Journal of Pediatric Infectious Diseases - Volume 7, issue 3

Authors: Nathawad, Rita | Hammerschlag, Margaret R. | Mendez, Hermann

Article Type: Research Article

Abstract: Few studies have examined the epidemiology of Staphylococcus aureus (S. aureus) colonization in human immunodeficiency virus (HIV)-infected children. The goal of this study was to determine the prevalence and risk factors for S. aureus colonization in our pediatric HIV-infected patients. HIV-infected patients and age-matched controls of 2–24 years of age were recruited in the pediatric outpatient clinics at SUNY Downstate Medical Center and Kings County Hospital, in Brooklyn, NY. Nares and axillary swabs were …collected from each patient and cultured. Confirmed S. aureus isolates were screened for sensitivity to antibiotics frequently used to treat staphylococcal infections. A total of 112 patients were screened; 63 HIV-infected and 49 controls. Eighteen of two hundred and twenty-four (8 specimens grew S. aureus. Only two grew methicillin resistant S. aureus. Within the HIV-infected group, 3 of 63 (5 contrast, 11 of 49 (22 colonized. None of the colonized patients reported taking any antibiotics in the last year. We did not find higher rates of S. aureus colonization in HIV-infected children and adolescents compared to healthy controls. The prevalence of S. aureus colonization in the HIV-infected group was significantly lower than controls, which may be related to the use of trimethoprim/sulfamethoxazole for Pneumocystis prophylaxis. The prevalence of methicillin resistant S. aureus colonization was low in both groups and is likely reflective of the low rates of both colonization and invasive disease seen with this pathogen at our institution. Show more

Keywords: Colonization, HIV, Staphylococcus aureus, methicillin-resistant S. aureus

DOI: 10.3233/JPI-120351

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 97-102, 2012

Authors: Sultan, Muhammad Ashraf | Afzal, Muhammad Faheem | Bashir, Saima | Chughtai, Akhtar Sohail

Article Type: Research Article

Abstract: World Health Organization (WHO) clinical case definition for the diagnosis of measles lacks diagnostic accuracy. We thus propose two separate scoring criteria for the diagnosis of acute and post measles cases. This study was conducted to determine the diagnostic accuracy of scoring criteria in confirmed cases of measles. This cross-sectional validation study was conducted in the Department of Paediatrics Unit-I, King Edward Medical University, Lahore, Pakistan, from March-August 2009. Sixty-one cases fulfilling the WHO …clinical case definition of measles were included in the study, and divided into Group A (Acute measles) and Group B (Post measles). A separate criterion was used for each. Positive Serology (IgM) was taken as confirmed cases. At scores ⩾ 3, ⩾ 4 and ⩾ 5, the sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were calculated. Appropriate statistical tests were applied. In Group A, out of 36 cases, 28 (78%) had total score ⩾ 4, whereas IgM was positive in 24 (67%). The scoring criteria had sensitivity, specificity, PPV and NPV of 100%, 66.7%, 86% and 100% respectively. In Group B, out of 25 cases, 23 (92%) had a total score ⩾ 4 whereas IgM was positive in 22 (88%) cases. The scoring criteria had sensitivity, specificity, PPV and NPV of 100%, 66.7%, 96% and 100% respectively. The measure and strength of association were statistically significant for both Groups. At scores ⩾ 3 and ⩾ 5, sensitivity, specificity and predictive values were not statistically significant in either group. This study has shown that the criteria for the diagnosis of acute and post measles cases at a score ⩾ 4 are valid to make a clinical diagnosis. Show more

Keywords: Acute measles, measles IgM, post measles, scoring criteria

DOI: 10.3233/JPI-120352

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 103-108, 2012

Authors: Onuchukwu, C.E. | Adedoyin, O.T. | Ernest, S.K.

Article Type: Research Article

Abstract: Viral hepatitis is a major cause of morbidity and mortality in Sub-Saharan Africa. Hepatitis B virus (HBV) infection is a major disease of serious public health concerns commonly encountered in developing countries. It remains an important cause of chronic liver disease and liver cancer worldwide. Presence of Hepatitis B surface antigen (HBsAg) in the blood indicates an infection with HBV. Patients with Sickle cell anemia (SCA), a common hematological disorder in Nigeria, may have complications that …require blood transfusion thus exposing them to the risk. This study therefore determined the prevalence of Hepatitis B surface antigen among transfused children with Sickle Cell Anemia (SCA) in Ilorin. One hundred and ten transfused SCA children aged 6 months to 14 years with age matched controls were recruited consecutively over a one year period, from February 2008 to January 2009. Hepatitis B surface antigen screening was done using a second generation ELISA method. The overall prevalence was 17.7%. There was statistically significant difference in the HBsAg positivity among transfused (23.6%) when compared to non transfused SCA children (11.8%) (p=0.03). The risk of HBV infection increased with increase in number of transfusion. More subjects in the lower social class were positive than their control counterparts (p=0.07). Transfused SCA patients belong to a high risk group for hepatitis B virus infection compared to the non-transfused population. The risk of HBV infection acquisition increased with higher number of transfusions and the high prevalence of HBsAg among children with SCA in Ilorin is related to blood transfusion. It is therefore recommended that adequate screening be done always before transfusion is undertaken. Show more

Keywords: Hepatitis B virus, sickle cell anemia, blood transfusion

DOI: 10.3233/JPI-120353

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 109-113, 2012

Authors: Gupta, Puneet Kumar | Chauhan, Smriti | Guleria, Ramesh Chand | Kanga, Anil | Singh, Digvijay

Article Type: Research Article

Abstract: We report a case of a previously healthy two month old infant with Group A streptococcal meningitis. The case should alert pediatricians regarding its possibility and treatment as early as possible to prevent fatal outcome.

Keywords: Group A streptococcus, meningitis

DOI: 10.3233/JPI-120357

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 115-117, 2012

Authors: Mundada, Vivek B.

Article Type: Research Article

Abstract: We report a case of bilateral adrenal abscess in a term neonate probably a consequence of perinatal adrenal hemorrhage caused by Prevotella bivia, an organism known to cause genital tract infections in women. Adrenal abscess is rare in the neonatal period and bilateral abscesses are even more uncommon. However its possibility should be listed in the differential diagnosis in the clinically well neonates with raised inflammatory markers.

Keywords: Adrenal, abscess

DOI: 10.3233/JPI-120356

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 119-122, 2012

Authors: Al Maskari, Nawal | Al Fawaz, Tariq Saleh | Al Mazrou, Abdulrahman | Al Shahrani, Dayel | Al Shehri, Mohammed

Article Type: Research Article

Abstract: We report a case of Invasive Yersinia infection in an immunocompetent child. The patient had a mass in the peripancreatic region with multiple low attenuation lesions in the liver and bilateral kidneys.

Keywords: Yersinia, yersiniosis, hepatosplenomegaly, invasive Yersinia

DOI: 10.3233/JPI-120355

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 123-125, 2012

Authors: Nirupam, Nilay | Kumar, Sandeep | Badatya, Sushant | Chhapola, Viswas | Sharma, Rajni | Kumar, Virendra

Article Type: Research Article

Abstract: We report an eight-year-old girl with Dengue Hemorrhagic Fever, shock and a life-threatening upper gastrointestinal and pulmonary bleed with refractory thrombocytopenia. She received 6 units of random donor platelets, 1 unit of single donor platelets, 1 unit of packed red cells and 4 units of fresh frozen plasma to control bleeding but had no response. Finally, 36 hour after onset of bleed intravenous Anti-D 75 μg/kg was given and she had a dramatic increase in platelet …counts and cessation of all clinical bleed. This case report highlights that intravenous Anti-D can be a treatment option in Dengue Hemorrhagic Fever with severe refractory thrombocytopenia and massive bleeding. Show more

Keywords: Dengue hemorrhagic fever, Anti-D, thrombocytopenia

DOI: 10.3233/JPI-120358

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 127-130, 2012

Authors: Gonçalves-Ferri, Walusa Assad | Sato, Diana Alburqueque | Ramalho, Fernando Silva | de Carvalho Panzeri Carlotti, Ana Paula | Duarte, Geraldo | Mussi-Pinhata, Marisa Márcia

Article Type: Research Article

Abstract: Congenital candidiasis is a rare condition and difficult to diagnose. We report a case of severe septic shock leading to death within six days of birth caused by disseminated candidiasis without cutaneous manifestations in a late preterm infant. We speculate that the use of drugs for treatment of gestational toxoplasmosis in a mother colonized by Candida species facilitated this occurrence.

Keywords: Congenital candidiasis, systemic candidiasis, sepsis, infant neonate

DOI: 10.3233/JPI-120354

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 131-134, 2012

Authors: Aswani, Rohit | Marti, Maria G. Lopez

Article Type: Research Article

Abstract: We report a case of persistent bacteremia secondary to methicillin-resistant S. aureus (MRSA) in a preterm neonate successfully treated with daptomycin. Although the MRSA isolate was susceptible to vancomycin, there was no clinical or microbiologic response. Within 3 days of therapy with daptomycin, clinical improvement was noted, along with sterilization of blood cultures. Little data exist on neonatal pharmacokinetics of daptomycin. This report highlights the potential advantage that daptomycin offers in treating …severe MRSA infections in neonates. Show more

Keywords: Daptomycin, neonate, MRSA, bacteremia

DOI: 10.3233/JPI-120359

Citation: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 135-138, 2012