Pan-vasculitis and fulminant hepatitis following routine vaccination at the age of 4months

Vaccines are known to have side effects, most of which are tolerable. Vasculitis following vaccination is reported and has various modes of presentation. We report a 4-month-old girl presented with an unusual presentation of fulminant hepatitis, pan vasculitis, and diffuse body aneurysms following routine immunization diagnosed by echocardiography and computed tomography angiogram. It is important to be aware of different possible adverse effects following vaccines and their different modes of presentation as well as possible treatments such as intravenous immunoglobulins and high dose methylprednisolone.

Risk Factors of catheter related blood stream infection in neonatal intensive care unit: experience from a developing country

Objective: The aim of this study was to detect the rate of catheter-related bloodstream infection [CRBSI] in NICU of Mansoura University Children's Hospital and to focus on possible predictors of infection. Study

Design: A cross sectional comparative study to detect rate of CRBSI among neonates with central vascular catheters during the period between January 2009 and April 2012. Then, a nested case control study done among CRBSI cases and central vascular catheters none infected as a control group to detect predictors associated with their occurrence

Patients and Methods: Blood samples were collected from III neonates clinically suspected ofsepticemia and had inserted venous line. Central, peripheral blood and catheter tip cultures were done for each case

Results: CRBSI was confirmed in 69 cases as central blood culture count was > 3 folds of peripheral blood culture count. Catheter tip culture showed > 103 CFV/ ml per catheter of the same organisms. Low birth weight, age below 7 days, prematurity, mechanical ventilation, TPN administration and prolonged hospital stay were predictors of CRBSI. Logistic regression of the studied predictors showed that birth weight, TPN administration and length of central venous catheter stay were significant predictors of CRBSI

Conclusion: CRBSI is a common problem in NICU. Predictors of CRBSI included low birth weight, prematurity and mechanical ventilation. Potential use of TPN, prolonged catheter stay and low birth weight are independent predictors for CRBSI