Aim and background: The recent Nigerian human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) Indicator and Impact Survey (NAIIS) has revealed a decline in the national seroprevalence of pediatric HIV infection. This study aimed to determine the seroprevalence of pediatric HIV infection in a hospital-based study and to determine the clinical presentations among newly diagnosed children at Federal Medical Centre (FMC), Katsina. Materials and methods: Consecutive new patients aged 2 months to 5 years who presented at the emergency pediatric unit of the hospital were screened for HIV infection. History and physical examination findings were documented for each child. Seropositive children <18 months had their status confirmed using HIV deoxyribonucleic acid polymerase chain reaction (HIV DNA PCR). Results: Of the 508 children screened, four were seropositive for HIV, giving a seroprevalence of 0.8%. Common symptoms in the HIV-infected children were fever (100%), vomiting (75%), poor weight gain (75%), and cough (50%). Common signs in HIV-infected children were oral thrush (75%), skin lesions (75%), generalized lymphadenopathy (50%), and parotid fullness (25%). However, only oral thrush was predictive of HIV infection (p < 0.007). Conclusion: This study reveals a substantial reduction in the seroprevalence of HIV infection among children presenting at the pediatric emergency unit of FMC Katsina. Of the symptoms and signs associated with the infection, only oral thrush was predictive. Clinical significance: The study contributed to knowledge by documenting the seroprevalence of pediatric HIV in FMC Katsina and the clinical features predictive of HIV infection.

Infections are an important cause of morbidity and mortality in the pediatric intensive care unit (PICU). Aims and objectives: To study the demographic profile, describe the spectrum and resistance pattern of organisms isolated from blood and respiratory cultures, and study the outcome. Materials and methods: This retrospective observational study, conducted from January 1 to December 31, 2021, was performed on children with positive blood and respiratory cultures admitted to the PICU of a tertiary care multispecialty hospital. Demographic profile and outcome measures were recorded. Positive cultures and resistance patterns were noted. Results: There were 139 children with positive cultures, with a median age of 12 months. The majority of children had comorbidities (62.6%), previous hospital admissions (83.5%), and/or antibiotic exposure (85.4%). Gram-negative bacilli (GNB) comprised 99% of positive respiratory cultures in hospital-acquired infections (HAI), and the most common organisms grown were Acinetobacter species, Klebsiella species, and Pseudomonas species. On antibiotic sensitivity testing, approximately three-fourths of the organisms showed multidrug resistance. High levels of carbapenem resistance were seen in isolates of Acinetobacter baumannii (40/48), Klebsiella pneumoniae (25/29), and Pseudomonas aeruginosa (22/37). Out of the 139 patients included in the study, 86 (61.9%) survived. On multivariate analysis, multidrug resistant organisms (MDRO) were significantly associated with mortality (p = 0.02). Conclusion: Infections in critically ill children were predominantly due to gram-negative organisms. There is a trend toward increasing antibiotic resistance over time. Infection with MDRO is associated with mortality. Highlights: Infections represent a major burden in developing countries, especially in critically ill children. Our study shows high levels of multidrug resistance and increasing carbapenem resistance over time. We have demonstrated a higher risk of mortality in children with MDRO.

Background: Malnutrition means both undernutrition and overnutrition. Under-five children who are malnourished are at increased risk of bacterial infection and sepsis, which contribute to morbidity and mortality. Methods: We conducted a cross-sectional survey among 155 under-five malnourished children through a consecutive sampling method in the Department of Pediatrics at Pt JNM Medical College, Raipur, Chhattisgarh, India, after obtaining informed consent from their respective parents. Results: The prevalence of bacterial infection in my study was 11.6%. Prevalence was higher in children with severe acute malnutrition (14.4%) compared to children with moderate acute malnutrition. The most common organism isolated was methicillin-resistant Staphylococcus aureus. Conclusion: A significant proportion of under-five malnourished children were complicated by serious bacterial infections, the majority in the form of respiratory illness, like bronchopneumonia. There is a need for intervention to improve the nutritional status of under-five malnourished children.

Background: Prolonged fever contributes significantly as a health problem, and the etiology remains a diagnostic challenge in clinical practice, determined by factors including age-group, ethnicity, season, or geographic location. Using a structured approach for evaluation is useful. The aim of this study was to determine the etiology of prolonged fever in children using a modified four-stage protocol. Objectives: The primary objective was to determine the broad etiology of prolonged fever in children using a protocol-based approach. The secondary objective was to correlate common demographic and clinical parameters with the four etiological categories: infections, immune disorders, malignancy, and therapeutic trial or undetermined etiology. Materials and methods: A cross-sectional descriptive study design was used. Children aged 2 months to 18 years admitted with fever >7 days’ duration were recruited with consent. Baseline details and the modified four-stage protocol were used to identify the etiology of prolonged fever. Descriptive statistical analysis was done using SPSS 13. Results: 90 children, aged 3 months to 16 years (mean 6.3, SD 4.6), 60% male, with prolonged fever were included. Etiology was identified in 69 (76.7%) children, and infections were the commonest cause (51.1%), followed by inflammatory disorders (15.6%) and malignancy (10%). Rickettsial infection was the commonest (19.6%). Using the modified four-stage protocol, 33 children (36.7%) were identified in stage 1, 10 (11.1%) in stage 2, 21 (23.3%) in stage 3, and 26 (28.9%) remained undetermined or responded to therapeutic trial in stage 4. Conclusion: Infectious disease remains the most common etiology of prolonged fever in children, with anemia present across etiological groups. Relevant history, demographic information, symptoms, clinical examination, and baseline investigations are most important for diagnosis. Using a structured approach ensures judicious use of invasive and expensive investigations during evaluation.

Mumps is a highly contagious, vaccine-preventable disease. It is one of the oldest human illnesses known to humans. Mumps is caused by paramyxovirus, which is a single-stranded ribonucleic acid (RNA) virus. It is a self-limited illness. Diagnosis is mainly clinical. Although infrequent in countries with extensive vaccination programs, mumps remains endemic in the rest of the world, warranting continued vaccine protection. Compared to other vaccine-preventable diseases, mumps is more benign. Consequently, topics relating to mumps have been somewhat neglected. Through this article, we are suggesting a wider range of protection through the measles, mumps, and rubella (MMR) vaccine to the susceptible population.

Aim and background: This report aims to enhance suspicion of Bartholinitis in patients presenting with labial swelling in the first few months of life. Case description: We describe a baby with triple X syndrome that presented at 8 weeks of life with swelling of the left labium. History included severe respiratory distress at birth. An abscess was suspected and worsened despite treatment with vancomycin and gentamicin. Culture of spontaneous drainage revealed pan-sensitive Escherichia coli. Additionally, labial ultrasound revealed a fluid collection compatible with an abscess of the greater vestibular glands (eponym “Bartholin's” gland abscess). Treatment with a fixed-dose combination of amoxicillin + clavulanate (Augmentin®), guided by susceptibility testing, resulted in its resolution. Conclusion: While Bartholinitis is a common diagnosis in postpubertal females, the literature reports only eight other cases in pediatric patients. To the best of our knowledge, there are no other reported cases of Bartholinitis in infants with triple X syndrome, casting doubt on an association. However, this case could shed light on infantile Bartholinitis as a potential complication of triple X syndrome or neonatal respiratory distress syndrome. Clinical significance: We report this case to increase suspicion of Bartholinitis in cases of labial swelling, even during the first few months of life.

Introduction: Chandipura virus (CHPV) is an emerging but underrecognized cause of acute encephalitis syndrome (AES), primarily affecting children in the Indian subcontinent. Typically, CHPV presents as a severe disease with high mortality, with nearly two-thirds of cases resulting in death. Case description: This report highlights an atypical presentation of CHPV encephalitis in an 18-month-old male during a recent outbreak. The child presented with symptoms including high-grade fever, generalized pustular rash, abnormal behavior, and a single episode of generalized tonic-clonic seizures (GTCS). This case is particularly significant due to its mild course and the involvement of skin manifestations, which are uncommon in CHPV infections. Initial investigations revealed normal organ function and normal cerebrospinal fluid (CSF) analysis. The diagnosis was confirmed by positive CHPV serology in serum samples. The patient responded well to supportive care and was discharged after 12 days without further complications. Discussion and conclusion: During the outbreak, six additional cases of suspected CHPV encephalitis were managed, with outcomes ranging from full recovery to fatal multiorgan failure, underscoring the virus's typical severity. The unique presentation of this case contrasts with the usually fatal course of CHPV, emphasizing the variability in clinical manifestations and the importance of early diagnosis and management. This case highlights the need for awareness of CHPV, especially in regions where it is endemic, and calls for further research into the virus's pathogenesis and clinical spectrum.

Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis, most commonly reported in high-prevalence countries like India. The diagnosis of cutaneous tuberculosis is challenging because of the paucibacillary nature of the disease, its rare occurrence, and its similarities with other cutaneous infections. It is characterized by a spectrum of distinct clinical and histopathological presentations, with underlying systemic involvement in most cases. Hence, awareness among clinicians of various cutaneous presentations of tuberculosis is crucial for early diagnosis and management. A thorough evaluation to identify the systemic focus is important, as it helps in determining the duration of therapy. The author herein presents a case of cutaneous tuberculosis presenting as multiple tubercular abscesses with concomitant central nervous system (CNS) tuberculoma in an adolescent girl.