No abstract

Mumps is a contagious viral illness that classically presents with fever, parotid gland swelling, headache, and vomiting in unimmunized children. The complications of mumps most commonly include orchitis, pancreatitis, encephalitis, and meningitis. Optic neuritis, which refers to the inflammation of the optic nerve, in rare cases, can present after mumps meningoencephalitis and causes pain in the eye, and a decrease in visual acuity. We report and discuss a case of bilateral optic neuritis following mumps meningoencephalitis in a child. The patient was managed with short-term steroid therapy.

Background: Typhoid illness is a significant cause of morbidity in Pakistan. This study aimed to determine the financial burden on parents of children infected with extensively drug-resistant (XDR) salmonella infection. Patients and methods: This observational study included 159 patients aged 6 months to 13 years admitted through OPD/ER of Karachi Adventist Hospital with the diagnosis of enteric fever and intravenous antibiotics started as per local antibiogram. To remove recall bias antibiotic cost before hospitalization was not included. All those patients who were culture positive for XDR salmonella, either continued or shifted to newer antibiotics as per susceptibility pattern were included. Depending upon the type and duration of antibiotic therapy cost was calculated in Pakistani rupee (1 USD = ~225 PKR). Results: Total 60.4% of patients aged less than 7.5 years; 62.3% were male, 41.5% from urban areas, 15.1% had graduated mothers, 27% had graduated fathers, 5.7% uses boiled water, and 1.9% typhoid vaccination. In 54.1% of patients antibiotic cost reached >40k PKR. Patients with urban dwelling were 0.29 times less likely for higher cost, increase in duration of fever (>7 days) at admission increased the cost 5.73 times, XDR samples found 13.5 time more likely for higher cost, and TLC between 4000 – 11000/mm3 gave negative association with higher cost. Conclusion: The burden of XDR salmonella infection is heavy and is related to urban residence, duration of fever at admission, and length of hospital stay.

Objectives: In resource limited countries facing a huge burden of multidrug resistant and extensively drug resistant (XDR) enteric fever, treatment is a great challenge on the part of a patient as well as a health care professional. This study was conducted to determine the association of XDR enteric fever with various studied factors among hospitalized culture-positive pediatric patients in a tertiary care hospital setup. Methods: We conducted a descriptive observational study at The Karachi Adventist Hospital from July 01, 2019, to March 31, 2020 on 143 hospitalized children with culture proven enteric fever who were already on empirical antibiotics. Depending on the variability of the course of illness and clinical responses to given antibiotics, the data was gathered on a structured data sheet. Association of various study parameters and their significance in relation to XDR salmonella infection was analyzed and studied. Results: The age group highly affected was 5-7.5 years, with a male preponderance of 61.5%. Majority were from urban slums areas of Karachi (53.8%) and 52% were admitted between 7 to 14 days of fever onset. XDR salmonella infection was observed in 79% of blood culture isolates. None of the XDR patients were consuming boiled water and neither of these infected children were vaccinated against salmonella typhi. Duration of fever before hospitalization, non-consumption of boiled or mineral water, ciprofloxacin use and lack of typhoid vaccination showed statistically strong association with XDR enteric fever (p<0.01). Conclusion: Prehospitalization fever duration, use of boiled/mineral water, ciprofloxacin use and typhoid vaccine status showed strong association with XDR salmonella infection. Prioritizing the focus on healthcare awareness, early access to proper health care facility, discouraging over-the-counter drugs and enforcement of immunization will help decline the dissemination of this dreadful disease. doi: https://doi.org/10.12669/pjms.38.7.5868 How to cite this:Memon H, Saeed F, Iqbal M, Saboohi E, Hanif S, Mallick AHH. Association of extensively drug resistant salmonella infection in children with typhoid fever. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5868 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To determine the effect of maternal colonization with history of PROM on neonatal colonization and early-onset sepsis.Methods: A descriptive cross-sectional study was carried out at a single tertiary care hospital of Karachi from June 1st 2018 to May 31st 2019. A total of 155 patients' full-term new-borns between 37 to 41 weeks of gestation with a history of rupture of membranes more than 18 hours duration was selected by convenience sampling method. A high vaginal swab was collected from all full-term pregnant women with a history of PROM. After delivery of their new-borns, all babies were kept in the nursery under closed observation for 72 hours duration and their blood cultures, CRP (C- Reactive Protein) and CBC (complete blood count) was sent within 24 hours of delivery.Results: In our study, out of 155 PROM cases 58 (37.4) were growth positive and 50 (32.3) neonates had positive blood C/S at delivery. Out of 58 cases with suspected growth positive PROM mothers 51 had gram-negative organisms in HVS while only 7 mothers were gram-positive in HVS. Of all neonates with positive blood C/S at delivery 44 cases were gram-negative organisms in their blood.Conclusion: In our study organisms found in a high vaginal swab of the mother are similar to the organisms found in the blood culture of their new-born with early-onset sepsis.