Meningococcal septicemia

Meningococcal disease is an illness caused by an organism called Neisseria meningitidis. The disease is highly contagious as it spreads through close contact. Immediate medical recognition of the disease is vital once it is suspected. Any person could be infected with meningococcal disease; however, certain groups are at practical risk. A healthy middle aged man presented with symptoms of fever, general fatigue, and widespread rash. The patient deteriorated rapidly and passed away. This case report is a typical presentation of meningococcal disease. The presentation could be vague and if not recognized early, might lead to rapid decline in health and eventual death

Pleuroperitoneal leak in a patient on automated Peritoneal Dialysis

A forty-year-old Bahraini female with a known case of End Stage Renal Disease [ESRD] on Peritoneal Dialysis [PD] presented with a complaint of shortness of breath. She was found to have right side pleural effusion on a chest X-ray. The effusion was managed initially with Intercostal Drainage [ICD] insertion. The patient was investigated for the cause of the effusion and she was found to have hydrothorax secondary to pleuroperitoneal leak. She was initially treated with pleurodesis and temporary cessation of PD. However, this maneuver failed and the patient had to be shifted to hemodialysis as a permanent solution

Fever in sickle cell disease patients in the Kingdom of Bahrain

Sickle cell disease [SCD] is a hereditary blood disorder characterized by abnormal red blood cell shape [sickling]. The incidence of the disease in the Kingdom of Bahrain is approximately 2.1%. Patients with SCD are prone to multiple health complications, some of which are fatal. A retrospective study was conducted at the Salmaniya Medical Complex in the Kingdom of Bahrain from June, 2012 to December, 2012 to assess the incidence of fever among the SCD in-patients at that institution. The study also assessed the antibiotics administered, type of organisms isolated and patient outcome. The results showed that a total of 59 patients developed fever and 33 of those with fever had a positive culture result [55.93%]. The most common isolate was gram-positive bacteria, most commonly Staphylococcus epidermidis [42.86%], and ceftriaxone was the most commonly prescribed antimicrobial. In conclusion, there was a low rate of hospital acquired infection and special attention needs to be paid to the infection control measures for SCD patients. For most of the SCD fever cases, there was no clear cause of the fever even after extensive diagnostic evaluations; thus, those fevers may have been of a non-infectious etiology in this population. Fortunately, none of the patients had any of the common preventable infections as a result of the high vaccination coverage and strong vaccination program in place in the Kingdom of Bahrain

Tetanus in an unvaccinated laborer in Bahrain

Mr. M.D.S., a 27-year-old Indian male, presented with complaints of diffuse body pain and spasms, 7 days after a needle penetrated his right foot at his place of work. He was diagnosed clinically with tetanus. The patient was electively intubated to protect the airway and transferred to an intensive care unit. In addition to his tetanus, he developed multiple hospital-acquired infections. After 34 days, he was successfully extubated and extensive physiotherapy commenced. He was discharged 10 days after extubation

Antibiotics surveillance in pediatrics in-patients, a point prevalence comparative study between kingdom of Bahrain and the European Union

To determine the variation in drug, dose and indications of antimicrobial prescription in children admitted in the hospital and compare the results with the European countries. Point Prevalence Survey [PPS]. All existing pediatric and neonatal wards [medical, surgical, PICU, NICU] within Salmaniya Medical Complex. Data collection was performed using pediatric department and NICU forms. Essential data collected were the patient's biographical data and details about the antibiotics used. The pattern of antibiotics choice and use in Bahrain and the European Union was almost similar in pediatric units. Almost all antibiotics prescribed were on empirical basis. There is a high rate of use of intravenous broad spectrum antibiotics in the pediatric services in Salmaniya Medical Complex for surgical prophylaxis and for medical reasons compared to European Union Centers. The decision to prescribe antimicrobial agents should always be clinically justified and the reasons should be recorded in the patient's medical record. It is important not to prescribe antibiotics on "just in case" basis