ABSTRACT
Sinus histiocytosis with massive lymphadenopathy is a rare histiocytic disorder with very few case reports in Indian literature. Immunological abnormalities have been documented in few cases. We report one such case of a child presenting with generalized lymphadenopathy and complicated by autoimmune hemolytic anemia, suggestive of an associated immune dysfunction.
Subject(s)
Anemia, Hemolytic/complications , Autoimmune Diseases/complications , Histiocytosis, Sinus/complications , Lymphatic Diseases/complications , Child , Histiocytosis, Sinus/drug therapy , Humans , MaleABSTRACT
PIP: A retrospective review of cases seen in the Diarrhea Treatment and Training Unit (DTU) of Bangalore (India) Medical College's Vani Vilas Children's Hospital during 1992-1994 confirmed the efficacy of the standard case management approach. This strategy entails oral rehydration therapy (ORT), continued feeding, and selective use of intravenous fluids and antibiotics. Of the 7966 children (4374 males and 3592 females) reporting to the DTU during the 2-year study period, only 2412 (30.5%) had received oral rehydration solution (ORS) or home-available fluids before admission. Acute watery diarrhea was present in 7316 cases (91.84%). Death occurred in 59 acute watery diarrhea cases, 6 dysentery cases, and 7 persistent diarrhea cases. The average time for cases managed in the ORT area was 2 hours and 45 minutes, while the hospital stay for admitted cases averaged 3 days. In 6957 cases (87.33%), ORS was sufficient treatment. Of the 1009 children (12.67%) who required intravenous fluids, 254 had dehydration attributable to conditions such as persistent vomiting and inability to drink due to oral thrush. Only the 512 children (6.2%) with cholera and dysentery received antibiotics. Of the 72 children who died (case fatality rate, 0.9%), 43 had associated severe malnutrition with pneumonia and anemia, 14 had a central nervous system infection, and 13 had septicemia; in only 2 cases could death be directly ascribed to diarrheal disease. One of these cases was due to shigella encephalopathy and the other to severe dehydration with acidosis. The average cost of treatment per patient was Rs 2.91 when only ORS was used compared with Rs 24.28 when intravenous rehydration was required. The finding that less than one-third of children had received ORS before admission suggests a need for the establishment of more DTUs in large hospitals that can train community-based health personnel in diarrhea case management.^ieng
Subject(s)
Case Management , Diarrhea/therapy , Anti-Bacterial Agents/economics , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Diarrhea/economics , Diarrhea/mortality , Female , Fluid Therapy/economics , Hospital Departments , Hospitals, Teaching , Humans , India , Infant , Male , Retrospective StudiesSubject(s)
Palatal Muscles , Paralysis/etiology , Typhoid Fever/complications , Child, Preschool , Female , HumansABSTRACT
An outbreak of encephalitis in Bellary district of Karnataka state and adjoining areas of Andhra Pradesh which occurred during October 1986 to January, 1987, has been investigated. Out of the 219 patients reported, 110 were from Bellary district and the remaining 109 were from Anantapur and Kurnool districts of Andhra Pradesh; 131 (59.8%) were males and 88 (40.2%) females, while 192 (87.7%) patients were aged 10 yr and below. Sixty one patients died giving a case fatality rate of 27.9 per cent. Virological/serological investigations were carried out on 153 patients. Japanese encephalitis (JE) virus was isolated from the brain tissue of 2 cases. On the basis of the results of serological tests and virus isolation, a flavivirus (JE/WN/DEN) etiology could be established in 116 (75.8%) patients.
Subject(s)
Disease Outbreaks , Encephalitis, Japanese/epidemiology , Flavivirus/isolation & purification , Togaviridae Infections/epidemiology , West Nile Fever/epidemiology , Adolescent , Child , Child, Preschool , Female , Humans , Incidence , India/epidemiology , Infant , MaleABSTRACT
One hundred and fifty cases of Japanese encephalitis (JE) in children below 12 years of age admitted to the Headquarters Hospital, Bellary Medical College during October, 1986 to January, 1987 were studied. The youngest child affected was 1 year old. The ratio of male to female was 2:1. Hindu patients (93.33%) were significantly more than Muslim patients (6.6%). The average duration of illness prior to hospitalisation was 4.2 days (SD +/- 1.9 days). Fever, headache and/or vomiting were common presenting symptoms at the onset of illness. Onset of illness was acute or sub-acute in 105 cases (70%). CSF examination showed pleocytosis with lymphocytic reaction and normal sugar. Japanese encephalitis virus was isolated from the brain biopsy tissue in one case and the seropositivity rate for JE was 50%. The mortality was 26% and was directly related to younger age, longer duration of illness prior to admission and deeper grade of coma at the time of admission. Moderate to severe sequalae were seen in 31 patients (28.82%). The mean duration of hospital stay was 8 days.
