Objective: To determine factors associated with mortality by sepsis syndrome in children. Methods: We performed an analytical study of cases and controls, which included patients between 31 days and 14 years of age, treated at Hospital Universitario del Valle in Cali, Colombia, with sepsis syndrome between 1999 and 2003. Information was gathered from medical records and books. The outcome variable was the status on discharge from hospital (alive or dead). All the dead children were verified in the hospital records and all the living children were confirmed alive four weeks after discharge. The exposure control variables were age, gender, origin, socioeconomic status, educational level of mothers, family order of the child, classification and origin of sepsis, nutritional status, underlying disease, presence and type of immunosuppression, invasive procedures, duration of surgery, broad-spectrum antibiotics, as well as preoperative, hospital and intensive care stay. Results: We evaluated 110 cases and 110 controls, 79 with diagnosis of sepsis and 31 with septic shock. The cases had more days of evolution of the disease, higher proportion of family order of the child between third and fifth offspring, malnutrition, acquired immunosuppression, respiratory origin of sepsis, and shorter hospital stay and in intensive care. The logistic regression model showed that more days of disease progression (OR 1.05 CI 95% 1.01-1.10), and family order of the child (1.39 CI 95% 1.11-1.74), meant greater risk of dying from sepsis syndrome. Conclusions: It must be insisted to the community of the importance of consultation and early diagnosis of any infectious process for rapid identification of the bacteria, allowing the introduction of specific treatment and referral according to severity level.

Introduction: Afebrile pneumonia syndrome in infants, also called infant pneumonitis, pneumonia caused by atypical pathogens or whooping cough syndrome is a major cause of severe lower respiratory infection in young infants, both in developing countries and in developed countries. Objective: To describe children with afebrile pneumonia syndrome. Methods: Through a cross-sectional study, we reviewed the medical records of children diagnosed with afebrile pneumonia treated at Hospital Universitario del Valle, a reference center in southwestern Colombia, between June 2001 and December 2007. We obtained data on maternal age and origin, prenatal care, the child’s birth, breastfee­ding, vaccination status, symptoms, signs, diagnosis, treatment, and complications. Results: We evaluated 101 children with this entity, noting a stationary presentation: June-August and November- December. A total of 73% of the children were under 4 months of age; the most common symptoms were: cya­notic and spasmodic cough (100%), respiratory distress (70%), and unquantified fever (68%). The most common findings: rales (crackles) (50%), wheezing and expiratory stridor (37%); 66% were classified as mild and of the remaining 33%, half of them required attention in the intensive care unit. In all, there was clinical diagnosis of afebrile pneumonia syndrome in infants, but no etiologic diagnosis was made and despite this, 94% of the chil­dren received macrolides. Conclusions: These data support the hypothesis that most of these patients acquired the disease by airway, possi­bly caused by viral infection and did not require the indiscriminate use of macrolides.

During the period between Rajab 1405 and Jamad Thani 1407 (March 1985-January 1987) a total of 5280 babies were delivered at King Khalid Hospital, Al-Kharj, Saudi-Arabia. Out of these children, 345 i.e. 6.53% weighed less than 2500g. Seventy-three, i.e. 21% of the low birthweight (LBW) babies were born during the festival months of Ramadan and Hajj. When compared with the non-festival months, the number was statistically significant p less than 0.01; and Odds Ratio of 1.42. The perinatal mortality rate for the LBW infants was 176.8 per thousand compared with 25.82 for all deliveries during the same period of time. As in a previous report adolescent primiparae made a large contribution to the total number of LBW deliveries. Therefore there is a need for more vigilance in the care of pregnant patients and, more provisions for the care of LBW infants during the festival months.