Clinical and microbiological profile of pneumonia in severe acute malnourished children

Background: It is estimated that 57 million children are underweight (moderate and severe) in India. More than 50% of deaths in 0-4 years are associated with malnutrition. Pneumonia is common in malnourished children and is frequently associated with fatal outcome, especially in children younger than 24 months of age. The aim and objectives was to evaluate the clinical and microbiological profile of pneumonia in severe acute malnourished children.Methods: A cross sectional study was carried out on 60 severe acute malnourished children admitted at Department of Pediatrics, SSG Hospital Vadodara.Results: Most of the admitted children belonged to rural and tribal areas (81.7%). Children in the age group of 1-3 years were more prone to develop very severe pneumonia (51.7%). Blood culture yield was 80%. Most common isolate was Staphylococcal Aureus which was isolated in 16.6% of the patients.Conclusions: We concluded at the end of the study that malnourished children were prone to develop more severe pneumonia, required aggressive antibiotic usage as the causative organisms were strikingly different as compared to well-nourished children and needed a longer hospital stay

Pulmonary renal syndrome: treatment of acute renal failure secondary to double positive goodpasture syndrome

This is a case of a 34 year old female who presented with lower epigastric pain, flank pain and hematuria. Her symptoms started two days after being treated on Trimethoprim+Sulfamethoxazole for urinary tract infection. Worsening of her symptoms despite switching to Cephalexin prompted her to come to the emergency department. On admission, her creatinine was 5.3 mg/dL with potassium of 5.2 mEq/L and albuminuria of 100 mg/dL. Chest computed tomography (CT) without contrast revealed findings consistent with goodpasture disease. Biopsy of the kidney confirmed diffuse necrotizing and crescentic glomerulonephritis consistent with anti-glomerular basement membrane antibody disease. She was treated with plasmapheresis and steroids with complete resolution of symptoms at follow up

Duodenal perforation: role of multi detector computed tomography (MDCT)

Perforation of peptic ulcers, more specifically; ulcers of the first part of the duodenum carry mortality up to 11 %, with a higher mortality seen in patients over the age of 50 years. Main symptoms are acute onset abdominal pain and vomiting. Guarding & rigidity is present on examination. Conventional X-ray abdomen standing is the first investigation, which shows free gas under diaphragm. MDCT scan is required for identifying the presence, site and cause of gastrointestinal tract perforation. Early diagnosis and treatment is mandatory as it is a grave emergency condition

Pulmonary renal syndrome: treatment of acute renal failure secondary to double positive goodpasture syndrome

This is a case of a 34 year old female who presented with lower epigastric pain, flank pain and hematuria. Her symptoms started two days after being treated on Trimethoprim+Sulfamethoxazole for urinary tract infection. Worsening of her symptoms despite switching to Cephalexin prompted her to come to the emergency department. On admission, her creatinine was 5.3 mg/dL with potassium of 5.2 mEq/L and albuminuria of 100 mg/dL. Chest computed tomography (CT) without contrast revealed findings consistent with goodpasture disease. Biopsy of the kidney confirmed diffuse necrotizing and crescentic glomerulonephritis consistent with anti-glomerular basement membrane antibody disease. She was treated with plasmapheresis and steroids with complete resolution of symptoms at follow up

Hemichorea - hemiballismus in undiagnosed diabetes mellitus asian female patient associated with non ketotic hyperglycemia: putamenal and caudate nucleus lesions on magnetic resonance imaging

Hemichorea-Hemiballismus (HCHB) with corresponding putaminal T1 hyperintensity on MRI has occasionally been reported in diabetes mellitus (DM) type 2 with non ketotic hyperglycemia, which is believed to be pathogenetically related to HCHB. A 65 year female presented with fever, diarrhea, and involuntary movements on all 4 limbs in known case of diabetes mellitus type 2, hypertension, chronic heart failure and chronic renal failure. We report occurrence of HCHB in a female patient with DM type 2, Hypertension and acute renal failure

Hemichorea - hemiballismus in undiagnosed diabetes mellitus asian female patient associated with non ketotic hyperglycemia: putamenal and caudate nucleus lesions on magnetic resonance imaging

Hemichorea-Hemiballismus (HCHB) with corresponding putaminal T1 hyperintensity on MRI has occasionally been reported in diabetes mellitus (DM) type 2 with non ketotic hyperglycemia, which is believed to be pathogenetically related to HCHB. A 65 year female presented with fever, diarrhea, and involuntary movements on all 4 limbs in known case of diabetes mellitus type 2, hypertension, chronic heart failure and chronic renal failure. We report occurrence of HCHB in a female patient with DM type 2, Hypertension and acute renal failure