RESUMO
OBJECTIVE: To determine the utility of CSF Xpert MTB/RIF (GeneXpert) in diagnosis of tubercular meningitis in children in the age group of 2 mo to 12 y. METHODS: This hospital based prospective observational study was conducted at Department of Pediatrics, Karnataka Institute of Medical Sciences (KIMS), Hubli from December 2015 through November 2016. All children with clinically suspected tuberculous meningitis (TBM) were included in the study. These children underwent a detailed history taking, clinical examination, blood investigations, lumbar puncture and CT brain. Cerebrospinal fluid (CSF) samples were sent for CSF GeneXpert examination. Statistical analysis was done using IBM SPSS Statistics Version 20. RESULTS: A total of 28 children were enrolled in the study. Six (21.4%), 4 (14.3%) and 18 (64.3%) cases were definite, probable and possible TBM cases respectively. Most common age group affected was <5 y (83.33%) with median age 2.5 y (IQR 4.875). Male:female ratio was 1.5:1. CSF GeneXpert was tested positive in 6 cases (21.4%). The sensitivity of the test against the clinical scoring (>/=10) was 46.15% (95% CI, 19.22-74.87) and specificity was 100% (95% CI, 78.20-100). There was a significant association between CSF GeneXpert and Mantoux test (P = 0.002), CSF cell type >50% lymphocytes (P = 0.005) and CSF protein >100 mg/dl (P = 0.025) along with CT hydrocephalus (P = 0.021), granuloma (P = 0.009) and basal exudates (P = 0.025). None of the cases were tested smear positive for acid-fast bacilli (AFB). CONCLUSIONS: CSF GeneXpert is superior to smear for AFB in TBM.
Assuntos
Pediatria/métodos , Tuberculose Meníngea/líquido cefalorraquidiano , Tuberculose Meníngea/diagnóstico , Encéfalo/diagnóstico por imagem , Líquido Cefalorraquidiano/microbiologia , Criança , Pré-Escolar , Testes Diagnósticos de Rotina , Feminino , Humanos , Lactente , Masculino , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/isolamento & purificação , Estudos Prospectivos , Sensibilidade e Especificidade , Tuberculose Meníngea/epidemiologiaAssuntos
Antibacterianos/uso terapêutico , Doenças da Túnica Conjuntiva/diagnóstico , Corynebacterium diphtheriae/isolamento & purificação , Difteria/diagnóstico , Infecções Oculares Bacterianas/diagnóstico , Doenças da Túnica Conjuntiva/tratamento farmacológico , Doenças da Túnica Conjuntiva/microbiologia , Difteria/tratamento farmacológico , Difteria/microbiologia , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/microbiologia , Feminino , Humanos , Imunização , LactenteRESUMO
Dengue fever is on rise globally. In India, Dengue epidemics are expanding geographically, even into the rural areas. Dengue can present with varied manifestations. The mortality rate has been brought down with high index of suspicion, strict monitoring and proper fluid resuscitation. Herewith, we are presenting clinical features and outcome of Dengue cases seen in and around Hubli (North Karnataka).
Assuntos
Dengue/epidemiologia , Encefalite/etiologia , Criança , Dengue/complicações , Dengue/diagnóstico , Dengue/terapia , Feminino , Humanos , Índia/epidemiologia , Masculino , Prognóstico , Estudos RetrospectivosRESUMO
Hemiplegia and motor aphasia are rare complications following scorpion sting. This report describes a case of hemiplegia and motor aphasia occurring in a young child, following a scorpion sting.
