Subject(s)
Cesarean Section/standards , Female , Humans , Infant, Newborn , Pediatrics , Physician's Role , PregnancyABSTRACT
Adenosine deaminase (ADA) activity measurement and C-reactive protein (C-RP) detection were done in CSF of 27 tuberculous meningitis (TBM) and 8 patients of partially treated bacterial meningitis, apart from routine biochemical tests. Both the groups had comparable CSF cell count, protein and sugar concentrations. The mean CSF ADA activity was significantly raised in TBM as compared to partially treated bacterial meningitis patients (p < 0.05). A cut-off ADA level < or = 5 IU/L and C-RP positively were used for differentiation of partially treated bacterial from TBM cases. Based on this, the sensitivity and specificity of ADA and C-RP were 62.5%, 88.9% and 75%, 100%, respectively. Since both the tests are simple and take lesser time to perform, they can be used as rapid diagnostic tests to remove diagnostic dilemma between the two diseases.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Chi-Square Distribution , Child , Child, Preschool , Diagnosis, Differential , Humans , Infant , Meningitis, Bacterial/diagnosis , Sensitivity and Specificity , Spectrophotometry , Tuberculosis, Meningeal/diagnosisABSTRACT
A nursery epidemic caused by multidrug resistant Salmonella typhimurium is reported. In total, 21 infants developed symptomatic illness; of these, 17 had septicemia (7 blood culture positive) and 4 had diarrhea alone. Asymptomatic carrier state was identified in 13 infants. Male sex and birth asphyxia increased the risk for symptomatic illness. Fever, lethargy, and diarrhea were the most common clinical features. Amongst the septicemic infants there was no difference in clinical profile whether the blood culture was positive or negative for S. typhimurium. In the symptomatic group, S. typhimurium was isolated from feces in 19 cases and from blood in 7 cases. In both symptomatic and asymptomatic infants, all isolates of S. typhimurium, whether obtained from feces and/or from blood, were resistant to ampicillin, chloramphenicol, and trimethoprim, and a significant number (almost one-fifth) of them also showed resistance to third generation cephalosporins. More than 90% of isolates were sensitive to aminoglycosides and ciprofloxacin. On a combination of third generation cephalosporin (cefotaxime or ceftriaxone) and amikacin, 17 (81%) infants recovered, 2 succumbed to their illness, and 2 failed to improve and required ciprofloxacin. The origin of epidemic was traced to a carrier staff nurse working in nursery.