Journal of Pediatric Infectious Diseases - Volume 7, issue 1

Authors: Mukherjee, Satarupa | Mitra, Souvik | Samanta, Moumita | Roy, Prithwish | Sarkar, Mihir | Chatterjee, Sukanta

Article Type: Research Article

Abstract: Background: Traditionally complications of Dengue infection is limited to vascular and haematological system. The present study describes the changing clinico-epidemiological and laboratory profile of children hospitalized with dengue infection. Methods: Prospective observational study of children hospitalized with a diagnosis of dengue illness from October to December, 2010 at a tertiary care centre in Kolkata. Results: Of 50 children admitted with dengue infection, 24 had dengue fever (DF), 18 dengue hemorrhagic fever (DHF) …and 8 had dengue shock syndrome (DSS). The mean age of affected children was 6.25 ± 3.34 years, mostly being males from rural areas. The common clinical manifestations were fever, rash, body ache, hemorrhagic manifestations and oedema. While headache and body ache was commoner among DF cases, rash and hemorrhagic manifestations were significantly more among DHF group. Incidence of altered sensorium, neck rigidity, fulminant hepatitis, and splenomegaly were significantly higher among the DHF/DSS group. 12% case fatality rate was found. Conclusion: Clinical manifestations of dengue seem to be changing. Fever, rash and bodyache are not the only clinical presentations. Encephalopathy, encephalitis, 6$^{th}$ cranial nerve palsy, fulminant hepatic failure, acute acalculous cholecystitis, myocarditis, myelitis, splenomegaly are some unusual but novel presentations of dengue in pediatric population that clinician in endemic area should be aware of though they are not mentioned in conventional guidelines Dengue is no longer restricted to urban areas but has propensity to spread to rural areas also. Show more

Keywords: Dengue, pediatric population, tertiary care hospital

DOI: 10.3233/JPI-2012-0339

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 1-7, 2012

Authors: Weatherhead, Jill E. | Revell, Paula | Munoz, Flor M.

Article Type: Research Article

Abstract: Salmonella spp., a common cause of gastroenteritis, can result in invasive infections in children. While reported in developing countries, Salmonella meningitis has rarely been described in the United States. To evaluate the incidence and clinical characteristics of Salmonella meningitis at Texas Children's Hospital, we conducted a retrospective chart review to identify children up to 18 years of age with positive cerebrospinal fluid cultures for Salmonella from 2000 to 2010. Salmonella meningitis …occurred in 7 of 112 (6.5%) cases of invasive Salmonella infection in children at our institution. Non-typhi Salmonella species were isolated in all cerebrospinal fluid samples, but only one had bacteremia. Patients were otherwise healthy infants under 4 months of age with no travel history. The most frequent symptoms at presentation included irritability, fever and diarrhea. Management and treatment regimens were varied. All infants survived and recovered without sequelae. Patients who received longer duration of intravenous antibiotics had a longer hospital stay, required central venous access, and developed side effects from medications. Non-typhi Salmonella meningitis was exclusively diagnosed in healthy infants younger than 4 months of age, and was not associated with high morbidity or mortality. Evaluation for meningitis is warranted in infants with gastroenteritis and systemic symptoms such as fever and irritability. The management of non-typhi Salmonella meningitis in children is not standardized and deserves further evaluation. Show more

Keywords: Salmonella, non-typhi, meningitis, infants, United States

DOI: 10.3233/JPI-2012-0340

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 9-14, 2012

Authors: Al-Sweedan, Suleimman A. | Hyajneh, Wail | Al-Ostath, Ahmad

Article Type: Research Article

Abstract: Chemotherapy-induced febrile neutropenia with positive blood culture in children admitted to King Abdallah University Hospital between January 1, 2003 and December 31, 2008 were enrolled. 167 patients prediagnosed with malignancy (94; 56% male and 73; 44% female) with a mean age of 7 years (range: 1–17 years) were enrolled in this study. One hundred patients (60%) had gram positive bacteria, while forty eight patients (29%) had gram negative bacteria, and only 19 patients (11%) had fungal …infection. Coagulase Negative Staphylococcus was the most common gram positive organism (59%), followed by Staphylococcus aureus (S. aureus) (28%). Klebsiella pneumoniae was the most common gram negative organism (25%), followed by Escherichia coli (19%). Finally, all of fungal infection caused by Candida species. Ten of the blood cultures with S. aureus were Methicillin-resistant S. aureus (MRSA) and one was intermediate to Vancomycin. All Enterococcus isolates were susceptible to Vancomycin and Teicoplanin except one was intermediate to Vancomycin. Ten percent of the gram negative organisms were Extended-spectrum beta-lactamase producers (ESBL). All Pseudomonas aeruginosa organisms were sensitive to Piperacillin-Tazobactam, and Carbapenems. All Enterobacter species were sensitive to Aminoglycosides, Carbapenems and 4th generation Cephalosporin. Gram-positive organisms are the predominant isolates in febrile neutropenic episodes in this cohort of patients. Show more

Keywords: Infection cancer Neutropenia

DOI: 10.3233/JPI-2012-0343

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 15-20, 2012

Authors: Murillo, Jeremias L. | Bailey, Keneisha | Recio, Evita | Espiritu-Fuller, Maria | Sykes, Joseph | Phatak, Tej

Article Type: Research Article

Abstract: Non-surgical management of descending necrotizing mediastinitis secondary to a retropharyngeal abscess is a viable management option in children in contrast to the adult experience. We describe a pediatric case that underwent incision and drainage of a retropharyngeal abscess but did not require surgical drainage of a subsequent mediastinal abscess because of excellent clinical and radiologic response to intravenous antibiotics. The patient also had a co-existing Lemierre syndrome. Methicillin-resistant Staphylococcus aureus was …recovered from the purulent drainage of the retropharyngeal abscess. Show more

Keywords: Retropharyngeal abscess, descending necrotizing mediastinitis, mediastinal abscess, Lemierre syndrome, Methicillin-resistant Staphylococcus aureus

DOI: 10.3233/JPI-2012-0335

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 21-25, 2012

Authors: Mondal, Rakesh | Pant, Pragya Ghosh | Ghosh, Jayant Kumar | Sabui, Tapas

Article Type: Research Article

Abstract: We report a child with multiple joint swellings, being treated as a case of poly-articular juvenile idiopathic arthritis subsequently turned out to be tubercular origin. Development of overlying sinuses, lytic lesions on radiographs, synovial fluid analysis showing tubercular infection and demonstration of epitheloid granulomas on bone biopsy confirmed the diagnosis of tubercular poly-arthritis with dactylitis. Child was asymptomatic after two months of starting antitubercular treatment. The case highlights the need to consider …the possibility of tuberculosis as aetiology of poly-arthritis, at least in endemic areas, even in the absence of a tuberculosis contact history and overt pulmonary symptoms. Show more

Keywords: Juvenile idiopathic arthritis, tuberculosis, polyarticular

DOI: 10.3233/JPI-2012-0336

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 27-29, 2012

Authors: Smith, Jennifer | Han, Rachel | Mailman, Tim | MacDonald, Noni

Article Type: Research Article

Abstract: Chryseobacterium indologenes (C. indologenes) is a rarely described clinical isolate, especially in pediatric patients. We report the second case of C. indologenes isolated from a neonatal endotracheal tube in an infant with Escherichia coli septicemia. The challenge of distinguishing colonization, contamination and infection for this microorganism is discussed. Additionally, the resistance of C. indologenes to antibiotics used in pediatric medicine is raised as a significant challenge for therapeutic measures. We review nine …cases of pediatric C. indologenes infection published in the English medical literature. C. indologenes is likely of low pathogenicity in the pediatric population. Show more

Keywords: Chryseobacterium indologenes, pediatric, neonate, pneumonia, infection, contaminant, congenital diaphragmatic hernia

DOI: 10.3233/JPI-2012-0337

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 31-35, 2012

Authors: Ramesh, Venkateswari | Sankar, Janani | Ramamoorthy, Ramkumar

Article Type: Research Article

Abstract: Tuberculosis is a multisystemic disease with varied presentations.We report a case of Tuberculous gumma masquerading as mycetoma foot in a child. A nine year old malnourished boy, who was diagnosed and treated as mycetoma foot, was reevaluated in view of persisting skin lesions. Tissue biopsy histopathology was suggestive of tuberculoid granuloma. Mycobacterium tuberculosis was isolated in tissue biopsy culture. He also had underlying dissemination with meningeal involvement. The unusual presentation and the …importance of screening for underlying dissemination in children diagnosed to have cutaneous tuberculosis will be discussed. Show more

Keywords: Tuberculous gumma, tuberculous meningitis, mycetoma foot

DOI: 10.3233/JPI-2012-0338

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 37-40, 2012

Authors: Meena, K. Courtney | Nesmith, Clare C. | Palmer, Kristine G. | Jacobs, Richard F. | Burke, Jr., Bryan L.

Article Type: Research Article

Abstract: A quick diagnosis for disseminated neonatal Herpes simplex virus (HSV) infection is not easy, potentially affecting morbidity and mortality. We report a case of disseminated HSV occurring at 4 days of life whose mother had fever for 4 days before delivery, a negative history for all sexually transmitted diseases, and a normal genitourinary examination (including visual examination of external genitalia and cervical/vaginal mucosa without colposcopy). A septic work-up done at birth was negative. A second …septic work-up at 4 days of age, after clinical deterioration, led to the correct diagnosis and therapy. This case illustrates some of the difficulties in making a rapid diagnosis of neonatal HSV in all cases, especially at this age, and emphasizes the need for inclusion in this differential diagnosis and appropriate presumptive therapy. Show more

Keywords: Neonate, herpes simplex virus, acyclovir, early diagnosis

DOI: 10.3233/JPI-2012-0341

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 41-44, 2012

Authors: Paul, Siba P. | Candy, David C.A.

Article Type: Research Article

Abstract: Apart from causing the majority of episodes of gastroenteritis in children, rotaviruses can also cause systemic illnesses such as encephalitis, hepatitis, and acute haemorrhagic edema. Infectious rotavirus particles have been demonstrated in the blood and CSF and more associations are to be expected. This case series present a new association of encephalopathic state and vasculitic rash in 3 children who were found to have rotavirus on stool testing. Rotavirus can mimic serious bacterial infections including …meningococcaemia and meningitis and any child presenting with vasculitic rash, encephalopathy and gastroenteritis should have a stool sample examined for rotavirus. Awareness of this association will help paediatricians provide a definitive diagnosis for some children presenting with signs of meningococcal sepsis who test positive for rotavirus. Show more

Keywords: Rotavirus, encephalopathy, vasculitis, systemic illness, meningococcal infection

DOI: 10.3233/JPI-2012-0342

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 1, pp. 45-48, 2012