Clinical features and antibiotic susceptibility of Salmonella gastroenteritis in children: A ten-year review

@#extraintestinal infections among Thai children,especially infants, and leading to overwhelming antibioticuse.Materials and Methods: In this retrospective review, datacollected during 2006-2015 from the medical charts ofpatients with evidence of infection, caused by anySalmonellaserogroup or clinical form, were examined. Weaimed to assess the clinical manifestations, antibioticsusceptibility, and antibiotic use in children with Salmonellagastroenteritis over the ten years’ period.Results: A total of 419 patients had non-typhoidalSalmonellainfection. Four-hundred (95.5%) patients werediagnosed with acute gastroenteritis, which was common inchildren aged <12 months (72.3%). The clinical features ofpatients with gastroenteritis included fever (74.5%),diarrhoea with bloody mucus (60.5%), watery diarrhoea(39.5%), and vomiting (19.8%). Serogroup B was mostcommonly detected in the stool specimens. Thesusceptibility of non-typhoidal Salmonellato ampicillin,norfloxacin, and co-trimoxazole was 36.3%, 98.0%, and80.5%, respectively. Serogroup B was the most resistantstrain, which was sensitive to ampicillin in only 21.6% ofspecimens, while it showed high susceptibility tonorfloxacin and co-trimoxazole (98.1 and 84.0%,respectively). Third-generation cephalosporin andfluoroquinolone were most commonly prescribed. Conclusions: Acute gastroenteritis is the most commonform of Salmonellainfection. Gastroenteritis caused byserogroup B is still the most common infection, whichmostly occurs among infants under one year of age. Themajority of stool specimens were still susceptible toantimicrobial agents, especially fluoroquinolone and co-trimoxazole; however, there was an overuse of antibioticswithout proper indications.

Dengue associated haemophagocytic lymphohystiocytosis: An often-missed complication of a common infection

@#life-threatening condition causing multisystem involvementsuch as cytopenia, hepatosplenomegaly, and death. Dengueinfection is one of the leading causes of HLH. We reviewedthree cases of children at HRH Princess Maha ChakriSirindhorn Medical Center, Faculty of Medicine,Srinakharinwirot University, Nakhon Nayok, Thailand, withdengue fever who subsequently developed HLH, based onthe HLH-2004 diagnostic criteria. Following treatment withdexamethasone and intravenous immunoglobulin, there wasa dramatic response including defervescence andimprovement of cytopenia, hyperfibrinogenemia, andhyperferritinemia. Key features for diagnosis of denguefever complicated by HLH include a history of prolongedfever exceeding seven days, splenomegaly, and worseningcytopenia. Early recognition and treatment are crucial for asuccessful outcome.