case of scrub typhus encephalopathy

Scrub typhus, caused by Orientia tsutsugamushi, is prevalent in the tropical areas like South-East and Far East Asia. A seven-year-old Indian boy who had recently returned from India, presented with fever, headache, vomiting and convulsions refractory to anticonvulsants and multiple antimicrobials. He was diagnosed as a case of Scrub Typhus by Weil-Felix test. He responded well to a ten day course of chloramphenicol. A huge population in Kuwait travels to and from the areas endemic for Scrub typhus. A clinical suspicion is prudent in all such cases presenting with a pyrexia of unknown origin. In cases with involvement of the central nervous system, chloramphenicol should be the first choice of treatment, as it penetrates the blood brain barrier well

first reported case of possible Haemophilus influenzae type b vaccine failure from Kuwait and literature-review

A 17-month-old vaccinated Kuwaiti boy presented with meningitis. The Haemophilus influenzae type b [Hib] capsular antigen was detected in his blood, CSF and urine. The microorganism failed to grow in culture. This case represents the first report of possible Hib vaccine failure from Kuwait. This report examines the possible reasons for this failure by reviewing the literature and emphasizes the need to broaden the definition of vaccine failure with the aim of optimizing the timing of the vaccine booster dose for prematurely born children and establishing continuous surveillance for Hib vaccine failure.