Pediatric Infectious Disease

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2019 | July-September | Volume 1 | Issue 3

Original Article

Rukhayya Nasser, Manakkattu TP Mohammed, Radhamani K Veettil, Ravikumar Payora, Ambily S Jacob

Clinical Characteristics and Microbiological Analysis of Urinary Tract Infection in Children of 2 Months to 12 Years: A Prospective Study

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:3] [Pages No:79 - 81]

Keywords: Micturating cystourethrogram, Urinary tract infection, Vesicoureteric reflux

PDF  |  DOI: 10.5005/jp-journals-10081-1219  |  Open Access |  How to cite  | 

Abstract

Objectives: To study the clinical characteristics and etiological agents of urinary tract infection (UTI) in children of 2 months to 12 years, and to find the prevalence of vesicoureteric reflux (VUR) in children with UTI. Materials and methods: This prospective study was conducted among 47 children with culture-positive UTI in children between 2 months to 12 years. All children attending the pediatric outpatient department (OPD) of Government Medical College Hospital, Kannur, Kerala, India, were enrolled. Clinical and bacteriological profile of all cases were evaluated and ultrasonogram (USG) abdomen/micturating cystourethrogram (MCU) were done for these patients to find the predisposing factors associated with recurrent infections like VUR and posterior urethral valve. Results: A total of 47 children were enrolled, of which 25 (53.19%) children were below 1 year of age. Male to female ratio was 2.1:1. The most common symptom was fever, and Escherichia coli (65.9%) was the most common organism isolated. Within the cohort, 23.40% of children had recurrent UTI and 19.14% showed VUR. Conclusion: Urinary tract infection is a very common infection in infants and children. It is equally important that we treat the child with antibiotics and investigate for any underlying causes such as VUR or obstructive uropathy.

REVIEW ARTICLE

Rehna K Rahman, Nivedita Kamath

Consensus and Controversies in Antibiotic Prophylaxis for Urinary Tract Infections

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:4] [Pages No:82 - 85]

Keywords: Antibiotic prophylaxis, Urinary tract infection, Vesicoureteric reflux

PDF  |  DOI: 10.5005/jp-journals-10081-1203  |  Open Access |  How to cite  | 

Abstract

Antibiotic prophylaxis in children with urinary tract infection (UTI) is controversial. There is some evidence to show that antibiotic prophylaxis reduces the risk of infection in children with vesicoureteric reflux (VUR) and recurrent UTI. However, there is also an increased risk of UTI by resistant organisms in children on long-term antibiotic prophylaxis. Little is known about the benefit of antibiotic prophylaxis in reducing the risk of scars and long-term sequelae of urinary tract infections.

REVIEW ARTICLE

Bidisha Banerjee, Muhammed Hafis, Ullas Acharya

Acute Encephalitis Syndrome: Approach to a Changing Paradigm

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:9] [Pages No:86 - 94]

Keywords: Acute encephalitis, Encephalitis mimics, Etiology, Neuroimaging

PDF  |  DOI: 10.5005/jp-journals-10081-1210  |  Open Access |  How to cite  | 

Abstract

Purpose: Acute encephalitis syndrome (AES) poses challenges to physicians owing to acute presentation, often rapid neurologic deterioration, myriad causes including noninfective inflammatory disorders of central nervous system (CNS) and low microbiologic yield. We broadly discuss common and less common causes of AES and their clinical, laboratory including radiologic features as specific diagnosis guides management and improves outcome. Materials and methods: Literature search was performed using keywords “Paediatric acute encephalitis” in MEDLINE database from 2009 to 2019 and all relevant articles (barring case reports) in English language were reviewed. Landmark articles prior to 2009 were also reviewed. Conclusion: Acute encephalitis remains a diagnostic and therapeutic challenge in neurocritical care. The recognition of etiological agent and encephalitis mimics by investigations is important for specific therapeutic measures. Judicious use of neuroimaging, cerebrospinal fluid (CSF) analysis and appropriate lab tests helps in diagnosing specific entities especially noninfective mimics of AES which has important treatment and prognostic implication. Initial stabilization and institution of supportive measures remains key to successful management.

REVIEW ARTICLE

Rashna D Hazarika

Invasive Meningococcal Disease: A Review

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:13] [Pages No:95 - 107]

Keywords: Invasive meningococcal disease, Meningitis, Meningococcemia, Neisseria, Purpura fulminans, Shock

PDF  |  DOI: 10.5005/jp-journals-10081-1215  |  Open Access |  How to cite  | 

Abstract

Background: Invasive meningococcal disease (IMD) is a potentially fatal disease occurring all over the world. It affects predominantly young children, adolescents and young adults. However, even today cases are missed and there may be a delay in diagnosis and treatment leading not only to a fatal outcome but also to large scale epidemics. Materials and methods: An extensive review of literature was done to describe the history, microbiology, global epidemiology, transmission and risk factors, pathogenesis, clinical features, management, prognosis, care of relatives and close contacts, prevention by the current vaccines available in the world and in India. Results: Invasive meningococcal disease was first described in 1805 in Sweden. Subsequently periodic epidemics continue to occur all over the world. Globally it is present in more than 80 countries. Currently 12 known serotypes are described with a complex microbiology which helps the bacteria to not only survive in the human nasopharynx but also to adhere to and invade the meninges and the blood stream and present as meningitis, meningococcemia or both. Due to its capacity to produce various toxins and ability to survive destruction by the host immune system, it produces a number of clinical manifestations in a short time. Being potentially fatal, death in such patients can occur in a matter of hours. Microbiological diagnosis is difficult as the organism is fastidious and requires special conditions for growth and can explain the poor microbiological results worldwide. However attempts to culture the bacteria should be made from all available sites such as cerebrospinal fluid, blister fluid, blood and even skin biopsy specimen. The cornerstone of management is aggressive treatment with antibiotics, and other supportive care. Complications are common during the course of the infection and one must anticipate and tackle them aggressively and at the appropriate time. A large number of sequelae can occur in spite of optimal management. Prophylactic antibiotics in the care-givers and relatives is extremely important for short term protection. Long term protection of the community as well as of care-givers and close relatives is by vaccination. A number of effective vaccines have been developed over the years for the prevention of this deadly infection. Vaccine cost remains a major hindrance to universal vaccination. Conclusion: Invasive meningococcal disease exists all over the world. It is important to be able to correctly recognize these patients for early and aggressive management. Prevention by vaccination remains the best public health measure to tackle this deadly infection.

REVIEW ARTICLE

Tanushri Mukherjee, Sanjay Wazir

Recent Advances in Diagnosis, Prevention and Treatment of Neonatal Sepsis

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:6] [Pages No:108 - 113]

Keywords: Adjuvant treatment, Antibiotics, Developing countries, Early onset sepsis, Empiric treatment, Late-onset sepsis, Neonate

PDF  |  DOI: 10.5005/jp-journals-10081-1213  |  Open Access |  How to cite  | 

Abstract

Sepsis is one of the most common causes of morbidity and mortality in the neonatal period. Although this is a global problem, the magnitude of the problem is huge in developing countries because of a lack of clear guidelines for the management of the condition, lack of standard laboratory services and impulsivity of the clinician in changing the antibiotics for any slight deterioration which can be explained by other noninfectious conditions. The source of infection in the baby can be from the mother called the early onset sepsis or from the community or hospital called the late-onset sepsis. Proper identification and knowledge of the causative microorganism can help decide the right antibiotic and causative microorganisms in one area or hospital would be different from the other area and hence it is prudent to make efforts for the identification of the organism causing the disease. Treatment requires the judicious use of antibiotics with the proper choice of antibiotics as well as proper dose and duration. Overuse of antibiotics should be discouraged because of risk of complications and resistance development.

REVIEW ARTICLE

Prakash K Wari, Siddappa F Dandinavar, Raghavendraswami Amoghimath, Roopali Desai, HR Puneeth

Streptococcal Infections in Children: An Update

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:6] [Pages No:114 - 119]

Keywords: Acute rheumatic fever, Group A Streptococcus, Streptococcal pharyngitis

PDF  |  DOI: 10.5005/jp-journals-10081-1211  |  Open Access |  How to cite  | 

Abstract

Streptococcus is the general term for a diverse group of gram-positive cocci that appear in chains or pairs. The most prevalent of the human streptococcal pathogens are the Lancefield group A Streptococcus (GAS). This review article provides an update on group A streptococcal infections with key highlights on classification, presentation, the latest diagnostic criteria, management protocols, and complications. Background: Group A Streptococcus is involved in the pathogenesis of a wide variety of pathologic conditions varying from noninvasive infections such as pharyngitis, erysipelas, scarlet fever, and cellulitis to invasive diseases, such as bacterial sepsis, streptococcal toxic shock syndrome, and necrotizing fasciitis. It is also linked with nonsuppurative and postinfectious immunological sequelae, such as acute rheumatic fever (ARF), poststreptococcal glomerulonephritis (PSGN) and pediatric autoimmune neuropsychiatric disorder associated with Streptococcus pyogenes (PANDAS). Globally around 18 million people suffer from GAS-related illnesses. Conclusion: Group A streptococcal infections have a high prevalence and morbidity across the globe, especially in developing countries. Children older than 3 years have a higher risk of such complications necessitating need for proper diagnosis and treatment.

Immunology Corner

Neutrophil Counts—Too Less and Too Many—Both Can Be Immune Deficiency

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:3] [Pages No:120 - 122]

PDF  |  DOI: 10.5005/jp-journals-10081-1216  |  Open Access |  How to cite  | 

Antimicrobial

Antiviral Drugs in Children and Adolescents

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:6] [Pages No:123 - 128]

Keywords: Antiviral drugs, Acyclovir, CMV infections, Hepatitis, Herpes virus, HIV, RSV infections

PDF  |  DOI: 10.5005/jp-journals-10081-1221  |  Open Access |  How to cite  | 

Abstract

This article on antiviral drugs is aimed at providing recommendations for treatment of selected viral infections in pediatric population. This article will discuss commonly used antivirals, their pharmacokinetics, pharmacodynamics, mechanisms of action, spectrum of activity, and toxicities. Biologics such as interferons will also be discussed.

CASE REPORT

Shyam Kukreja, Tapisha Gupta, Arundeep Bagania

An Interesting Case of Fever with Rash

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:2] [Pages No:129 - 130]

Keywords: Diagnosis, Infectious mononucleosis, Preschoolers, Rash

PDF  |  DOI: 10.5005/jp-journals-10081-1220  |  Open Access |  How to cite  | 

Abstract

Infectious mononucleosis (IM) caused by Epstein–Barr virus (EBV) is well known to occur in adolescents and is also termed as kissing disease. However, children in developing countries acquire the infection in first few years of life, and universal seroconversion is seen by ages 3–4 years. Transmission in this age group is through saliva from seropositive adults on fingers or toys. Recognition of disease is important as potentially life-threatening complications occur. Awareness of the disease occurrence in this age group also avoids antibiotic use for pharyngitis that mimics streptococcal sore throat. The presence of rash intrinsic to the disease along with other clinical features may give a clue to the diagnosis. Data from India on IM in children is scarce, perhaps due to lack of awareness or availability of diagnostic tests. We present a case in a preschooler who presented with fever, pharyngitis, lymphadenopathy, and rash without any prior antibiotic use and was managed on supportive therapy.

Case File

S Balasubramanian, Kuppusamy Dhanalakshmi, Silky Agarwal, Sabapathyraj L Raj

From the Case Records of Kanchi Kamakoti CHILDS Trust Hospital: An Adolescent with Recurrent Meningitis

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:3] [Pages No:131 - 133]

PDF  |  DOI: 10.5005/jp-journals-10081-1222  |  Open Access |  How to cite  | 

What\'S In?

Dr Vikram S Kumar

Recent Advances

[Year:2019] [Month:July-September] [Volume:1] [Number:3] [Pages:2] [Pages No:134 - 135]

PDF  |  DOI: 10.5005/jp-journals-10081-1208  |  Open Access |  How to cite  | 

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