Bandemia in sickle cell disease: a marker for differentiating osteomyelitis from vaso-occlusive crisis

Find out if bandemia [increase in the absolute band cell count] can differentiate osteomyelitis from vaso-occiusive crisis involving the bones in patients with sickle cell disease. Meaningful cut-off-points in the absolute band count [>/= 1000 and >/= 500] differentiation are also looked at. A retrospective review of records of 50 patients from each category for comparison was performed. Two cut-off-points were considered namely bandemia of >/= 1000 and >/= 500 and these were subjected to analysis. Bandemia [both >/= 1000 and >/= 500] was generally more prominent in cases of osteomyelitis as compared to VOC. There were problems with sensitivity and specificity of bandemia as a single criterion for differentiation between the two entities. Although seemingly we encounter higher counts of band white blood cells in cases of osteomyelitis occurring in patients with SCD as compared to VOC, yet because of low sensitivity in case of >/= 1000 as a cut-off-point and low sensitivity as well as non-specificity in case of >/= 500 as a cut-off-point, bandemia cannot be recommended as single diagnostic criterion

Paratyphoid outbreak in children: description of therapy and important features

An outbreak of paratyphoid fever occurred in Bahrain in 1987. There were 227 cases, 39 of whom were children who were admitted to the paediatric wards in Salmaniya Medical Centre. Diagnosis of paratyphoid fever was confirmed by positive blood culture in 94.8% of the cases. The patients were randomly assigned to receive either ampicillin, amoxicillin, chloramphenicol or co-trimoxazole. All patients responded to treatment although variations in response to the different antibiotics were noted. Co-trimoxazole and chloramphenicol produced the best response and were equally effective with their mean period for defervesence being 3.4 and 3.9 days respectively. Corresponding values for amoxicillin and ampicillin were 4.5 and 5.5 days. One patient from the amoxicillin group relapsed and was readmitted