ABSTRACT
Background: Dengue fever and scrub typhus are considered an endemic disease in the Indian subcontinent. The epidemiology and clinical presentations are complex and vary each year.? Objective: The objective of this study was to estimate the prevalence of coinfection with scrub typhus in children diagnosed with dengue fever. Methods: A retrospective hospital-based, cross-sectional study was done in the Department of Pediatrics of a teaching hospital in Puducherry. All children (0–14 years) who had enzyme?linked immunosorbent assay (ELISA) reported scrub typhus among those diagnosed with dengue fever (NS1Ag or immunoglobulin M ELISA positivity) during 2012–2016. Medical records with incomplete data were excluded from the study. Odds ratio was calculated to find out the association of coinfections. An independent t-test was used to find out the statistical significance. P < 0.05 was considered statistically significant. Results: Atypical features of dengue were present in 250/318 (78.6%) children. Coinfections were seen in 62/318 (19.4%) children. Scrub typhus was the most common (n = 51/62, 82.2%). The chance of scrub typhus in a dengue serology?positive child is significant when the symptoms are atypical or protracted (OR– 2.6, P = 0.033). Conclusion: High index of suspicion should be present in endemic dengue and scrub typhus coinfection.
ABSTRACT
Background: Purpura fulminans and bilateral perinatal testicular torsion are rare and may co-exist. Case characteristics: A 3-day-old neonate with bilateral swelling of scrotum; torsion and gangrenous changes were observed on exploration. Interventions: Left orchidectomy with preservation of right testis was done. Outcome: At 2-month follow-up, right testis showed signs of atrophy. Child developed full thickness skin lesions and died of sepsis. Message: Perinatal testicular torsion can be bilateral, and requires urgent surgical exploration.
ABSTRACT
Although the cause of sudden infant death syndrome (SIDS) remains unknown, extensive studies over the last 10 years have begun to shed some light on this family tragedy. 5% of all cases of SIDS are caused by fatty acid oxidation disorders. We report a case of fatty acid oxidation disorder causing SIDS.