Pediatric Infectious Disease最新文献

Hemophagocytic syndrome covers a wide array of related life-threatening conditions characterized by an uncontrolled hyperinflammatory response. HS is often triggered by infection. Hemophagocytosis is described as a rare extra-intestinal complication of typhoid fever. We report here the case of an 11-year-old child who has developed a hemophagocytic syndrome secondary to typhoid fever which has been managed successfully by antibacterial therapy alone without the need of intensive therapy.

Acute urinary retention in children is uncommon, with a much lower incidence than in adult population. We report a 12-year-old girl who presented with urinary retention due to varicella zoster virus infection involving the sacral nerves. The perineum over dermatomes S2–S4 on the left was involved with a vesicular and superficially erosive rash. Initial management included urethral catheterization as well as full course of oral acyclovir therapy. At follow-up 4 weeks later, the perineal skin lesions had healed, the catheter was removed, and the patient was able to pass urine.

Cat-scratch disease is an uncommon cause of lymphadenopathy in India. It occurs in children and presents as a regional lymphadenopathy. It is a benign, self-limiting disease caused by Bartonella henselae, a bacterium. Clinically, a wide spectrum of differential diagnosis such as tuberculosis, Epstein Barr virus infection, malignancies like lymphomas and metastases may be considered and should be ruled out before the treatment is decided. We report this case, as the patient presented with a very large sized lymph node, giving a clinical suspicion of lymphoma.

Human papilloma virus is the agent that is responsible for cervical cancer in women, that causes an overwhelming mortality in the developing countries. This is mainly due to the lack of effective screening programs. This DNA virus has over 200 serotypes, of which 18 are classified as oncogenic and 12 of these are high risk HPV prototypes. The time lag between infection and the progression to invasive cancer is almost 20 years. Pap smears are useful to screen women to pick up precancerous lesions. HPV DNA testing is more significant for detecting early changes in the cervix. Several factors increase the risk of developing cervical cancer, including multiparity, co infection with sexually transmitted diseases, smoking, and promiscuity. Vaccination provides a potent modality to improve the immunity to infection by the oncogenic types of HPV and thus reducing metaplastic changes in the cervix which ultimately undergo malignant transformation. This paper looks at the role of screening tests and the available vaccines and their efficacy in reducing the incidence of cervical cancer.

Background

Neonatal tetanus (NNT) is considered as one of the most underreported diseases in the developing countries, seen in the newborn within the first 28 days of life. In the 1989 World Health Assembly and the 1990 world summit for children, WHO/UNICEF together with partner agencies to set up a strategic framework for the elimination of the disease by 1995 and subsequently reviewed to 2015. In spite the global success recorded in the NNT elimination strategy, it is disheartening to note that Nigeria is still among the 25 remaining countries that are yet to achieve the global NNT elimination target as set by the WHO.

Study Design

Retrospective study.

Methods

Quantitative cross-sectional study involving mothers who gave birth to children with NNT within their first 28 days of life. The study used secondary data collected between January 2008 and December 2013.

Results

Using SPSS 22, single sample proportions test and chi-square test of independence was conducted to determine if significant differences in frequency of antenatal care existed between mothers who indicated receiving care and those who did not. Result found that a significant difference did exist; z-statistic (N = 273) = 4.50, p < 0.001; 95% confidence interval (CI) = 0.308 to 0.421. The Null Hypothesis (Ho) was rejected.

Conclusion

There is need for the Nigerian government to prioritize its activities to encourage and ensure that women within the childbearing age are fully vaccinated with the tetanus toxoid, that pregnant women receive quality ANC services and deliver in functional hospitals.

Skin and soft tissue infections caused by Staphylococcus aureus are commonly encountered in pediatric practice. Staph infections acquired in the hospital setting are generally methicillin resistant. However these days, infections which are clearly “community acquired” are increasingly found to be due to methicillin resistant Staphylococcus—so called CA MRSA. Community-associated MRSA (CA-MRSA) refers to a MRSA infection with onset in the community in an individual lacking established MRSA risk factors, such as recent hospitalization, surgery, residence in a long-term care facility, receipt of dialysis, or presence of invasive medical devices. Literature from western countries suggests a significant prevalence of CA MRSA and the same scenario seems to be developing in our country. We had three recent cases of such CA MRSA infections, with no prior contact with hospital, all “community acquired” which was also reflected in their antibiotic sensitivity pattern.

The lumbar puncture (LP) and cerebrospinal fluid (CSF) examination have been considered important in diagnosis of neurologic diseases. Analysis of CSF helps in diagnosis of many conditions. Routine CSF analysis includes appearance, color, glucose, proteins, cells, Gram stain and Ziehl–Neelson (Z–N) stain. Every sample should be subjected for Gram and Z–N stains. CSF cultures should also be sent in case of suspected infective etiology. Advanced diagnostic evaluations in context with etiology of microorganism are available such as latex agglutination, PCR, and various specific antibodies. Immunologic analysis and neurometabolic studies performed in CSF samples have further broadened horizon of CSF sampling.

Kikuchi Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis is an uncommon, idiopathic, generally self-limited cause of lymphadenitis. Kikuchi first described the disease in 1972 in Japan. Fujimoto and colleagues described Kikuchi's disease in the same year. The cause of Kikuchi-Fujimoto's disease is unknown. Some kind of viral or post viral aetiology has been proposed. There have also been reports of a possible link between KFD and Systemic Lupus erythematosus (SLE).