ABSTRACT
Opsoclonus-myoclonus ataxia (OMA) syndrome is rare in children, mostly caused by neuroblastoma. Here, we present two very rare cases presenting with OMA due to falciparum malaria. Both of them responded to a high dose of adrenocorticotrophin hormone and intravenous immunoglobulin without recurrence and complication.
Subject(s)
Malaria, Falciparum/complications , Opsoclonus-Myoclonus Syndrome/etiology , Animals , Antigens, Protozoan/analysis , Brain/pathology , Child , Humans , Magnetic Resonance Imaging , Malaria, Falciparum/diagnosis , Malaria, Falciparum/parasitology , Male , Opsoclonus-Myoclonus Syndrome/diagnosis , Plasmodium falciparum/immunology , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Empyema thoracis in children causes significant morbidity. Standard treatment of Empyema thoracis includes tube drainage and antibiotics. But the tube drainage often fails. Intrapleural Streptokinase has been used in empyema thoracis with good success rate. OBJECTIVES: We evaluated the efficacy of intra-pleural Streptokinase in management of empyema thoracis even in advanced stages. PATIENTS AND METHODS: A total of 28 patients with empyema thoracis requiring intercostal tube drainage aged zero to twelve years were included in the study who were admitted in Pediatric intensive care unit. 15,000 units/kg of Streptokinase was instilled into the pleural cavity. Response was assessed by clinical outcome, after unclamping and subsequent chest radiography and serial chest ultrasounds. RESULTS: Streptokinase enhanced drainage in all patients with complete resolution of empyema thoracis in 26 patients. Two patients were referred for surgery. Only 7.2% required surgery. Streptokinase was equally effective if started before or after seven days. CONCLUSIONS: Intrapleural Streptokinase is the preferred treatment for treating pediatric empyema thoracis even in advanced stages and can avoid surgery.
ABSTRACT
A prospective observational study was performed to know the profile and outcome of paediatric Intensive care unit admitted patients. Paediatric intensive care unit admitted patients are mostly male (65%), suffering from critical respiratory (36%) and CNS diseases (35.4%). The survival at paediatric intensive care unit was 37.5% (25% were mechanically ventilated). Successful mechanical ventilation was done for 45 days. Major cause of mortality was sepsis with multiorgan dysfunction. Commonest organism Isolated from blood was Klebsiella pneumoniae (38%). Most Gram-negative organisms were sensitive only to carbapenems, some were sensitive only to polymyxin B. All staphylococci were resistant to vancomycin.
