Pediatric Infectious Disease

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2023 | October-December | Volume 5 | Issue 4

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Original Article

Nikhil Raj, Priyanka Gupta, Dipti Agarwal, Jyotsna Agarwal, Jaya Garg

Demographic and Diagnostic Predictors of Respiratory Syncytial Virus in Children of Less than 2 Years Presenting with Acute Respiratory Tract Infection

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:5] [Pages No:109 - 113]

Keywords: Acute lower respiratory infection, Children, Respiratory syncytial virus, Reverse transcription polymerase chain reaction

   DOI: 10.5005/jp-journals-10081-1405  |  Open Access |  How to cite  | 

Abstract

Background: Worldwide respiratory syncytial virus (RSV) is one of the leading infectious causes of acute respiratory tract infection (ARTI) and related death in children under the age of 2 and it accounts for 60–80% of bronchiolitis presentations in developing countries like India. The present study was done to determine the diagnostic and demographic predictors of RSV in children <2 years old who presented with ARTI. Materials and methods: This was a pilot study that was performed over a period of 18 months in a tertiary healthcare facility in Northern India. A total of 55 nasopharyngeal swab samples from cases with ARTI presentation were collected in viral transport media (VTM) and were tested for RSV using reverse transcription polymerase chain reaction (RT-PCR). Result: A total of 55 clinically suspected cases of ARTI with age <2 years, eight (14.5%) cases were positive for RSV RT-PCR, male gender, ear discharge, risk factors such as premature birth, bottle feeding, and chest X-ray findings such as hyperinflation had a significant association with children with RSV (p < 0.05) which can be used as diagnostic predictors for RSV during the study period peak of RSV cases occurred in between November and December (winter season). Conclusion: Diagnostic predictors are very important in identifying RSV in resource-limited countries like India where an expensive, technically cumbersome, and complex molecular confirmatory test is not possible. This study identifies a set of risk factors, demographic characteristics, and radiological findings that will guide clinicians to start management for RSV.

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Original Article

Nikita M Savani, Yamini Gurjar, Nitin Lodha, Richa Nathwani

Uptake of Immunization and Its Determinants among Children of Migrant Population Residing in Amreli, Gujarat, India

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:6] [Pages No:114 - 119]

Keywords: Coverage, Full immunization, Partially immunization, Recent migrants, Settled migrants

   DOI: 10.5005/jp-journals-10081-1411  |  Open Access |  How to cite  | 

Abstract

Aim and background: Immunization stands as a cornerstone of public health advancements, offering unparalleled effectiveness and cost-efficiency. The overall known vaccination coverage of resident children in Amreli was 60.1%, as per the National Family Health Survey-5 (NFHS-5). Regardless of these efforts, an issue of inequity is observed on different platforms. This study was an effort to understand the immunization uptake and its determinants influencing the utilization of immunization services among migrant children from September 2022 to February 2023. Materials and methods: Demographic and socioeconomic information, migration history, the child's immunization status, and the mother's usage of healthcare services were included in the questionnaire. Some of the data were taken from vaccination cards. Results: A total of 110 eligible mothers were contacted for the survey. Children were from 12 to 60 months old. Full immunization coverage was found among 38 (34.5%) children. Among them, 26.3% (12–24 months) and 73.7% (>24–60 months) children were having full immunization. Coverage of individual vaccines was Bacillus Calmette–Guérin (BCG) (94.5%), Penta 1 (41.8%), Penta 2 (38.2%), Penta 3 (35.5%), measles and rubella 1 (MR 1) (34.5%), diphtheria, pertussis, tetanus 1 (DPT 1) (34.5%), oral polio vaccine (OPV) booster (66.4%), and MR 2 (29.1%). The major factors associated with low immunization coverage were recent migrant status (p = 0.001), male gender (p = 0.04), age <24 months (p = 0.04), and home birth (p = 0.04). The study also found that settled migrants, female children, hospital-born children, and children whose mothers received antenatal care (ANC) visits from health workers were more likely to be fully immunized. Conclusion: The coverage among immigrants is less (34.5%) than that of children residents of Amreli (60.1%). The study highlights the need for targeted interventions to improve immunization coverage among children of migrant mothers.

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REVIEW ARTICLE

R Mohamad Javier, A Saidah Rahmat, Halimah Labiba Noerraihana, Firda Athaya Nadhirah, Mudzakkir Taufiqur Rahman

Prevalence and Contributing Factors of Urinary Tract Infection in Human Immunodeficiency Virus Patients: A Systematic Review

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:6] [Pages No:120 - 125]

Keywords: Cluster of differentiation 4, Human immunodeficiency virus, Prevalence, Urinary tract infection

   DOI: 10.5005/jp-journals-10081-1410  |  Open Access |  How to cite  | 

Abstract

Aims and background: This study aims to understand the effect of human immunodeficiency virus (HIV) incidence with cluster of differentiation 8 (CD8) T cell maturity accompanied by urinary tract infection (UTI). Methods: This study is a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) method; this method is carried out systematically by following the correct stages or research protocols. The sources were taken from the PubMed and Google Scholar sites with the requirements of journals published in 2017–2022, and then screening was carried out, obtaining the results of 20,486. Results: The result of this study is—journal clustering was carried out, and the number of journals indexed by Scopus Q1 and Q2 was two, while it was indexed by Science and Technology Index (SINTA) National Index S1. This study found a significant association between HIV infection and an increased risk of UTI. Conclusion: The majority of journals discuss the age-related effects of HIV on CD8 T cell maturity with UTI in commercial sex workers.

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REVIEW ARTICLE

Harshini T Reddy, Bhaskar Shenoy

Mechanisms of Secondary Bacterial Infections in Viral Infections

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:3] [Pages No:126 - 128]

Keywords: Mechanisms, Mucin, Secondary bacterial infection, Viral infection, Viral predisposition

   DOI: 10.5005/jp-journals-10081-1402  |  Open Access |  How to cite  | 

Abstract

Secondary bacterial infections most commonly occur post-viral or concomitant with viral infections. Viral infections damage both innate and acquired immune systems which facilitates bacterial adhesion, growth and invasion of healthy sites of body. These secondary bacterial infections lead to more severe clinical course and worsen the prognosis of the infection. Viral infections alter the commensal microbiota leading to dysbiosis which in turn predisposes to secondary bacterial infections. This review article elaborates the underlying mechanisms of secondary bacterial infections which will lead us to develop novel and therapeutic approaches towards prevention and treatment of secondary bacterial infection which plays a vital role in improving clinical outcome.

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CASE REPORT

Kalyani Srinivas, Prajnya Ranganath, Palle Sreelekha, Kalivela Santhimayee, Shaik Mahin

Immunodeficiency, Centromeric Region Instability, Facial Anomalies Syndrome 1

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:3] [Pages No:129 - 131]

Keywords: Case report, Facial dysmorphism, Primary immune deficiency

   DOI: 10.5005/jp-journals-10081-1406  |  Open Access |  How to cite  | 

Abstract

The immunodeficiency, centromeric region instability, facial anomalies (ICF) syndrome is a rare autosomal recessive disease characterized by facial dysmorphism, immunoglobulin deficiency, and centromeric instability. We describe a 14-month-old female child with recurrent infections, facial anomalies, and psychomotor retardation. The child had recurrent admissions for fever, cough, and cold—7 times and required intensive care unit (ICU) stay for pneumonia twice at 4 and 9 months of age, urinary tract infection at 4 months of age, febrile seizures at 9 months of age, and left otitis media at 13 months of age. Serum immunoglobulin G (IgG), IgA, and IgM deficiency levels were low. Further evaluation for immunodeficiency revealed a homozygous variant in the deoxyribonucleic acid methyltransferase 3B (DNMT3B) gene at exon 22 c.2401T>C variant.

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CASE REPORT

Rajender Singh, Naveen Sharma, Pancham Kumar, Vipin Roach

Tuberculous Radiculomyelitis Presenting as Bilaterally Symmetrical Proximal Lower Limb Weakness

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:3] [Pages No:132 - 134]

Keywords: Case report, Motor weakness, Radiculomyelitis, Tubercular Arachnoiditis

   DOI: 10.5005/jp-journals-10081-1407  |  Open Access |  How to cite  | 

Abstract

Tuberculosis (TB) is one of the infectious diseases that can present in diverse forms in countries like India with a higher burden of disease. Spinal TB, as a manifestation of TB, can also present in myriad ways, such as tuberculous spondylitis, tuberculous myelitis, tubercular radiculomyelopathy, spinal tuberculoma, and tuberculous arachnoiditis. We hereby report a case of tuberculous radiculomyelitis, which presented to us with bilateral progressive weakness of more of the lower limbs, which was more marked in proximal muscles and had sparing of bowel, bladder, and sensory system, except for pain which was present in the initial phase of illness.

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CASE REPORT

Ashwani K Sood, Saguna Pandit, Nidhi Chadha, Naresh I Jindal

Secondary Hemophagocytic Lymphohistiocytosis with Severe Dengue: A Rare but Dreadful Complication

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:3] [Pages No:135 - 137]

Keywords: Case report, Cytokine storm, Dengue fever, Dengue fever with warning signs, Hemophagocytic lymphohistiocytosis

   DOI: 10.5005/jp-journals-10081-1412  |  Open Access |  How to cite  | 

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a devastating and rare multisystemic disorder characterized by an autoimmune phenomenon leading to reactive hyperactivity of cytotoxic T cells and histiocytes mediated by cytokine storm. HLH could be primary (hereditary) or secondary (acquired). Unremittent fever, organomegaly, lymphadenopathy, and neurologic dysfunction are among the common manifestations of HLH, along with abnormal lab parameters like hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia, and transaminitis. We report a case of a 16-year-old adolescent girl presenting to the emergency department with a history of high-grade fever, with partial response to antipyretics, body aches, and severe headache for 4 days. The physical examination revealed significant hepatomegaly. enzyme-linked immunosorbent assay was positive for dengue nonstructural protein 1 (NS1) antigen (Ag) assay. The patient was managed as per the World Health Organization (WHO) protocol and started improving from dengue; however, during the second week of the illness, the patient continued to have persistent fever. A repeat lab workup revealed bicytopenia with elevated ferritin levels (17891 ng/mL). Diagnosing dengue-associated HLH is challenging unless the treating team is aware of this association, as early recognition and timely institution of immunosuppressive and specific therapy for the underlying infection is associated with improved outcomes. Physicians should collaborate with pathologists and microbiologists for early diagnosis.

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NOTES FROM LAB

Nivedhana Subburaju

Lab Diagnosis of Epstein–Barr Virus

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:3] [Pages No:138 - 140]

Keywords: Atypical lymphocytes, Epstein–Barr virus, Heterophile antibodies, Infectious mononucleosis, Viral capsid antigen

   DOI: 10.5005/jp-journals-10081-1409  |  Open Access |  How to cite  | 

Abstract

This article aims to summarize the hematological and biochemical findings in acute Epstein–Barr virus (EBV) infection and serological diagnosis of infectious mononucleosis (IM).

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Journal Watch

Vikram S Kumar

Managing Pediatric Urinary Tract Infections: Key Insights from Recent Studies

[Year:2023] [Month:October-December] [Volume:5] [Number:4] [Pages:5] [Pages No:141 - 145]

Keywords: Bowel bladder dysfunction, Dimercaptosuccinic acid scan, Renal ultrasound, Urinary tract infections in the pediatric population, Vesicoureteric reflux

   DOI: 10.5005/jp-journals-10081-1404  |  Open Access |  How to cite  | 

Abstract

This collection of studies presents significant insights into various aspects of pediatric urinary tract infections (UTIs).

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