Prevalence of Mycoplasma pneumoniae infection among children with acute respiratory tract infection: A prospective case control study

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Mycoplasma pneumoniae has been implicated as a significant etiologic agent of lower respiratory tract infection among children to 18 years old, however, its prevalence in younger children age 5 years and below appears to be increasing.<br /><strong>OBJECTIVES:</strong> This study was performed to determine the prevalence, clinical and radiologic features associated with children 5 years old and below admitted with respiratory tract infection.<br /><strong>METHODS:</strong> This is a prospective case control study involving children 5 years old and below with signs and symptoms of respiratory tract infection, and were tested for M. pneumoniae IgM at the Makati Medical Center and admitted between May 1, 2012 to September 30, 2012. Subjects were children with positive M pneumoniae IgM test (MPP) and controls were children with negative M pneumoniae IgM test (MPN). Clinical, radiologic and laboratory characteristics of MPP and MPN were recorded.<br /><strong>RESULTS:</strong> Twenty-one out of 82 (25.6%) subjects were MPP. The male to female ratio was 1:1.05 witha mean age of 34 months. Clinical, radiologic characteristic and laboratory findings between MPP and MPN were not statistically significant.<br /><strong>CONCLUSION:</strong> The prevalence of M. pneumoniae infection among the subjects was 25.6%. distinguish M. pneumoniae infection.</p>

A case control study of the demographic characteristics, risk factors, clinical findings, treatment and outcome among children 18 years and below who are confirmed to have influenza A H1N1/09 Virus

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> The H1N1/09 virus was reported to be similar to the seasonal flu. However, the World Health Organization (WHO) documented a substantial proportion of patients with H1N1/09 who developed severe illness and death particularly among those with underlying medical conditions. Presently, to our knowledge, there is no data in the Philippines where the demographic and clinical characteristics, risk factors and outcome of children positive for H1N1/09 virus were compared to those with influenza but were negative for H1N1/09.</p> <p style="text-align: justify;"><strong>OBJECTIVE:</strong> The objective of this study was to compare the demographic and clinical characteristics, risk factors, treatment and outcome of the two groups.</p> <p style="text-align: justify;"><strong>METHODS:</strong> A review was done of the charts of 162 patients who were tested for H1N1/09 virus by RT-PCR assay at the Makati Medical Center from May 5 to July 16, 2009. Demographic characteristics, risk factors, clinical features, treatment and outcomes were compared between the two groups. Categorical variables used between the two groups were compared using Fisher's exact test or Chi square test while quantitative variables were compared using T-test; odds ratio was determined.</p> <p style="text-align: justify;"><strong>RESULTS:</strong> A total of 162 patients were included in this study. The largest group of patients positive for H1N1/09 was from the age group of 11-15 years old (35.8%). Risk factors such as travel history and exposure to a confirmed case showed no association to having a positive H1N1/09 test. Clinical features such as fever (100%) and cough (82.1%) were the most common presenting symptoms for both groups. Majority of these patients were given supportive treatment and out of 162 subjects, 91.4 % were treated as outpatient. Clinical outcome showed one mortality from the case group and none from the controls.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> Thus, the demographic characteristics and clinical findings were similar for both groups. Future studies are recommended to include those with influenza-like illness not tested for H1N1/09 virus.</p>

Haemophilus influenzae type B conjugate vaccine (HiBCV) and heptavalent pneumococcal conjugate vaccine (PCV7) immunization status of patients 5 years and below hospitalized for pneumonia

@#Introduction: Community-acquired pneumonia remains to be an important cause of morbidity and mortality among the pediatric age group with Streptococcus pneumoniae and Haemophilus influenzae typ B being the predominant bacteria identified. Conjugate vaccines against these organisms are available however, the prevalence of pneumonia in our country continues to be high. Objectives: The aim of this research is to determine the HiBCV and PCV 7 immunization status of children 5 years and below who were hospitalized due to pneumonia compared to controls. This study also aims to describe the clinical outcome of pneumonia among children who were vaccinated with HiBCV and/or PCV7 compared to those without vaccination. Methods: This retrospective case-control study was conducted in Makati Medical Center from January 1, 2009 to August 31, 2010. Cases were children five years old and below discharged with the final diagnosis of pneumonia. Controls were patients five years and below discharged without pneumonia during the same study period. Medical records were reviewed for information on age, gender, clinical findings upon admission, laboratory results, vaccination status, interventions and outcomes. Conclusion: The findings indicated that clinical and radiologically-confirmed pneumonia still occurred among children with complete vaccination with HiBCV and PCV7. Although not statistically significant, those without vaccination had higher odds of having pneumonia.

Clinical profile and histopathologic diagnoses of childhood peripheral lymphadenopathy: An MMC experience

Peripheral lymphadenopathy is a common clinical problem wherein surgery is performed, especially, when malignancy cannot be eliminated as a differential diagnosis. In the Philippine setting, there is a paucity of data on the incidence of lymphadenopathy in children. Objectives: This descriptive study aims to describe the clinical profile and histopathologic diagnoses of peripheral lymphadenopathy requiring biopsy in children aged one-to-eighteen years seen at the Makati Medical Center (MMC) from 1998 to 2008. Methods: Patients' charts were reviewed and 22 patients were included in the study; 17 were male and 5 were female. All patients underwent excision biopsy, except for one who had fine needle aspiration biopsy. Results: The most common sites of peripheral lymphadenopathy were cervical (78%) and inguinal (14%). The most common histopathologic diagnoses were benign etiology (46%), tuberculous (TB) adenitis (32%), and malignancy (23%). Of the malignant cases, three were Hodgkin's lymphoma and two were non-Hodgkin's lymphoma. Clinical profile included the findings that patients with benign etiology were younger, presented more frequently with fever; and males were more commonly affected; whereas children with malignant etiology were older, had a shorter duration of lymphadenopathy, which were of a larger size, and with accompanying weight loss. Conclusion: The following occurred more often in patients with malignancy: children more than 12 years old, cervical location of lymph nodes, shorter duration of lymph node enlargement, the lack of response to initial antibiotic treatment, and the presence of certain signs and symptoms such as fever and weight loss. Excision biopsy was the predominant surgical procedure used despite extensive invasiveness and the requirement of general anesthesia.

Infections in febrile neutropenic cancer patients who were undergoing chemotherapy at the Makati Medical Center

The immune system of children with malignancies is compromised by chemotherapy and by the cancer itself. In addition, frequent intravenous cannulation, indwelling catheters, malnutrition, prolonged exposure to antibiotics and frequent hospitalizations increase the risk for infection. Neutropenia may lead to an inappropriately low inflammatory response so that fever may be the only manifestation of infection. Management of this complication can vary widely, relating to different geographic patterns of infections and antimicrobial resistance, as well as, issues of treatment availability and cost attainment. The objective of this study was to determine the etiology of infections in febrile neutropenic cancer patients aged 18 years and below who were undergoing chemotherapy at the Makati Medical Center. Inpatient charts of 21 episodes of febrile neutropenia in 19 cancer patients undergoing chemotherapy were reviewed. The primary diseases were mostly acute leukemias (94.7%). Sites of documented infections were the respiratory tract (26.1%), skin and soft tissues (21.7%) oral cavity, ear and sinuses (19.6%), gastrointestinal tract (17.4%), bloodstream (8.7%) and the genitourinary tract (6.5%). Cultures from different sites of infection yielded Escherichia coli (36.4%) and Staphylococcus species (27.3%) to be the most common isolates. The overall mortality was 4.8%. Although broad spectrum antibiotics were used as empiric therapy, the number of isolates obtained was too few to allow a standard recommendation on an appropriate antibiotic regimen.

Clinical characteristics of children with complicated community-acquired pneumonia who were admitted at Makati Medical Center from January 1999 to August 2009

Pneumonia is a prevalent cause of death in children. This study was undertaken to determine the clinical characteristics, outcomes and bacterial etiology of children with complicated community-acquired pneumonia. Methodology: All patients who were between one month and 18 years old and diagnosed with complicated community-acquired pneumonia at the Makati Medical Center from January 1999 to August 2009 were included. Each case was matched with four controls of uncomplicated pneumonia. Data collected were demographic information, laboratory results, management and outcome. Conclusion: There were no significant differences in the demographic profile, class of antibiotics prior to admission, and underlying conditions between the two groups. Complicated cases presented with fever of longer duration, higher respiratory rates and had more frequent retractions, of longer hospital stay, more frequent changes of antibiotics and a 14.3% mortality rate.