Ann Trop Paediatr
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Management of multidrug-resistant Acinetobacter baumannii (MDRAB) meningitis/ventriculitis is a difficult therapeutic problem owing to the limited penetration of antibiotics into cerebrospinal fluid (CSF). A 2-month-old girl with ventriculitis caused by MDRAB is reported. ⋯ Intraventricular/intrathecal and IV colistin might be the best therapeutic option in the treatment of central nervous system infection caused by MDRAB. Further studies are required to evaluate pharmacokinetic and pharmacodynamic parameters of combined IV and intraventricular/intrathecal colistin administration, especially in children.
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Infection with resistant gram-negative bacteria is a growing threat to hospitalised patients. ⋯ While empirical use of carbapenems for nosocomial sepsis might be appropriate in areas where Klebs-ESBL is prevalent, their use can be restricted to those with cardio-respiratory compromise or severe sepsis without an increase in mortality.
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Pulmonary alveolar microlithiasis (PAM) in an 8-month-old male infant is reported. He presented initially at 2 months of age with worsening respiratory distress and cyanosis. Chest imaging by X-ray and by CT scan showed widespread reticulo-nodular densities mostly in the mid and lower zones. The diagnosis of PAM was confirmed by an open lung biopsy which showed diffuse alveolar calcium deposits.
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Echocardiographic findings in children with surgically correctable non-cardiac congenital anomalies.
Congenital cardiac anomalies may co-exist with non-cardiac congenital malformations and, for those requiring surgical correction, there can be an anaesthetic risk. ⋯ Over one-third of patients undergoing surgical correction of congenital malformations have co-existing CHD. Echocardiography is important for pre-surgical evaluation. No association between type of CHD and specific non-cardiac congenital malformations was found.
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To compare oxygen saturation levels (SaO(2)) by pulse oximetry among healthy Indian children aged from 1 month to 5 years age residing at two different altitudes, Chennai and the Shervaroy hills. ⋯ The reference value for mean SaO(2) in healthy children aged 1 month to 5 years in the Shervaroy hills (1500 m) was 97%, with the (-2 SD) values having a mean of 93% which is significantly lower than those living in Chennai (sea level), 99% of whom had a -2 SD mean of 96.6%.