ABSTRACT
Background: Hemorrhagic manifestations are common with Dengue but thrombotic events are uncommonly reported. Case characteristics: 11-year-old boy who presented with ileo-femoral deep vein thrombosis associated with serologically confirmed infection with DEN1 dengue virus. Observation: There was no other history or investigation suggestive of a procoagulant state. Outcome: Successfully treated with enoxaparin and warfarin. Message: Thrombotic complications are possible with dengue infection.
ABSTRACT
We report Rhizomelic Chondrodysplasia Punctata (RDCP), a rare, autosomal recessive disorder with rhizomelic shortening of limbs, congenital cataracts and seizures but without any biochemical abnormality. The mother of the baby developed Systemic Lupus Erythromatosus (SLE) with Ro/SSA antibodies 11 months after delivery. Ro/SSA antibodies may generate calreticulin antibodies causing characteristic skeletal changes.
ABSTRACT
Objective: To identify the outcome of acute lower respiratory tract infection (ALRTI) and factors contributing in mortality. Design: Prospective cohort study. Setting: Urban tertiary care teaching hospital. Methods: 100 cases with ALRTI between 2 weeks to 5 years of age were prospectively enrolled and followed up to determine outcome. Detailed history and clinical evaluation were recorded on a pre-tested proforma.Outcome and significant independent factors contributing to mortality were determined by comparison of dead subjects (n=10) with surviving children (n=90) in a multiple logistic analytic framework. Results: The case fatality rate (CFR) was 10%. The significant (p <0.05) independent factors contributing to mortality were pallor (OR 10.7), age less than 1 year (OR 9.4), inability to feed (OR 9.3), weight for age Z score (WAZ) <-3 (OR 6.6), presence of loose stools (OR 5.3), Hb<10(OR 1.6). The CFR was related to severity of WHO classification (“pneumonia”-0%, “severe pneumonia”-8.7% and “very severe pneumonia”-47.0%). Factors contributing to prolonged hospital stay included lack of exclusive breastfeeding [OR (95%CI)-4.37(1.69-11.28) RR (2.04)] and fever [OR (95%CI)-5.59(1.92-16.2) RR (2.3)] on multivariate analysis. Conclusion: ALRTI in children is a major concern. Presence of factors like pallor, age below 1 year, inability to feed, presence of loose stools and severe malnutrition require urgent intervention.