scholarly journals A study of etiology of fever of unknown origin in children aged 2 months to 18 years

2021 ◽  
Vol 8 (11) ◽  
pp. 1842
Author(s):  
Naveen Gandla ◽  
Sheela A. Bharani ◽  
Tushar P. Shah
Keyword(s):  
Enteric Fever ◽  
Fever Of Unknown Origin ◽  
Lymphoblastic Leukemia ◽  
Connective Tissue Diseases ◽  
Unknown Origin ◽  
Age Group ◽  
Antimicrobial Drugs ◽  
Cross Sectional ◽  
Female Ratio ◽  
Geographical Regions

Background: In an era of advance science of modern technologies, many diseases are diagnosed and excluded rapidly and now Fever of Unknown Origin (FUO) has been redefined for any fever of 380C lasting for more than 7 days without any clear cause. The aetiology varies according to different geographical regions, socioeconomical status, age, prevalence of resistance to antimicrobial drugs and genetic susceptibility.Methods: It was a descriptive cross sectional, hospital-based study, carried out on 150 children from August 2018 to May 2020. All cases in the age group of 2 months to 18 years with fever of >38.0°C, lasting for more than 7 days without a clear source were included.Results: The mean age of presentation was 5.8 years±Standard Deviation of 3.7 years with male to female ratio was 1.4:1. Nearly half of the cases, presented with the duration of fever between 8-14 days. Enteric fever in 52%, tuberculosis in 13.3% and acute lymphoblastic leukemia (ALL) in 8.5% were three common etiologies found in this study. Amongst all cases of FUO, infective causes were seen in 113 (75.3%) followed by malignancies in 15(10%) cases. In 10 (6.7%) cases, cause could not be established.Conclusions: Enteric fever and tuberculosis were the leading etiologies from infective subgroup of FUO. ALL was the commonest cause from malignancies sub group. FUO presenting with low haemoglobin, platelet is a pointer towards malignancy. Occurrence of FUO with infectious diseases and malignancies was found in younger age group as compared to connective tissue diseases. 

scholarly journals Etiology of fever of unknown origin in children.

2021 ◽  
Vol 28 (04) ◽  
pp. 552-556
Author(s):  
Aysha Mansoor Lodhi ◽  
Wajiha Rizwan ◽  
Mubeen Nazar ◽  
Asma Mushtaq ◽  
Muhammad Sahir Saud ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Fever Of Unknown Origin ◽  
Lymphoblastic Leukemia ◽  
Unknown Origin ◽  
Connective Tissue Disorder ◽  
Definitive Diagnosis ◽  
Female Ratio ◽  
Qualitative Variables ◽  
Age Range

Objectives: To determine the etiology of Fever of Unknown Origin (FUO) in children. Study Design: Prospective Observational study. Setting: Department of Pediatric Medicine, The Children's Hospital, Lahore. Period: August 2019 to January 2020. Material & Methods: A total of 45 children aged between 01 to 180 months (15 years), having FUO were included. FUO was defined as a temperature of greater than 100.4ºF documented by a health care provider, persisting over a period of three weeks and for which no cause could be identified after at least 8 days of evaluation. All the study information was analyzed by using standard software SPSS 20. The quantitative variables like age and duration of fever before hospital admission were presented as mean and standard deviation. Qualitative variables like sex, antibiotic therapy use before definitive diagnosis and various diagnoses made were presented as frequencies and percentages. Results: The patient’s age range was from 01 to 180 months with mean of 80±45.12 months and male to female ratio was 2.2:1. Definitive diagnosis was made in 37(82.2%) patients. Infections were the predominant cause of FUO (44.4%) followed by malignancy (24.4%). Tuberculosis was the most common infection while Acute Lymphoblastic leukemia dominated the malignancy. Systemic lupus erythematosus was the most commonly diagnosed connective tissue disorder.  There was a significant association between duration of fever and the ultimate diagnosis (p=0.01). Conclusion: Infectious diseases were the most common cause of FUO followed by malignancy, connective tissue disorders and miscellaneous causes.

scholarly journals Clinical Profile and Sensitivity Pattern of Salmonella Serotypes in Children: A Hospital Based Study

2011 ◽  
Vol 31 (3) ◽  
pp. 180-183 ◽  
Author(s):  
BG Joshi ◽  
K Keyal ◽  
R Pandey ◽  
BM Shrestha
Keyword(s):  
Salmonella Enterica ◽  
Enteric Fever ◽  
Wide Spectrum ◽  
Clinical Profile ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Sensitivity Pattern ◽  
Study Results ◽  
Culture Positive

Introduction: Enteric fever is a systemic infection caused by the bacteria, Salmonella enterica serovar Typhi (S.typhi) and Salmonella enterica serovara Paratyphi (S. paratyphi A, B and C). Most of the burden of the disease is limited to the developing world and the disease still has the issues like wide spectrum of clinical presentation and multidrug resistance. Objectives: This study was done to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive enteric fever. Methods: A prospective cross-sectional study was conducted in Civil Service Hospital from February 2010 to January 2011 in the paediatric population in the age group of 2 to 14 years. Children with Salmonella species isolated in blood culture were included in the study. Results: Out of the 40 children with culture positive enteric fever, male to female ratio was 1.3:1 with common age group between 11-14 years. S typhi was isolated in 25 cases while S. paratyphi in 15 cases. Clinical features of S. typhi and S. paratyphi were indistinguishable. Both S.typhi and S. paratyphi were found to be 100% sensitive to drugs like Ceftriaxone, Cefotaxime, Cefixime and Chloramphenicol. Sensitivity to Ofloxacin was 100% in S. paratyphi and 92% in S.typhi. Similarly sensitivity of Azithromycin was 92% and 93% for S.typhi and S. paratyphi respectively. Conclusion: Salmonella serotype is still 100 % sensitive to third generation cephalosporin. Some percentage of resistance is seen with Ofloxacin in S. typhi and with Azithromycin in both S.typhi and S. paratyphi. Key words: Enteric fever; S.typhi; S.paratyphi; Sensitivity DOI: http://dx.doi.org/10.3126/jnps.v31i3.4382 J Nep Paedtr Soc 2011;31(3): 180-183

scholarly journals Study of psychiatric morbidity of patients attending free mental health check up camp, Simara, Bara district of Nepal

2013 ◽  
Vol 2 (1) ◽  
pp. 30-34
Author(s):  
CP Sedain
Keyword(s):  
Mental Health ◽  
Depressive Disorder ◽  
Demographic Data ◽  
Psychiatric Morbidity ◽  
Cross Sectional Study ◽  
Health Clinic ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Community Mental Health Clinics

Introduction: Maryknoll Nepal has been running community mental health clinics different part of the country. The aim of the study was to find out psychiatric morbidity of patients attending Maryknoll free check up clinic Simara, Bara district of Nepal. Methods: A prospective cross-sectional study comprised of all consecutive patients attending Maryknoll free check up clinic Simara, Bara district, Nepal. All the patients attending the free clinics were taken as cases. The study was conducted in January 2009. Demographic data and disease profile of 87 patients attending the clinic were analyzed. The ratios and proportions were used for statistical analysis. Results: Data from Simara free mental health clinic shows that the male to female ratio was 0.55:0.44.The age group 30-39(N-25, 28.74%) followed by age group 20-29 (N-19, 21.84%) was the commonest. The farmer were (N-49, 56.31 %) the most common visitor. The highest number of cases were depressive disorder (N-16, 18.93 %) followed by mania/BPAD (N-14, 16.09 %) and Schizophrenia (N-12, 13.73 %). Conclusion: The commonest incidence of psychiatric illness attending the free clinic is depressive disorder and mania/BPAD. DOI: http://dx.doi.org/10.3126/jpan.v2i1.8572 J Psychiatrists’ Association of Nepal Vol .2, No.1, 2013 30-34

CLINICAL STUDY OF POST COVID SYMPTOMS AFTER 1ST WAVE OF COVID 19, AT A TERTIARY HOSPITAL

2021 ◽  
pp. 51-53
Author(s):  
Dilip Pandurang Patil
Keyword(s):  
Chest Pain ◽  
Tertiary Hospital ◽  
Residual Effects ◽  
Chronic Obstructive ◽  
Age Group ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Female Ratio ◽  
Raising Awareness ◽  
Cognitive Disturbances

Background: Early reports suggest residual effects of SARS-CoV-2 infection, such as fatigue, dyspnea, chest pain, cognitive disturbances, arthralgia and decline in quality of life. In present study we aimed to evaluate post covid symptoms after 1st wave of COVID 19 in COVID 19 recovered patients at a tertiary hospital. Present study was Material and Methods: hospital based, descriptive, cross-sectional, questionnaire-based study conducted in Covid 19 positive patients (RT-PCR or Rapid Antigen positive patients) either hospital admitted or home isolation patients, recovered (either RTPCR negative or completed 14 days isolation and no symptoms) came to post covid OPD for follow up, were studied. In present study 101 post Results: COVID 19 recovered patients were studied. Most of patients were from age group 51-60 years (19.8 %) followed by age group 41-50 years (16.83 %). Male patients (65.35 %) were more than female patients (34.65%), male to female ratio was 1.9 :1. Majority of patients received treatment at hospital (75.25%) & were diagnosed by RTPCR (57.43%). Most of patients had recovered from COVID 61-90 days ago (28.71%) followed by 121-150 days ago (19.8%). During acute COVID-19 pneumonia was diagnosed in 36.63 % cases. Other characteristics were intensive care unit admission (14.85 %), oxygen supplementation (21.78 %), noninvasive ventilation (7.92 %) & mechanical ventilation (2.97 %). Pre-existing comorbidities noted were hypertension (12.87 %), thyroid disease (4.95 %), diabetes (3.96 %), chronic obstructive pulmonary disease (3.96 %), h/o kidney failure (1.98 %), active smoker (8.91 %) & former smoker (14.85 %). No regular physical activity was noted in 83.17 %. Post COVID symptoms noted in present study were cough (14.85 %), fatigue (13.86 %), Breathlessness (8.91 %), headaches (5.94 %), myalgia (3.96 %), palpitation (3.96 %), loss of smell sensation (3.96 %), muscle weakness (2.97 %), loss of taste sensation (2.97 %) & chest pain (1.98 %). Most of the Conclusion: COVID-19 survivors experienced mild post-recovery symptoms such as cough, fatigue, breathlessness, headache, myalgia & palpitation. Raising awareness, recognition, research, and multidisciplinary involvement will be considered the cornerstones to manage long-term sequelae of COVID-19 effectively.

scholarly journals Prevalence of Autism Spectrum Disorder among Rural, Urban, and Tribal Children (1–10 Years of Age)

2017 ◽  
Vol 08 (03) ◽  
pp. 368-374 ◽  
Author(s):  
Sunil Kumar Raina ◽  
Vishav Chander ◽  
Ashok K. Bhardwaj ◽  
Dinesh Kumar ◽  
Seema Sharma ◽  
...  
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Autism Spectrum ◽  
Second Phase ◽  
Age Group ◽  
Socioeconomic Group ◽  
Cross Sectional ◽  
Geographical Regions ◽  
Evaluation Phase ◽  
Tribal Populations

ABSTRACT Introduction: Studies on autism spectrum disorders (ASDs) have largely focused on children in specific settings. The current scenario of research in ASDs is limited largely to clinic-based case reports, case series, and retrospective chart reviews. The present study is the first population-based prevalence study conducted across rural, urban, and tribal populations in India. Materials and Methods: A cross-sectional two-phase study was conducted cring children in the age group of 1–10 years of age across geographical regions representing rural, urban, and tribal populations. The first phase (screening phase) involved administration of the Hindi version of the Indian Scale for Assessment of Autism. Those identified as suspected of ASD and 10% of all classified as nonsuspects for autism were also evaluated by the clinical team in second phase (evaluation phase). Results: Forty-three children out of a total of 28,070 children in rural, urban, and tribal area in the age group of 1–10 years were diagnosed as cases of ASD yielding a prevalence of 0.15% (95% confidence interval [CI] =0.15–0.25). Logistic regression analysis showed a two times significantly higher risk of diagnosing ASD in rural area as compared to tribal (odds ratio [OR]; 95% CI = 2.17 [1.04–4.52], P = 0.04). Male sex and upper socioeconomic group of head of family/father had a higher risk of getting diagnosed as autism as compared to lower socioeconomic group (OR; 95% CI - 3.23; 0.24–44.28, P = 0.38). Conclusions: Estimation of true prevalence of ASD in India is going to improve policies on developmental disabilities.

scholarly journals Fever of unknown origin as the major manifestation of subacute thyroiditis

2021 ◽  
Vol 2021 ◽  
Author(s):  
Ahmad Housin ◽  
Marc P Pusztaszeri ◽  
Michael Tamilia
Keyword(s):  
Fever Of Unknown Origin ◽  
Connective Tissue Diseases ◽  
Unknown Origin ◽  
Signs And Symptoms ◽  
Medical Problem ◽  
Subacute Thyroiditis ◽  
Endocrine Disorders ◽  
List Type ◽  
Thyroid Function Tests ◽  
Markers Of Inflammation

Summary Fever of unknown origin is a commonly encountered medical problem. Most common causes include infections, malignancy, and connective tissue diseases. Endocrine causes are rare but are well documented. While fever is common in some endocrine disorders, fever of unknown origin as the sole presenting feature is very rare. We describe a case report of a 63-year-old male who presents with fever of unknown origin. Imaging and biopsy results confirmed the diagnosis of subacute thyroiditis. He was started on prednisone with a good response. We conclude that subacute thyroiditis should be considered in the work up of fever of unknown origin even in the absence of classical signs and symptoms. Learning points Fever of unknown origin is a rare sole presentation of subacute thyroiditis. The classic signs and symptoms may not be manifest at the time of presentation. Normal thyroid function tests and elevated markers of inflammation often make infections, malignancy and autoinflammatory conditions the prime consideration. Imaging of the thyroid gland may point to a morphologic aberration and prompt a thyroid biopsy. After exclusion of infection, a rapid response to steroids may be both diagnostic and therapeutic.

scholarly journals Dermatophytes in Skin, Nail and Hair among the Patients Attending Out Patient Department

2019 ◽  
Vol 16 (41) ◽  
pp. 434-437 ◽  
Author(s):  
Beena Jha ◽  
Sabina Bhattarai ◽  
Jyotshna Sapkota ◽  
Manisha Sharma ◽  
Chandra Prakash Bhatt
Keyword(s):  
Laboratory Diagnosis ◽  
Cross Sectional Study ◽  
Age Group ◽  
Aetiological Agent ◽  
Cross Sectional ◽  
Female Ratio ◽  
Direct Microscopy ◽  
Male Predominance ◽  
Medical College ◽  
Patient Department

Background: Dermatophytosis are the most common types of cutaneous fungal infection seen in human and animals affecting skin, hair and nails caused by dermatophytes. The diagnosis of dermatophytes is based on the clinical observation and laboratory diagnosis by direct microscopic examination and fungal cultures. The present study is undertaken to isolate different type of dermatophytes causing fungal infection.Methods: A prospective cross-sectional study design was used in a total of 90 clinically suspected cases of dermatophytic infection attending the out patient department of Kathmandu Medical College and Teaching hospital (KMCTH). Skin scraping, hair and nail samples were collected from the patients and were processed by direct microscopy and culture using standard protocol. Dermatophytes were identified based on the microscopic arrangement of microconidia and macroconidia.Results: Dermatophytosis was more common in the age group of 21-40 years and was more predominant among male with male to female ratio of 1.7: 1. Among the total clinically suspected cases of dermatophytosis, 53 were positive in direct microscopy and only a total of 20 were positive by culture. Most common clinical type observed in our study was Tinea corporis(25%) followed by Tinea cruris. Trichophyton rubrum(50%) was the commonest aetiological agent in majority of clinical types followed by Trychophyton mentagrophytes(35%). Conclusions: The study highlighted T. corporis followed by T. cruris and T. unguim as the most common clinical pattern of dermatophytosis with a male predominance and 21-40 years being the most affected age group. T. rubram was the most common aetiological agent causing dermatophytosis.Keywords: Dermatophytes; dermatophytosis; epidermophyton; tinea; trychophyton.

scholarly journals A Prospective Study of Clinical Profile in Febrile Illness with Thrombocytopenia in Children Aged 1 to 12 Years Admitted in a Tertiary Care Centre in Telangana

2021 ◽  
Vol 8 (35) ◽  
pp. 3247-3251
Author(s):  
Sreelatha Martha ◽  
Goutham Deeti ◽  
Chaitanya Jyothi Ravula ◽  
Nirmala Cherukuri ◽  
Srinivasa Suresh Nadavapalli
Keyword(s):  
Dengue Fever ◽  
Enteric Fever ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Clinical Problem ◽  
Severe Thrombocytopenia ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Gi Symptoms

BACKGROUND Fever with thrombocytopenia is a common clinical problem in paediatric wards. Significant number of acute febrile illnesses have an infectious aetiology and are often associated with thrombocytopenia. The objective of the study was to determine the clinico-etiological profile and outcome of children admitted with febrile thrombocytopenia, especially in those with infective aetiology. METHODS The study design is a prospective observational study. It was conducted from September 2017 to August 2019 in the Department of Paediatrics, Niloufer Institute of Women and Child Health, Hyderabad. A total of hundred (100) children in the age group of 1 year to 12 years presented with fever, and thrombocytopenia were included in the study. Newborns, infants, children with febrile thrombocytopenia, known ITP (idiopathic thrombocytopenic purpura), already diagnosed haematological malignancy and children on antiplatelet drugs like aspirin were excluded from the study. After informed written consent, detailed history was elicited, clinical examination and necessary laboratory investigations were carried out, and the data was captured in a pre-structured proforma. Study parameters were analysed using Statistical Package for Social Sciences (SPSS) version 16 software. RESULTS The study included 100 children. A ratio of 1.4 : 1 was observed in male to female ratio. As of the clinical features, gastrointestinal (GI) symptoms such as nausea, vomiting and pain abdomen were more common, followed by headache and myalgia. On examination, two-thirds of the children had hepatomegaly, and onethird had splenomegaly. Among 100 children with febrile thrombocytopenia, 38 children had bleeding manifestations (cutaneous bleeds > GI bleeds > other bleeds) in those with moderate to severe thrombocytopenia. In the etiological profile, dengue fever was more common, followed by undiagnosed fever, enteric fever, ALL (acute lymphoblastic leukemia), scrub typhus, malaria and leptospira, respectively. Out of 100 children, 94 were discharged, and 6 children with ALL were referred to the haemato-oncology center for further management. CONCLUSIONS Clinical presentation of cases with febrile thrombocytopenia is varied. Common causes of febrile thrombocytopenia observed in this study were dengue fever followed by un diagnosed fever and enteric fever. KEYWORDS Fever, Thrombocytopenia, Platelet count, Bleeding

scholarly journals Clinical and diagnostic profile of patients with anal fistula: a cross sectional study from Vilasrao Deshmukh Government Institute of Medical Sciences, Latur, Maharashtra

2020 ◽  
Vol 7 (8) ◽  
pp. 2494
Author(s):  
Praffula V. Mahakalkar ◽  
Ganesh Swami ◽  
Halnikar Chandrashekhar S. ◽  
Anant A. Takalkar
Keyword(s):  
Anal Fistula ◽  
Cross Sectional Study ◽  
Internal Opening ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Fistula In Ano ◽  
Surgical Department ◽  
Male Predominance ◽  
External Opening

Background: Anal fistulas are one of the commonest causes for a persistent discharge seropurulent in nature that irritates the skin in the neighbourhood and leads to discomfort. Fistula-in-ano is seen quite frequently in perirectal perianal suppuration. The objective of this study to study the clinical profile and diagnosis of anal fistula at surgical OPD of VDGIMS.Methods: The present cross-sectional observational study was carried out in patients with fistula-in-ano admitted at surgical department of VDGIMS, Latur during the period of 2017-19 in 50 diagnosed patients. Data was analysed by using SPSS 24.0 version IBM USA.Results: Majority of the patients with anal fistula were from 41-50 years age group i.e. 15 (30%) and males were predominantly affected 40 (80%) compared to females i.e. 10 (20%). Male to female ratio was 4:1. Perianal discomfort was the commonest symptom in all patients i.e. 100%. It is followed by perianal discharge complained by 54% and perianal itching in 38% cases. The anterior position of external opening is found to be significant (p<0.05). Fistulogram showed external opening in all patients i.e. 50 cases whereas internal opening in 46 (92%) cases. Findings of MRI revealed that anal fistula was intra sphincteric in 28 cases i.e. 56%, extra sphincteric in 2 cases i.e. 4% and trans sphincteric in 20 cases i.e. 40%.Conclusions: Commonest age group affected in our study was 40-50 years with male predominance. Perianal discomfort and discharge were the commonest symptom. E. coli was the predominant organism isolated. Fistulogram and MRI is useful in detecting the aetiology of fistula in ano.

scholarly journals Prevalence of Connective Tissue Diseases in Egyptian Patients Presenting with Fever of Unknown Origin

2011 ◽  
Vol 4 ◽  
pp. CMAMD.S6763 ◽  
Author(s):  
Mohamad S. Abdelbaky ◽  
Howaida E. Mansour ◽  
Shafika I. Ibrahim ◽  
Iman A. Hassan
Keyword(s):  
Connective Tissue ◽  
Fever Of Unknown Origin ◽  
Urine Analysis ◽  
Complete Blood Count ◽  
Connective Tissue Diseases ◽  
Unknown Origin ◽  
Medical Problem ◽  
Advanced Technology ◽  
Diagnostic Tools ◽  
History Taking

Objective To estimate the prevalence of connective tissue diseases in patients presenting with fever of unknown origin (FUO). Patients and Methods In this study thirty patients diagnosed as FUO (Group 1), in 2008, were included in an observational study and diagnostic workup. Additionally, retrospective analysis of seventy patients’ files (Group 2), for patients who presented with prolonged unexplained pyrexia to the same hospital in the previous two years, was performed. Patients were subjected to: full clinical assessment including full history taking, thorough clinical examination, laboratory investigations including the basic investigations for patients with prolonged fever, complete blood count, erythrocytes sedimentation rate, urine analysis and culture, blood culture, sputum culture and plain chest X ray. Further diagnostic work up and/or procedures were requested according to the potential diagnostic clues (PDC) present in every patient. Results Out of 100 FUO patients, 50% were found to have infectious diseases, 24% were found to have connective tissue diseases, 8% miscellaneous causes and 7% neoplastic diseases ( P < 0.05). In 11 patients no definite cause for FUO could be identified. Connective tissue patients were: eight systemic lupus patients (33.3%), five patients with familial mediterranean fever (20.8%), four patients with rheumatoid arthritis (16.6%), three patients (12.5%) with Still's disease and Rheumatic fever and one patient with Behçet syndrome/Crohn's disease (4.3%), ( P < 0.05). Conclusions Despite the advanced technology, FUO remains a challenging medical problem. Infections were the most common cause of FUO in Egypt, confirming the trends found in other parts of the world. There was an increased prevalence of connective tissue patients presented with prolonged unexplained fever. A keen clinical eye, meticulous history taking and repeated physical examination remained the most important diagnostic tools in FUO patients.

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