Infective endocarditis in children with atopic dermatitis

The aim of this study was to evaluate the role of bacteria, whether on the skin or in the blood, in inducing infective endocarditis in cases of atopic dermatitis. Twenty-five children with atopic dermatitis [AD] were subjected to history taking, eczema area and severity index [EASI] evaluation, blood culture, lesional and non-lesional skin swab culture and a proper cardiac examination, chest X-ray and echocardiography to detect infective endocarditis [IE]. Six out of these patients had IE, four had a predisposing cardiac condition [ventricular septal defect, VSD] and two patients had cardiac vegetations on a previously normal heart. In AD patients with IE, the mean patients' age, mean EASI, mean disease duration and mean IgE level but not the lesional bacterial colony count were statistically significantly higher than the remaining patients complaining of AD only [n = 19]. In the controls, two subjects out of 10 were confirmed to have VSD. None of them had infective endocarditis or a positive blood culture

Etiological basis of some chronic chest problems of obscure nature in infants and children

Patients with chronic chest problems where no specific diagnosis has been made by non-invasive methods present a diagnostic problem. In this work, 17 patients with chronic chest problems of obscure nature had been studied. Computed tomography delineated the nature of both the bronchogenic and post-traumatic lung cysts while lung biopsy proved useful in the diagnosis of pulmonary hemosiderosis, congenital bronchiectasis, as well as the miliary shadows in the case of miliary T.B. Chest X-ray with barium swallow revealed indentation and kinking of the esophagus by the aberrant left subclavian artery in the cases of Dysphagia lusoria which was subsequently confirmed by echocardiography. Echocardiography also elicited dilated cardiomyopathy and mitral regurge in another case while immunological deficiency syndromes were detected in four cases after thorough immunological study

value of blood cultures in the management of febrile patients later found to have septicaemia

Septicaemia, a common problem among the pediatric patients in the preantibiotic era, has been identified recently in several reports amongapparently healthy children. The impact of blood cultures in detection and early management of 13 cases with septcaemia was evaluated. The blood cultures proved to be of diagnostic value in 77% of cases of septicaemia as clinical assessment is not always reliable in identifying these children, yet its value is negligible in those with serious complications