ABSTRACT
We recorded three cases of faucial Diphtheria in two Nigerian hospitals between 2021 and 2022. Hitherto, no infections were documented in these hospitals in the prior ten years. All infected children missed their routine childhood vaccinations and presented with reduced feeding, a bull neck and a light yellowish throat or tonsillar pseudo-membrane. Outcome was fatal in the first case after two weeks of antibiotic treatment. Diphtheria anti-toxoids (DAT); were not available at this time in Osun state, Nigeria. Outcome was good in the other two children following treatment with antibiotics and compatible plasma transfusion as an alternative for DAT. The predominant contrasting colour of our reported pseudo-membrane compared to the grey colour dominantly well-known is highlighted. We also proffer Plasma transfusion as an alternative to DAT when unavailable. Disease resurgence from the other associated missed pentavalent vaccines is a potential risk.
Nous avons enregistré trois cas de diphtérie fauve dans deux hôpitaux nigérians entre 2021 et 2022. Jusqu'à présent, aucune infection n'avait été documentée dans ces hôpitaux au cours des dix années précédentes. Tous les enfants infectés n'avaient pas reçu les vaccinations infantiles de routine et présentaient une alimentation réduite, un cou de taureau et une gorge légèrement jaunâtre ou une pseudo-membrane amygdalienne. L'issue a été fatale dans le premier cas après deux semaines de traitement antibiotique. Les antitoxines diphtériques (DAT) n'étaient pas disponibles à cette époque dans l'État d'Osun, au Nigeria. L'évolution a été bonne chez les deux autres enfants après un traitement antibiotique et une transfusion de plasma compatible en remplacement des DAT. La couleur contrastante prédominante de la pseudo-membrane que nous avons rapportée, comparée à la couleur grise dominante bien connue, est mise en évidence. Nous proposons également la transfusion de plasma comme alternative à la DAT lorsqu'elle n'est pas disponible. La résurgence de la maladie à partir des autres vaccins pentavalents manqués associés est un risque potentiel. Mots clés: Pédiatrie, diphtérie, maladie infectieuse évitable par la vaccination, ré-émergence.
Subject(s)
Diphtheria , Child , Animals , Cattle , Male , Humans , Diphtheria/prevention & control , Blood Component Transfusion , Plasma , Anti-Bacterial Agents/therapeutic use , HospitalsABSTRACT
BACKGROUND: Short-term emergency department (ED) observation care may prevent prolonged and unnecessary hospital admission in patients with sickle pain. This study highlights the outcomes of short-term ED care of acute pain in children with sickle cell disease (SCD). METHODS: Children aged 6 mo to 19 y with SCD and painful crises who were managed by short-term ED care from July 2017 to June 2019 were studied retrospectively. Biodata, pain score, type of care, length of hospital stay, inpatient transfer rate (the proportion that required transfer for full admission) and return rate (the proportion that returned to the hospital for retreatment of unresolved pain) were documented. RESULTS: From July 2017 to June 2019, 122 children with SCD were admitted to the ED for painful crises, of whom 118 (96.7%) with 167 hospital visits were managed by short-term ED observation care. The median length of stay was 10.5 h. In 50.3% of encounters, patients were successfully managed without requiring further care. However, in 17.4% of encounters, they had their ED observation care terminated and converted to full admission. The overall return rate for acute care within 1 wk for either persistence of symptoms or any other complaint was 31.7%. CONCLUSIONS: Dedicated short-term ED observation care has the potential to provide effective and timely management of acute pain in children with SCD.
