Refluks Vesiko Ureter

Refluks vesiko ureter (RVU) merupakan kelainan traktus urinarius yang biasa terjadi pada anak. Kelainan ini seringkali didiagnosis sebagai penyerta pada anak dengan infeksi saluran kemih (ISK), meskipun terjadi peningkatan jumlah kasus yang didiagnosis saat lahir melalui pemeriksaan sonografi terdapat pelvo-kaleaktasis atau hidronefrosis. Kejadian RVU dapat menyebabkan terjadinya parut ginjal disertai hipertensi yang dapat berlanjut menjadi gagal ginjal kronik. Diagnosis dini melalui anamnesis, pemeriksaan fisik, laboratorium dan radiologi khususnya voiding cystourethrogram (VCUG) harus dilakukan untuk menentukan tata laksana yang sesuai. Sebagian besar pasien mendapat pengobatan medikamentosa tanpa memerlukan tindakan pembedahan

Necrotizing pneumonia pada anak

Pneumonia merupakan penyakit dengan angka morbiditas dan mortalitas tinggi pada anak usia di bawah 5 tahun, terutama negara berkembang. Necrotizing pneumonia (NP)  merupakan komplikasi yang jarang dan berat dari community acquired pneumonia (CAP). Destruksi parenkim paru normal disertai nekrosis multipel, abses, kavitas atau pneumatokel sebagai akibat oklusi trombotik kapiler alveolus di area konsolidasi terjadi pada NP. Pneumonia yang dalam perjalanannya terlihat lebih sesak, respon yang tidak adekuat dengan antibiotik konvensional, demam yang menetap dapat diperkirakan terjadi NP. Diagnosis ditegakkan dengan CT-scan toraks dengan kontras. Komplikasi berupa fistula bronkopleura, empiema, dan abses paru

Risk factors associated with nasopharyngeal carriage and density of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in young children living in Indonesia

Abstract Background Potentially pathogenic bacteria Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus are commonly carried in the nasopharynx of young children. Host and environmental factors have been linked with pathogen carriage, and in many studies rural children have higher carriage rates than their urban counterparts. There are few published data on what factors contribute to increased pathogen density. The objectives of this study were to identify risk factors for nasopharyngeal carriage and density of S. pneumoniae, H. influenzae, M. catarrhalis, and S. aureus in young children in Indonesia. Methods Risk factor analysis was done using data on bacterial carriage and participant characteristics from a cross-sectional study that enrolled 302 children aged 12–24 months living in urban or semi-rural areas of Indonesia. Associations between host factors and odds of pathogen carriage were explored using logistic regression. Characteristics identified to be independent predictors of carriage by univariable analysis, as well as those that differed between urban and semi-rural participants, were included in multivariable models. Risk factors for increased pathogen density were identified using linear regression analysis. Results No differences in carriage prevalence between urban and semi-rural children were observed. Multiple children under the age of 5 years in the household (< 5y) and upper respiratory tract infection (URTI) symptoms were associated with S. pneumoniae carriage, with adjusted odds ratios (aOR) of 2.17 (95% CI 1.13, 4.12) and 2.28 (95% CI 1.15, 4.50), respectively. There was some evidence that URTI symptoms (aOR 1.94 [95% CI 1.00, 3.75]) were associated with carriage of M. catarrhalis. Children with URTI symptoms (p = 0.002), and low parental income (p = 0.011) had higher S. pneumoniae density, whereas older age was associated with lower S. pneumoniae density (p = 0.009). URTI symptoms were also associated with higher M. catarrahlis density (p = 0.035). Low maternal education (p = 0.039) and multiple children < 5y (p = 0.021) were positively associated with H. influenzae density, and semi-rural residence was associated with higher S. aureus density (p < 0.001). Conclusions This study provides a detailed assessment of risk factors associated with carriage of clinically-relevant bacteria in Indonesian children, and new data on host factors associated with pathogen density

Nasopharyngeal carriage prevalence (%) of <i>S</i>. <i>pneumoniae</i>, <i>H</i>. <i>influenzae</i>, <i>M</i>. <i>catarrhalis</i>, and <i>S</i>. <i>aureus</i> in Indonesian children aged 12–24 months.

<p>Results are shown by region (Bandung, Padang, and Lombok). Error bars represent 95%CI.</p

Median density in log₁₀ genome equivalents/ml of pneumococcus (SP), <i>H</i>. <i>influenzae</i> (HI), and <i>M</i>. <i>catarrhalis</i> (MC) when found with (+) or without (-) another species.

<p>Median density in log₁₀ genome equivalents/ml of pneumococcus (SP), <i>H</i>. <i>influenzae</i> (HI), and <i>M</i>. <i>catarrhalis</i> (MC) when found with (+) or without (-) another species.</p

Characteristics of study participants.

<p>Characteristics of study participants.</p

The twenty most common pneumococcal serotypes identified in nasopharyngeal swabs collected from Indonesian children aged 12–24 months, shown by region (Bandung, Padang, and Lombok).

<p>* indicates serotypes included in PCV10 and ⁺ indicates the additional three serotypes included in PCV13.</p