Tropical Doctor最新文献

Neonatal rectal prolapse (NRP) is a rare, distressing condition in neonates, often linked to malnutrition, diarrhoea, and constipation. The effectiveness of glycerine soaked bandage drain for non-surgical management of idiopathic NRP is demonstrated.

We encountered a febrile child with constitutional symptoms in north India. The child was hospitalised, and a routine testing for febrile conditions was negative. A bedside ocular examination raised suspicion of granulomatous uveitis. This led us to seek a diagnostic test, which led us to confirm an infectious etiology.

An intestinal stoma is often created to protect a distal anastomosis. Factors affecting morbidity and mortality of stoma closure have been well studied; however, the role of fungal infection in peristomal skin has not. This prospective, observational study was conducted between August 2022 and July 2024 to determine the incidence of fungal infection in peristomal skin, in patients undergoing stoma closure, and its association with postoperative complications such as surgical site infection (SSI), anastomotic-leak, bowel obstruction/ileus and mortality. The incidence of paralytic ileus, bowel obstruction, anastomotic leaks, and mortality were insignificant, but peristomal Candida infection is a significant risk factor for postoperative SSI.

Amoebic meningo-encephalitis is difficult to diagnose because the clinical signs of the disease mimic bacterial meningitis, compared to which it progresses rapidly towards a fatal outcome. Diagnosis is possible by cerebro-spinal fluid (CSF) wet mount examination. Two confirmed cases of amoebic meningoencephalitis from Kerala state India are presented.

Multiple magnetic foreign body ingestion can cause serious complications in children. Such events are now more frequently seen. We report such a case and present a systematic review to identify the variety of fistulae thereby caused. Timely diagnosis through radiographic imaging plays a pivotal role in guiding clinical decisions.

Necrotizing enterocolitis, a life-threatening surgical condition, is uncommon in the first week of life in preterm neonates. However, the certainty of the risk factors contributing to NEC in preterm neonates during the first week of life remains ambiguous. Our case was amoderately preterm, small for gestation at birth, and delivered by emergency Caesarean section for maternal respiratory distress. In the background of growth restriction and perinatal asphyxia, this neonate deteriorated at 90 h of life and developed feed intolerance, abdominal distension, and haemodynamic compromise. Abdominal radiography demonstrated pneumatosis intestinalis suggestive of necrotizing enterocolitis. The child subsequently succumbed at 110 h of life, possibly to catecholamine-resistant septic shock secondary to multidrug-resistant Klebsiella pneumonia. In the background of conditions causing gut ischaemia, bacterial sepsis may have set off an inflammatory cascade that led to necrotizing enterocolitis at a younger age than usual described in the literature.

BackgroundRalstonia species are emerging nosocomial pathogens linked to significant clinical disease in high-risk populations, particularly preterm neonates.ObjectiveTo study the clinical and epidemiological characteristics including source identification of Ralstonia outbreak in NICU.MethodsThis study was conducted in a tertiary care NICU in South India, identifying 14 cases of Ralstonia infection over two epochs: May to August 2021 and December 2022 to February 2023. We reviewed patient characteristics, clinical manifestations, antimicrobial profiles, and outcomes, alongside an epidemiological investigation for source identification.ResultsAmong the 14 cases, 13 were R. mannitolilytica and 1 was R. pickettii. No source was identified in the first epoch; however, contaminated sterile water ampoules used for IV preparations were implicated in the second. The mean gestation was 28 weeks (± 3), and the mean birth weight was 1192 g (± 539). Most neonates exhibited nonspecific symptoms. All isolates were sensitive to ciprofloxacin and trimethoprim-sulfamethoxazole, with all cases recovering fully.Teaching implicationsRalstonia species are capable of causing outbreaks and should prompt epidemiological surveillance for source identification. Clinical infection is usually mild with full recovery. Key interventions to prevent outbreaks include rigorous surveillance, infection control, and prompt antibiotic treatment.

Malaria and filariasis are mosquito-borne diseases caused by protozoal and nematode parasites, respectively. Despite different vectors, they can occur together under suitable conditions in endemic regions. In our case, microfilariae were incidentally discovered during a blood film examination for malaria. Accurate detection of microfilariae, especially in cases of low parasitemia, requires multiple blood smears and consideration of Wuchereria bancrofti's nocturnal periodicity, with blood collection ideally performed at night when parasitemia levels are highest. The presence of eosinophilia in our patient suggested a non-malarial parasitic infection, as eosinophilia is relatively uncommon in acute malaria. Our case highlights the need for a broad differential diagnosis, particularly in regions where both diseases are endemic and emphasise the value of detailed peripheral smear examinations to detect parasitic co-infections. Proper identification is essential for guiding tailored treatments in such complex cases.

Maternal and congenital syphilis are a major public health problem worldwide. The World Health Organization and Centre for Disease Control both recommend routine screening of pregnant females for syphilis. Despite guidelines in place, maternal syphilis often remains undiagnosed and untreated and there is currently a surge in cases of congenital syphilis. We present a case of a 3-month-old male illustrating a delayed diagnosis of congenital syphilis despite characteristic skin lesions, hepatosplenomegaly, haemolytic anaemia, failure to thrive and history of untreated syphilis in the mother. This case highlights the need to strengthen existing guidelines for intensive screening and early treatment for maternal syphilis. It also underscores the importance of increased awareness amongst paediatricians and dermatologists regarding overlapping clinical features of congenital syphilis.

A 10-year old girl presenting with an insidious-onset low-grade fever for one month was found to have mediastinal widening with bilateral perihilar opacities. MRI scanning further revealed dorsal spondylitis with collapse of T2-4 vertebral bodies with prevertebral and epidural tubercular collections of 3 × 6.5 × 8 cm. This case emphasises the importance of considering TB among differential diagnoses of a mediastinal mass, especially among children from endemic countries.