ABSTRACT
@#Purpura fulminans (PF) is a severe clinical manifestation of Neisseria meningitides infection that is associated with high mortality rates in children. Survivors are frequently left with debilitating musculoskeletal sequelae. There is a paucity of reports on the musculoskeletal pathology of purpura fulminans. We report on a 2-year-old boy with purpura fulminans due to meningococcemia. The child developed distal gangrene in both the upper and lower limbs. Amputations were done for both lower limbs. Histological examination of the amputated specimens showed an inflammatory process and features of osteonecrosis. The latest follow-up at the age of 6 years showed a right knee valgus due to asymmetrical growth arrest of the proximal tibia. PF and its complications are challenging to treat and may require a multidisciplinary approach to improve patient’s functional ability.
ABSTRACT
Soil-transmitted helminths (STH) is a group of parasitic nematodes, including Trichuris trichiura, Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus, which can cause gastrointestinal disorders in humans. STH is prevalent among neglected communities in both developing and developed countries. This present study aims to determine the current prevalence of STH infections in Aboriginal population after mass delivering of antihelminthic drugs was proposed by WHO in 2005 and a health education learning package (HELP) was initiated in Malaysia in 2012. A total of 235 human fecal samples were collected and a pre-tested questionnaire was given to gather information about the socio-demographic of the Aborigine communities living in Kedah and Selangor, Malaysia. The samples were screened by a direct-fecal smear and confirmed by formalin-ether sedimentation methods. From human faeces, 81.7% was found to be infected with one or more STH species. T. trichiura was the most commonly detected (76.6%), followed by hookworms (26.4%) and A. lumbricoides (19.1%). Triple infections were found in 6.4% of the studied population. Univariate analysis showed that individuals with age group, male, presence of indoor toilet, family size with <7 members and bad living habits (i.e., without antihelminthic drugs) were significantly associated with STH infections. The analysis further showed that walking barefoot was the significant contributing factor to hookworm infections. The high prevalence of human STH infections is alarming. Thus, the urgency in implementing health education related behavioral practice and hygiene to reduce disease burden in these rural communities are a crucial need.