, 2013

Authors: Bannier, Michiel A.G.E. | Miedema, Carien J. | Brackel, Hein J.L.

Article Type: Research Article

Abstract: A 3-month-old female infant was admitted with an infection of the left thumb after parental nail biting. A herpetic whitlow was diagnosed, although there were no signs of a herpes gingivostomatitis. Inoculation probably occurred through parental nail biting. Herpetic whitlow in young infants is rare and often misdiagnosed as a staphylococcal skin infection. It should be considered when an infection of the distal phalanx is accompanied by vesicles.

Keywords: Herpetic whitlow

DOI: 10.3233/JPI-130396

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 153-154, 2013