Definite bacterial infection in recently vaccinated febrile infants.

AIM: There is insufficient evidence regarding the best approach to evaluating recently vaccinated (RV) infants presenting to the paediatric emergency department with fever. The aim of the present study is to determine the prevalence of bacterial infections in infants presenting with fever within 72 h after vaccination. METHODS: We retrospectively reviewed the electronic medical record of infants aged between 6 and 12 weeks who presented with a fever ≥38°C to the emergency department from January 2016 to December 2018. Febrile infants who were vaccinated within 72 h prior to their emergency department presentation were matched to those who had not received their vaccines in the previous 72 h. Definite serious bacterial infection was diagnosed based on culture results. RESULTS: A total of 198 infants (age: 9 ± 1.84 weeks, male: 119 (60.1%)) were enrolled in this study. Overall, 60 of 138 (30.3%) had received their vaccines within the previous 72 h. The prevalence of bacterial infection in RV infants was 5% compared to 15.2% in non-RV infants (P = 0.056). Interestingly, all vaccinated infants who had proven bacterial infection presented to the emergency department with fever within 24 h of vaccination, and all bacterial infections in that group were urinary tract infections. CONCLUSIONS: The prevalence of bacterial infection among non-RV febrile infants is relatively higher than those RV. However, fever should not be attributed only to the vaccinations, and all febrile RV infants should be carefully evaluated, and at least urine testing should be performed regardless of the time of vaccination.

Transient acute adrenal insufficiency associated with adenovirus serotype 40 infection.

We present an instance of a 6-year-old boy who was admitted with adenovirus infection and developed transient acute adrenal insufficiency, which required supplementation with glucocorticoids and mineralocorticoids for 8 weeks. Adenovirus has got adrenotropic potential and can cause adrenal insufficiency. We could not find any similar reported case in medical literature. We hope our case would add to the existing knowledge of adenoviral complications in paediatric patients.