Pertussis and pertussis like illness: Pediatric experience in Oman

Objectives: Aresurgence of pertussis or whooping cough has been observed worldwide despite broad vaccination coverage. Pertussis like illness [PLI] refers to a clinical syndrome compatible with pertussis infection but lacking laboratory confirmation or an epidemiological link to a confirmed case. Our study aimed to estimate the contribution of Bordetella pertussis infection and identifying predictors of its diagnosis in a cohort of children with PLI

Methods: Demographic and clinical information were retrospectively collected from the medical records of children < 13 years old and hospitalized for PLI in two pediatric units in Oman from 1 January 2012 to 31 December 2013. The laboratory data of all cases were reviewed and confirmed cases of pertussis were identified, analyzed, and compared with non-confirmed cases

Results: A total of 131 patients were enrolled in this study. The majority [95.4% [125/131]] were infants. Only 54.1% [71/131] of admitted children with PLI were tested for pertussis. The incidence of pertussis infection among the tested group was 16.9% [12/71] with a 95% confidence interval 8.2?25.6. Severe illness occurred in 56.4% [74/131] of patients, and six were confirmed to have pertussis. Pediatric intensive care unit admission was required for one confirmed case of pertussis and eight cases from the PLI group [three were negative for pertussis, and five were not tested]. Receiver operator characteristic curve analysis revealed that a white blood cell count >/= 23.5 × 10[9]/L had 96.6% specificity and lymphocytes >/= 17 × 10[9]/L had 98.3% specificity

Conclusions: Taking into consideration that the number tested for pertussis was limited, the incidence of pertussis was 16.9% [12 out of 71 patients]. Lymphocytosis can be used as a reliable predictor for the diagnosis of pertussis especially in the absence of specific confirmatory tests or until their results are available

Imported case of melioidosis in Oman: case report

Melioidosis is an infectious disease caused by the bacterium Burkholderia pseudomallei. It is most commonly described in Southeast Asia and Northern Australia and some imported cases in non-endemic areas. We describe the case of a 55-year-old Omani man with fulminant sepsis who worked in Laos, Cambodia. B. pseudomallei was isolated from the patient's blood and was identified by means of microbiological and biochemical tests. We highlight the importance of careful attention to non-fermentative gram-negative rods in a septic patients who have worked or travelled to Southeast Asia

Hospitalised patients with influenza A [H1N1] in the Royal hospital, Oman. Experience of a tertiary care hospital, July-December 2009

The aim of this study was to describe the clinical characteristics, risk factors, laboratory investigations and outcome of hospitalised patients with positive influenza A [H1N1] at the Royal Hospital in Oman. We extracted data from the retrospective medical charts, radiological and laboratory findings of 131 patients who were confirmed as positive foriInfluenza A [H1N1] by real-time reverse-transcriptasepolymerase-chain-reaction from 21 July to 23 December 2009. The median age was 24 years with 34.4% in the paediatric age group. Most [63%] of hospitalised patients were female. Symptoms at presentation included mainly fever [93.9%] and respiratory symptoms [89.3%]. 83% of the patients had at least one risk factor and pregnancy was the most common associated condition [22.9%]. Most of the patients had reduced lymphocytic count [57.3%] and high levels of serum C-reactive protein, aspartate transaminase and lactate dehydrogenase [75.7%, 75% and 70.8% respectively]. The majority of the patients [64.5%] had evidence of pneumonia and radiological findings constituted mainly bi-lateral infiltrates [60.6%]. Antiviral therapy was administered to 95.4% of the patients who mostly received it 48 hours after disease onset. Death occurred in 6.9% of patients. Out of these, 88.9% required Intensive Care Unit [ICU] care and mechanical ventilation. Influenza A [H1N1] infection mainly affected those of younger age and females. Associated medical conditions were common, with pregnancy being interestingly the commonest risk factor. The infection caused severe illness that required ICU admission and led to death in 6.9% of patients