Streptobacillus moniliformis bacteremia in a child: case report

We report a case of bacteremia caused by Streptobacillus moniliformis. A 2 years and 3 months female Kuwaiti child presented with febrile convulsions, mild cough and vomiting. The patient's history, clinical findings and radiological investigations were reviewed. There was no history of rat/animal bite, but the child had been camping in the desert prior to the illness and may have been exposed to rodent excreta. On two occasions, blood culture specimens yielded pure growth of the organism which was identified by standard diagnostic criteria. The patient was successfully treated with cefotaxime and clarithromicin. S. moniliformis may be a cause of bacteremia even in the absence of rat/animal bites

Role of computed tomography [CT] in pediatric respiratory diseases

Respiratory illness is one of the major causes of morbidity and mortality in children. CT lung has some advantages over plain chest radiography but exposes the child to more radiation, 1 his study was carried to determine the value of performing lung CT in the management of children with respiratory diseases and to summarize the main indications for ordering pulmonary CT in Pediatrics. A hospital based, retrospective case-review study was carried out in Pediatric department, Al Adan Hospital, State of Kuwait. The files of all patients les then 12 year age, and for whom CT lung was performed during the last Ova years [2000-2005] were reviewed. Thirty patients for whom CT lung was performed were reviewed. The main indication for requesting chest CT was persistent abnormal CX-rey findings [0e/,] in a patient with uncontrolled wheeze and/or recurrent pneumonia. Findings of chest CT was the same as CX-ray findings [80%] and more specific +1- new diagnosis [20%]. Results of chest CT influenced medical treatment only in seven of the cases [23%] and led to surgical intervention in two patients [0.06%], [hernia, cystic adenomatoidmlformation]. Our data demonstrate that the result of CT lung in children doesn't alter clinical decision end management of most of the cases. Therefore CT lung should be requested mainly for the high risk patients, preferably by a pulmonologist and after discussing the chest x-ray findings with a radiologist

value of a positive nitrate test in routine urine analysis for the diagnosis of childhood UTI

Urinary tract infection [UTI] is one of the most common diseases in children. Its diagnosis depends mainly on urine culture. Urinalysis is used as a screening test to exclude UTI. A hospital based, prospective case-review study was carried out at the Pediatric Department, Al-Adan Hospital, State of Kuwait. The objectives of this study is: l.To determine the proportion of positive urine cultures identified in patient less than 12 years of age, admitted to hospital and was found to have a positive nitrite test in the routine urinanalysis. 2.Furthermore, to study the confound factors which increase the sensitivity of this test in order to reduce unnecessary culture of urinanalysis. A total of eighty patients admitted to Pediatrics wards at Al-Adan Hospital over a period of four months were found to have a positive nitrite test in routine urinanalysis. only 38 [47%] were significantly positive [pure bacterial growth of >= 100000 CFU/ml].Other studied confound factors such as fever, urinary symptoms, rigors, family history and past history of UTI, history of nocturnal enuresis or constipation were only significant if taken in combination [of those with positive urine cultures 97% had more than one factor]. Urinary leukocyte count was significantly elevated [> 10/hpf] in 90% of the patients with a positive urine cultures. Our data indicates that ordering urine culture in patients with a positive nitrite in urinanalysis should be restricted only to those who also have elevated urinary leukocyte esterase and those who have one or more risk factor for UTI

Canavan Disease: a case report from Kuwait

A Kuwaiti female presented at age of three months with macrocephaly, hypotonia, and global developemental delay. She was found to have Cancvan disease. Although Cancvan disease is a rare autosomal recessive neurometabolic disorder which occurs mainly in Ashkanazi Jews, we are reporting this case to highlight that neurometabolic diseases as well as other rare autosomalrecessive disorders affect a relatively large number of patients in countries with high rate of consanguineous marrige like Kuwait and other Gulf areas. We believe that it is high time for molecular cytogenetic studies to be done on Canvan disease and other rare neurometabolic disorders affecting Kuwaiti patients