Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220105
Denise Sembrano
Background: RT-PCR using respiratory tract specimens, most commonly nasopharyngeal swab (NPS), has been used to confirm the diagnosis of COVID-19. NPS is a relatively invasive procedure that causes patient discomfort and risks viral transmission. Other specimens are therefore being investigated for the detection of SARS-CoV-2 RNA. Objective: To determine the sensitivity of non-respiratory tract specimens in detecting SARS-CoV-2 RNA in patients with COVID-19. Methodology: This review summarized the results of eight studies obtained from a literature search done in May 2020 in PubMed MEDLINE, Cochrane Library and MedRxiv. Two independent investigators reviewed and appraised the studies that were included, and pooled estimates of sensitivity for each specimen were determined using Stata’s Metaprop function. Results: The sensitivity in detecting SARS-CoV-2 RNA in non-respiratory tract specimens of diagnosed COVID-19 patients are as follows: Saliva 77% (95% CI 71-83%), stool/rectal swab/anal swab 22% (95% CI 22-37%), blood/serum/plasma 2% (95% CI 1-3%), and urine 22% (95% CI 18-25%). Conclusion: SARS-CoV-2 RNA is detected in saliva, stool/rectal swab/anal swab, blood/serum/plasma and urine. Among these, saliva has the highest estimated sensitivity. However, more studies are needed to correct the heterogeneity brought about by factors such as timing of specimen collection, disease severity and treatment.
背景:利用呼吸道标本，最常见的是鼻咽拭子(NPS)进行RT-PCR，已被用于确认COVID-19的诊断。NPS是一种相对侵入性的手术，会导致患者不适，并有病毒传播的风险。因此，正在对其他标本进行调查，以检测SARS-CoV-2 RNA。目的:探讨非呼吸道标本检测COVID-19患者SARS-CoV-2 RNA的敏感性。方法:本综述总结了2020年5月在PubMed MEDLINE、Cochrane Library和MedRxiv进行的文献检索中获得的8项研究的结果。两名独立研究人员对纳入的研究进行了审查和评估，并使用Stata的Metaprop函数确定了每个标本的敏感性汇总估计。结果:确诊COVID-19患者非呼吸道标本检测SARS-CoV-2 RNA的敏感性为:唾液77% (95% CI 71 ~ 83%)，粪便/直肠拭子/肛门拭子22% (95% CI 22 ~ 37%)，血液/血清/血浆2% (95% CI 1 ~ 3%)，尿液22% (95% CI 18 ~ 25%)。结论:唾液、粪便/直肠拭子/肛门拭子、血液/血清/血浆和尿液中检测到SARS-CoV-2 RNA。其中，唾液具有最高的估计敏感性。然而，需要更多的研究来纠正标本采集时间、疾病严重程度和治疗等因素带来的异质性。
{"title":"\"A Rapid Review on the sensitivity of SARS-CoV-2 RT-PCR done on different clinical specimens \"","authors":"Denise Sembrano","doi":"10.56964/pidspj2021220105","DOIUrl":"https://doi.org/10.56964/pidspj2021220105","url":null,"abstract":"Background: RT-PCR using respiratory tract specimens, most commonly nasopharyngeal swab (NPS), has been used to confirm the diagnosis of COVID-19. NPS is a relatively invasive procedure that causes patient discomfort and risks viral transmission. Other specimens are therefore being investigated for the detection of SARS-CoV-2 RNA. Objective: To determine the sensitivity of non-respiratory tract specimens in detecting SARS-CoV-2 RNA in patients with COVID-19. Methodology: This review summarized the results of eight studies obtained from a literature search done in May 2020 in PubMed MEDLINE, Cochrane Library and MedRxiv. Two independent investigators reviewed and appraised the studies that were included, and pooled estimates of sensitivity for each specimen were determined using Stata’s Metaprop function. Results: The sensitivity in detecting SARS-CoV-2 RNA in non-respiratory tract specimens of diagnosed COVID-19 patients are as follows: Saliva 77% (95% CI 71-83%), stool/rectal swab/anal swab 22% (95% CI 22-37%), blood/serum/plasma 2% (95% CI 1-3%), and urine 22% (95% CI 18-25%). Conclusion: SARS-CoV-2 RNA is detected in saliva, stool/rectal swab/anal swab, blood/serum/plasma and urine. Among these, saliva has the highest estimated sensitivity. However, more studies are needed to correct the heterogeneity brought about by factors such as timing of specimen collection, disease severity and treatment.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"185 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125029359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220104
Jerrymae Blasurca
The clinical course of COVID-19 in the pediatric population has been reported to be mild in the majority of affected patients. However, a condition referred to as multisystem inflammatory syndrome in children (MIS-C) can occur with SARS-CoV-2 infection where patients can become critically ill. In this series, we describe five pediatric patients with the spectrum of MIS-C associated with SARS-CoV-2 infection.
{"title":"Multisystem Inflammatory Syndrome In Children (MIS-C): A Case Series in a Tertiary Hospital","authors":"Jerrymae Blasurca","doi":"10.56964/pidspj2021220104","DOIUrl":"https://doi.org/10.56964/pidspj2021220104","url":null,"abstract":"The clinical course of COVID-19 in the pediatric population has been reported to be mild in the majority of affected patients. However, a condition referred to as multisystem inflammatory syndrome in children (MIS-C) can occur with SARS-CoV-2 infection where patients can become critically ill. In this series, we describe five pediatric patients with the spectrum of MIS-C associated with SARS-CoV-2 infection.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116308312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220108
Robert Garcia
Introduction: Fever of unknown origin (FUO) is a problem commonly encountered by infectious disease specialists, and even general pediatricians, in spite of the improvement in diagnostic modalities. There is no local study on childhood FUO from a private hospital. Thus, there is a need to determine the etiology of FUO seen in private practice, which may be different from those encountered in government or teaching hospitals. Objectives: The purpose of this study is to identify the etiologies of childhood FUO from two private, urban, tertiary hospitals, as evaluated by a single pediatric infectious disease physician; and to discuss epidemiologic, clinical and diagnostic clues for the most common etiologies. Methods: Childhood FUO cases were compiled from 1993 to 2020. Each consecutive, inpatient, admission or referral of a patient, 18 years or younger, was logged into a personal computer, and the discharge diagnosis for the FUO was recorded. Clinical, epidemiologic, diagnostic and therapeutic data, relevant to the FUO diagnosis were likewise recorded. FUO was defined as daily fever of 380C for ten consecutive days, or more, with no etiology identified after being admitted for seven days. Results: Of 171 cases of childhood FUO, the etiology was an infection in 68%, collagen-vascular disease in 13%, miscellaneous cause in 8%, malignancy in 6%, and no diagnosis in 5%. The most common infections were Epstein Barr Virus (EBV) mononucleosis, tuberculosis, enteric fever, sinusitis, pneumonia and incomplete Kawasaki disease. The most common collagen vascular diseases were juvenile idiopathic arthritis and systemic lupus erythematosus. Hemophagocytic lymphohistiocytosis was the most common miscellaneous cause. Lymphoma was the most common malignancy. Conclusion: This study found EBV mononucleosis, sinusitis, pneumonia, incomplete Kawasaki disease, lymphoma, HLH and Kikuchi-Fujimoto disease to be FUO etiologies not reported previously in other local reports.
{"title":"Fever of Unknown Origin Among Children in Two Private, Urban, Tertiary Hospitals: A 27-year Retrospective Study","authors":"Robert Garcia","doi":"10.56964/pidspj2021220108","DOIUrl":"https://doi.org/10.56964/pidspj2021220108","url":null,"abstract":"Introduction: Fever of unknown origin (FUO) is a problem commonly encountered by infectious disease specialists, and even general pediatricians, in spite of the improvement in diagnostic modalities. There is no local study on childhood FUO from a private hospital. Thus, there is a need to determine the etiology of FUO seen in private practice, which may be different from those encountered in government or teaching hospitals. Objectives: The purpose of this study is to identify the etiologies of childhood FUO from two private, urban, tertiary hospitals, as evaluated by a single pediatric infectious disease physician; and to discuss epidemiologic, clinical and diagnostic clues for the most common etiologies. Methods: Childhood FUO cases were compiled from 1993 to 2020. Each consecutive, inpatient, admission or referral of a patient, 18 years or younger, was logged into a personal computer, and the discharge diagnosis for the FUO was recorded. Clinical, epidemiologic, diagnostic and therapeutic data, relevant to the FUO diagnosis were likewise recorded. FUO was defined as daily fever of 380C for ten consecutive days, or more, with no etiology identified after being admitted for seven days. Results: Of 171 cases of childhood FUO, the etiology was an infection in 68%, collagen-vascular disease in 13%, miscellaneous cause in 8%, malignancy in 6%, and no diagnosis in 5%. The most common infections were Epstein Barr Virus (EBV) mononucleosis, tuberculosis, enteric fever, sinusitis, pneumonia and incomplete Kawasaki disease. The most common collagen vascular diseases were juvenile idiopathic arthritis and systemic lupus erythematosus. Hemophagocytic lymphohistiocytosis was the most common miscellaneous cause. Lymphoma was the most common malignancy. Conclusion: This study found EBV mononucleosis, sinusitis, pneumonia, incomplete Kawasaki disease, lymphoma, HLH and Kikuchi-Fujimoto disease to be FUO etiologies not reported previously in other local reports.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126345154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220110
Kay-Ann Pabalate-Aquino
Background: In the Philippines, Leptospirosis is a seasonal but common and prevalent disease with an average of 680 cases and 40 deaths annually. Cases result from exposure to contaminated flood, water, or soil. Several studies showed that males are more commonly affected, who are believed to be more exposed to the outdoor environment. In terms of pediatric population, early diagnosis is based mainly on clinical and epidemiological factors. Objective: This study was conducted to determine the clinical features and outcomes of pediatric leptospirosis, as well as determine the prognostic factors associated with mortality. Methodology: A descriptive retrospective study was done in a tertiary hospital from January 2007 – December 2019. Review of all cases that satisfy the diagnosis of Leptospirosis by WHO Criteria (2003) was done. The data extracted from the chart were encoded using Microsoft Excel; processed and analyzed using STATA SE 15 to generate the required output. Results & Conclusion: In this 12-year study, a total of 85 cases of leptospirosis in children, aged 0-18 years, were reported. Leptospirosis predominates in males in the adolescent age group. It is noted all year round but noted mostly during the rainy months which increases the risk to exposure to contaminated water through wading, especially in the cities of Navotas, Malabon and Tondo. The mean duration of symptoms was 3.6 days. The most common clinical findings noted in this study were fever, gastrointestinal symptoms, conjunctival suffusion, oliguria, calf tenderness and headache. Abnormal laboratory findings were leukocytosis, neutrophilia, thrombocytosis, elevated BUN and creatinine, hypokalemia and hyponatremia. Significant correlation with poor outcome was found in patients who have had pulmonary hemorrhage.
背景:在菲律宾，钩端螺旋体病是一种季节性但常见和流行的疾病，平均每年有680例病例和40例死亡。病例是由于暴露于受污染的洪水、水或土壤造成的。几项研究表明，男性更容易受到影响，因为他们被认为更多地暴露在户外环境中。就儿科人群而言，早期诊断主要基于临床和流行病学因素。目的:本研究旨在确定小儿钩端螺旋体病的临床特征和预后，并确定与死亡率相关的预后因素。方法:2007年1月至2019年12月在某三级医院进行描述性回顾性研究。对符合世卫组织标准(2003年)钩端螺旋体病诊断的所有病例进行了审查。从图表中提取的数据使用Microsoft Excel进行编码;使用STATA SE 15进行处理和分析以生成所需的输出。结果与结论:本研究共报道85例0 ~ 18岁儿童钩端螺旋体病。钩端螺旋体病主要发生在青少年年龄组的男性中。这种情况全年都有，但主要发生在雨季，这增加了涉水接触受污染水的风险，特别是在纳沃塔斯、马拉邦和通多等城市。平均症状持续时间为3.6天。本研究中最常见的临床表现为发热、胃肠道症状、结膜充血、少尿、小腿压痛和头痛。实验室异常表现为白细胞增多、中性粒细胞增多、血小板增多、尿素氮和肌酐升高、低钾血症和低钠血症。有肺出血的患者与预后不良有显著相关性。
{"title":"Clinical Profile of Pediatric Patients with Leptospirosis admitted at a Tertiary Government Hospital","authors":"Kay-Ann Pabalate-Aquino","doi":"10.56964/pidspj2021220110","DOIUrl":"https://doi.org/10.56964/pidspj2021220110","url":null,"abstract":"Background: In the Philippines, Leptospirosis is a seasonal but common and prevalent disease with an average of 680 cases and 40 deaths annually. Cases result from exposure to contaminated flood, water, or soil. Several studies showed that males are more commonly affected, who are believed to be more exposed to the outdoor environment. In terms of pediatric population, early diagnosis is based mainly on clinical and epidemiological factors. Objective: This study was conducted to determine the clinical features and outcomes of pediatric leptospirosis, as well as determine the prognostic factors associated with mortality. Methodology: A descriptive retrospective study was done in a tertiary hospital from January 2007 – December 2019. Review of all cases that satisfy the diagnosis of Leptospirosis by WHO Criteria (2003) was done. The data extracted from the chart were encoded using Microsoft Excel; processed and analyzed using STATA SE 15 to generate the required output. Results & Conclusion: In this 12-year study, a total of 85 cases of leptospirosis in children, aged 0-18 years, were reported. Leptospirosis predominates in males in the adolescent age group. It is noted all year round but noted mostly during the rainy months which increases the risk to exposure to contaminated water through wading, especially in the cities of Navotas, Malabon and Tondo. The mean duration of symptoms was 3.6 days. The most common clinical findings noted in this study were fever, gastrointestinal symptoms, conjunctival suffusion, oliguria, calf tenderness and headache. Abnormal laboratory findings were leukocytosis, neutrophilia, thrombocytosis, elevated BUN and creatinine, hypokalemia and hyponatremia. Significant correlation with poor outcome was found in patients who have had pulmonary hemorrhage.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123624355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220106
Jemilly Margaux Po
Introduction: Pregnant women are a susceptible population to emerging infections. Recent published data have shown evidence of possible transplacental transmission of SARS-CoV-2. However, at present there are not enough data to determine its effect on the fetus. This study aims to determine the outcomes of infants born to mothers with SARS-CoV-2 infection. Methods: A retrospective descriptive institution-based study using data collected from medical records of infants born to confirmed COVID-19 mothers delivered from April to June 2020. Results: Of the 47 neonates, none of them were positive for SARS-CoV-2 RT-PCR. Majority were born full-term, mean gestational age of 37 weeks, weight of 2867 grams, appropriate for gestational age, good APGAR score, and delivered through cesarean section. Symptomatic neonates (27.7%) had tachypnea and vomiting as the most common manifestation, 13.3% had lymphopenia while pneumonia was the predominant radiologic finding. There was a significant association between the presence or absence of symptoms among mothers and neonates (p=0.037). Conclusion: The neonatal outcome in this study was good with 98% survival at 2 weeks of life. There was note of 2.1% morbidity and mortality. Given that the clinical data in newborns are very limited and the possibility of a vertical transmission is still uncertain, it is crucial to closely monitor neonates with increased risk of COVID-19 infection.
{"title":"Outcomes of Infants Born to Mothers with SARS-CoV-2 Infection in a Tertiary Hospital","authors":"Jemilly Margaux Po","doi":"10.56964/pidspj2021220106","DOIUrl":"https://doi.org/10.56964/pidspj2021220106","url":null,"abstract":"Introduction: Pregnant women are a susceptible population to emerging infections. Recent published data have shown evidence of possible transplacental transmission of SARS-CoV-2. However, at present there are not enough data to determine its effect on the fetus. This study aims to determine the outcomes of infants born to mothers with SARS-CoV-2 infection. Methods: A retrospective descriptive institution-based study using data collected from medical records of infants born to confirmed COVID-19 mothers delivered from April to June 2020. Results: Of the 47 neonates, none of them were positive for SARS-CoV-2 RT-PCR. Majority were born full-term, mean gestational age of 37 weeks, weight of 2867 grams, appropriate for gestational age, good APGAR score, and delivered through cesarean section. Symptomatic neonates (27.7%) had tachypnea and vomiting as the most common manifestation, 13.3% had lymphopenia while pneumonia was the predominant radiologic finding. There was a significant association between the presence or absence of symptoms among mothers and neonates (p=0.037). Conclusion: The neonatal outcome in this study was good with 98% survival at 2 weeks of life. There was note of 2.1% morbidity and mortality. Given that the clinical data in newborns are very limited and the possibility of a vertical transmission is still uncertain, it is crucial to closely monitor neonates with increased risk of COVID-19 infection.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125322433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220101
Carmina Delos Reyes
It’s been 1 year 4 months and 15 days since the world dealt with this pandemic head on. At the onset, we struggled with COVID-19 diagnosis, treatment and prevention. It was a tough process. We know better now as we continue to discover new things.
{"title":"Of Pandemics, Epidemics, and Outbreaks","authors":"Carmina Delos Reyes","doi":"10.56964/pidspj2021220101","DOIUrl":"https://doi.org/10.56964/pidspj2021220101","url":null,"abstract":"It’s been 1 year 4 months and 15 days since the world dealt with this pandemic head on. At the onset, we struggled with COVID-19 diagnosis, treatment and prevention. It was a tough process. We know better now as we continue to discover new things.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116026239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220102
Paul Sherwin Tarnate
The current strategy in treating multi-drug resistant gram-negative bacterial (MDR-GNB) infections is salvage therapy by using polymyxins. However, the beginning emergence of polymyxin resistance should enforce strict antimicrobial stewardship programs to preserve polymyxin efficacy. Knowledge of structural characteristics, pharmacodynamic, and pharmacokinetic profiles of polymyxins, as well as consideration of efficacy, safety, suitability, and cost, will help in the choice of the appropriate polymyxin for therapy. Polymyxin B is the recommended polymyxin for systemic use, while colistin is recommended for lower urinary tract infections, intraventricular, and intrathecal use. Either polymyxin can be used for hospital-acquired and ventilator-associated pneumonia. Combination therapy over monotherapy remains to be advantageous due to synergism and decreased resistance development. The choice of the second drug to be used should be based on full susceptibility, or if unavailable, a drug with the least minimum inhibitory concentration relative to the breakpoint set by the Clinical and Laboratory Standards Institute. Using the mnemonic ESCAPE can also guide physicians in their polymyxin prescription process: (1) Checking if the pathogen is Extensively resistant or multi-drug resistant; (2) checking the patient’s clinical status if compatible with Significant infection; (3) using Combination therapy; (4) ensuring Adequate dosing; (5) Proper preparation and administration of drug; and (6) keeping an Eye for response and adverse effects.
{"title":"Rational Use of Polymyxins Against Multi-Drug Resistant Gram-Negative Bacteria","authors":"Paul Sherwin Tarnate","doi":"10.56964/pidspj2021220102","DOIUrl":"https://doi.org/10.56964/pidspj2021220102","url":null,"abstract":"The current strategy in treating multi-drug resistant gram-negative bacterial (MDR-GNB) infections is salvage therapy by using polymyxins. However, the beginning emergence of polymyxin resistance should enforce strict antimicrobial stewardship programs to preserve polymyxin efficacy. Knowledge of structural characteristics, pharmacodynamic, and pharmacokinetic profiles of polymyxins, as well as consideration of efficacy, safety, suitability, and cost, will help in the choice of the appropriate polymyxin for therapy. Polymyxin B is the recommended polymyxin for systemic use, while colistin is recommended for lower urinary tract infections, intraventricular, and intrathecal use. Either polymyxin can be used for hospital-acquired and ventilator-associated pneumonia. Combination therapy over monotherapy remains to be advantageous due to synergism and decreased resistance development. The choice of the second drug to be used should be based on full susceptibility, or if unavailable, a drug with the least minimum inhibitory concentration relative to the breakpoint set by the Clinical and Laboratory Standards Institute. Using the mnemonic ESCAPE can also guide physicians in their polymyxin prescription process: (1) Checking if the pathogen is Extensively resistant or multi-drug resistant; (2) checking the patient’s clinical status if compatible with Significant infection; (3) using Combination therapy; (4) ensuring Adequate dosing; (5) Proper preparation and administration of drug; and (6) keeping an Eye for response and adverse effects.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123717388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220109
di Clemente
Background: Hemophagocytic lymphohistiocytosis (HLH) is a clinical syndrome that is associated with a variety of underlying conditions leading to the same characteristic hyperinflammatory phenotype. Objectives: To describe the clinical profile of patients diagnosed with HLH admitted between January 1, 2010 to September 30, 2019 in a tertiary care hospital. Methods: Retrospective descriptive study of pediatric patients diagnosed with HLH in a tertiary care hospital. Results: Eleven subjects were included in the study. Age distribution showed a bimodal pattern: < 5 years old (5, 46%) and 10-15 years old (4, 36%). Male to female ratio is 4.5:1. All patients presented with fever (100%) followed by hepatomegaly (5, 45%) and splenomegaly (4, 36%) on physical examination. All eleven subjects fulfilled the following criteria for HLH such as fever, splenomegaly, and hyperferritinemia. Six out of eleven showed hypofibrinogemia (55%) and hypertriglyceridemia (55%). Among the eleven with two cell cytopenia, five presented with anemia (46%), six with neutropenia (55%), while all of them had thrombocytopenia (100%). Other laboratory findings noted were elevated ALT (5, 46%), CRP (4, 36%), AST (3, 27%), alkaline phosphatase (3, 27%), and hyponatremia (3, 27%). EBV and dengue (3, 27%) were the most common etiologies. Pneumonia (3, 27%) was the most common complication, followed by sepsis (2, 18%). All but one patient were responsive to either dexamethasone (7, 64%) and or IVIG (5, 45%) and chemotherapy (1, 9%). The antibiotic most commonly used was piperacillin tazobactam (3, 27%). The median hospital stay was 17 days. There was one mortality (9%). Conclusion: HLH should be considered in children presenting with prolonged fever, hepatomegaly, and or splenomegaly, with hyperferritinemia, thrombocytopenia, anemia and neutropenia.
{"title":"Etiology, Treatment and Outcome of Children Diagnosed with Secondary Hemophagocytic Lymphohistiocytosis in A Tertiary Hospital","authors":"di Clemente","doi":"10.56964/pidspj2021220109","DOIUrl":"https://doi.org/10.56964/pidspj2021220109","url":null,"abstract":"Background: Hemophagocytic lymphohistiocytosis (HLH) is a clinical syndrome that is associated with a variety of underlying conditions leading to the same characteristic hyperinflammatory phenotype. Objectives: To describe the clinical profile of patients diagnosed with HLH admitted between January 1, 2010 to September 30, 2019 in a tertiary care hospital. Methods: Retrospective descriptive study of pediatric patients diagnosed with HLH in a tertiary care hospital. Results: Eleven subjects were included in the study. Age distribution showed a bimodal pattern: < 5 years old (5, 46%) and 10-15 years old (4, 36%). Male to female ratio is 4.5:1. All patients presented with fever (100%) followed by hepatomegaly (5, 45%) and splenomegaly (4, 36%) on physical examination. All eleven subjects fulfilled the following criteria for HLH such as fever, splenomegaly, and hyperferritinemia. Six out of eleven showed hypofibrinogemia (55%) and hypertriglyceridemia (55%). Among the eleven with two cell cytopenia, five presented with anemia (46%), six with neutropenia (55%), while all of them had thrombocytopenia (100%). Other laboratory findings noted were elevated ALT (5, 46%), CRP (4, 36%), AST (3, 27%), alkaline phosphatase (3, 27%), and hyponatremia (3, 27%). EBV and dengue (3, 27%) were the most common etiologies. Pneumonia (3, 27%) was the most common complication, followed by sepsis (2, 18%). All but one patient were responsive to either dexamethasone (7, 64%) and or IVIG (5, 45%) and chemotherapy (1, 9%). The antibiotic most commonly used was piperacillin tazobactam (3, 27%). The median hospital stay was 17 days. There was one mortality (9%). Conclusion: HLH should be considered in children presenting with prolonged fever, hepatomegaly, and or splenomegaly, with hyperferritinemia, thrombocytopenia, anemia and neutropenia.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128127117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220111
Cynthia Aguirre, Fpidsp
None
没有一个
{"title":"Childhood Immunization Schedule 2021","authors":"Cynthia Aguirre, Fpidsp","doi":"10.56964/pidspj2021220111","DOIUrl":"https://doi.org/10.56964/pidspj2021220111","url":null,"abstract":"<jats:p>None</jats:p>","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132791609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21DOI: 10.56964/pidspj2021220113
None
没有一个
{"title":"Covid bulletin No. 1","authors":"","doi":"10.56964/pidspj2021220113","DOIUrl":"https://doi.org/10.56964/pidspj2021220113","url":null,"abstract":"<jats:p>None</jats:p>","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134455950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：