Paediatrics and International Child Health最新文献

{"title":"Disseminated melioidosis presenting as pre-septal cellulitis and multifocal abscesses in an adolescent with type 1 diabetes mellitus: a case report.","authors":"Nikhil John, Pediredla Karunakar, Rajashree Choudhury, Arun Babu T, Sumit Rai, Debabrata Dash","doi":"10.1080/20469047.2026.2734362","DOIUrl":"https://doi.org/10.1080/20469047.2026.2734362","url":null,"abstract":"<p><p>Melioidosis, caused by <i>Burkholderia pseudomallei</i>, produces a wide range of clinical manifestations and may be difficult to diagnose in the pediatric population. We describe the case of a 12-year-old girl with poorly controlled type 1 diabetes mellitus that posed diagnostic challenges. Over 4 months, she experienced relapsing fever, multiple splenic abscesses with a 'target sign' on ultrasonography, right-sided preseptal cellulitis, and a left thigh ulcer. Repeated cultures of superficial swabs and blood yielded no growth of bacteria. Radiological mimicry and culture-negative results raised concerns regarding a fungal etiology, leading to empiric amphotericin B therapy. The definitive diagnosis was made after incision and drainage of a 4 × 6 cm² frontal abscess. Pus culture isolated <i>Burkholderia pseudomallei</i>, identified by matrix‑assisted laser desorption/ionization time‑of‑flight mass spectrometry (MALDI‑ToF MS). Patient was treated with intravenous meropenem for 4 weeks followed by oral cotrimoxazole for a planned 3‑month eradication course. The patient recovered with no relapse on follow‑up. This case highlights the need to consider melioidosis in diabetic patients presenting with recurrent, culture-negative abscesses that display a target sign in endemic regions. Deep tissue culture remains essential for diagnosis, as superficial swabs may be misleading. Source control, coupled with dual-phase antimicrobial therapy, remain the cornerstones of effective management.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"1-6"},"PeriodicalIF":1.6,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital multidrug-resistant tuberculosis (MDR-TB) in an extremely low birth weight neonate: diagnostic challenges, management and a narrative review.","authors":"Choudri Muzafar Paswal, Manoj Sai Vamsi Gudipudi, Swasthi KabiSatpathy, Dyvik Shivakumar, Sushil Kumar Choudhary, Arun Kumarendu Singh","doi":"10.1080/20469047.2026.2731528","DOIUrl":"https://doi.org/10.1080/20469047.2026.2731528","url":null,"abstract":"<p><strong>Background: </strong>Congenital tuberculosis(TB) is rare and often fatal, particularly with multidrug-resistant strains. Neonatal diagnosis is challenging due to nonspecific features and low-yield microbiology. Management in extremely preterm infants is further complicated by limited evidence on second-line drug dosing, safety, and monitoring.</p><p><strong>Methods: </strong>We describe a single patient case alongside a narrative review of the relevant literature. Literature search was conducted in major databases using predefined keywords. Reports describing congenital/presumed congenital drug-resistant tuberculosis in neonates or young infants were selected, and data concerning maternal disease, neonatal presentation, diagnosis, treatment, and outcome were extracted.</p><p><strong>Results: </strong>We report a rare case of congenital disseminated multidrug-resistant tuberculosis (MDR-TB) in a preterm neonate born to a mother later confirmed to have katG-mediated isoniazid, and rifampicin resistance.Accompanying narrative review idenntified eight neonatal drug‑resistant cases worldwide, demonstrating consistent themes of:maternal disseminated/extrapulmonary TB as the predominant risk factor, symptom onset typically between 2-4 weeks of life, frequent initial false-negative/partially informative resistance results on early CBNAAT, and improved outcomes with early repeat molecular testing and tailored MDR-regimens.Mortality remains high, particularly when diagnosis is delayed.In contrast, our infant showed steady clinical recovery without any major drug-related toxicities.At 12 months corrected age, neurodevelopment was normal.. On telephone follow-up at 2 years of age, the caregivers reported that the child was developmentally well and thriving.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic and therapeutic challenges of congenital disseminated MDR-TB in extremely preterm infants, where evidence is limited. To our knowledge, this is only the second preterm infant with MDR-TB to survive without neurological deficits and the first reported case of disseminated congenital MDR-TB with TB meningitis. Narrative review consolidates current evidence to guide clinicians facing similar high-risk scenarios.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with breastfeeding mothers' willingness to recommend human milk banks: a single-centre cross-sectional study in Türkiye.","authors":"Elanur Yolal Karimov, Halime Sema Can, Kazım Okan Dolu","doi":"10.1080/20469047.2026.2695573","DOIUrl":"https://doi.org/10.1080/20469047.2026.2695573","url":null,"abstract":"<p><strong>Background: </strong>Donor human milk is the recommended alternative when a mother's own milk is unavailable, especially for high-risk infants. Türkiye has no operational human milk bank, and the attitudes of actively breastfeeding mothers are poorly characterised.</p><p><strong>Aim: </strong>To describe the knowledge, attitudes and concerns of actively breastfeeding mothers regarding human milk banks and to identify factors associated with their willingness to recommend one.</p><p><strong>Methods: </strong>In this single-centre, cross-sectional study, 310 actively breastfeeding mothers with infants aged 0-6 months were recruited by consecutive sampling at a training and research hospital (March-May 2025). Data were collected using an interviewer-administered, 32-item questionnaire that was content-validated and piloted (not a formally validated scale). Associations were assessed with chi-square tests and binary logistic regression reporting adjusted odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Only 37.1% of mothers were willing to recommend a human milk bank, 40.3% were unwilling and 22.6% undecided. Educational level was the only independent predictor of willingness to recommend (adjusted OR 1.59, 95% CI 1.15-2.20, <i>p</i> = 0.005); knowledge and employment were not significant after adjustment. Knowledge of milk banking was higher among mothers who were not employed (44.5% vs 14.5%, <i>p</i> < 0.001). Religious and moral concerns were prominent among those opposing a milk bank (21.9%, and the distribution of concerns differed significantly according to mothers' views on establishment (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Willingness to recommend was low but broadly consistent with international figures. Higher education was associated with greater willingness yet appears necessary rather than sufficient, as many reservations are religious or cultural. Expanding milk banking in Türkiye will require culturally sensitive engagement alongside public-awareness activities.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent pulmonary tuberculosis in a child with primary ciliary dyskinesia: a rare association.","authors":"Dhruv Gandhi, Reepa Agrawal, Zahabiya Nalwalla, Avantika Chauhan, Parmarth Chandane, Ira Shah","doi":"10.1080/20469047.2025.2606436","DOIUrl":"10.1080/20469047.2025.2606436","url":null,"abstract":"<p><p>Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by defective ciliary motility, resulting in chronic pulmonary infections and bronchiectasis. An 8-year-old boy with recurrent pulmonary tuberculosis (PTB) and newly diagnosed PCD by whole exome sequencing (WES) is reported. He presented with a chronic cough, intermittent fever, night sweats and weight loss, 3 months after completing a 6-month first-line antituberculosis therapy (ATT) regimen for drug-sensitive PTB. High-resolution computerised tomography showed bronchiectatic changes and chronic suppurative lung disease. Broncho-alveolar lavage fluid was tested on Xpert MTB/Rif Ultra and detected rifampicin-sensitive <i>Mycobacterium tuberculosis</i>. In view of the bronchiectasis and chronic suppurative lung disease, WES was undertaken which identified a PCD variant of unknown significance. The Primary Ciliary Dyskinesia Rule (PICADAR) score was calculated to be 8. He was diagnosed with PCD and a relapse of drug-sensitive PTB, for which first-line ATT was resumed. In view of possible syndromic conditions such as PCD, this case highlights the need for clinical suspicion and genetic testing in paediatric patients with recurrent pulmonary TB and bronchiectasis.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"7-10"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variants in genes regulating thiamine metabolism in children in the Lao Thiamine study.","authors":"Kristin Cardiel Nunez, Sonja Y Hess, Taryn J Smith, Sengchanh Kounnavong, Tom D Thacher, Philip R Fischer","doi":"10.1080/20469047.2026.2657620","DOIUrl":"10.1080/20469047.2026.2657620","url":null,"abstract":"<p><strong>Background: </strong>The clinical symptoms of thiamine deficiency, or thiamine deficiency disorders (TDDs), present similarly in children with dietary thiamine deficiency and variants in genes of thiamine metabolism. In the rural north of Lao People's Democratic Republic there is a high incidence of TDDs, and the risk of TDDs differs with maternal ethnic group. While low dietary intake is a well-established risk factor for TDDs, the contribution of inborn errors of thiamine metabolism is unknown.</p><p><strong>Methods: </strong>This study was an adjunct to the Lao Thiamine study, a prospective cohort study of children aged ≥ 21 days to <18 months with and without symptoms of TDDs. Buffy coat samples were selected from 17 hospitalised children with clinical signs/symptoms of TDDs and both echocardiogram and cranial ultrasound changes consistent with thiamine deficiency, and 14 frequency-matched healthy children in the community. Genomic DNA was isolated, and samples underwent next-generation sequencing of genes involved in thiamine metabolism. Ultimately, 22 of 31 selected residual samples provided adequate material to complete gene sequencing.</p><p><strong>Results: </strong>No pathogenic variants were identified in any of the 22 samples with completed gene sequencing. In a healthy infant, there was one variant of uncertain significance in <i>LONP1</i>, a gene implicated in an autosomal recessive disorder.</p><p><strong>Conclusions: </strong>Variants in genes of thiamine metabolism are unlikely to be a common aetiology of TDDs in a region at high risk of dietary thiamine deficiency. Differences between ethnic groups in the incidence of TDDs are probably related to culture-specific dietary practices and socio-economic risk factors.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"34-39"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148033898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Paediatrics and International Child Health -</i> powerful past, fantastic future.","authors":"Philip R Fischer","doi":"10.1080/20469047.2026.2692840","DOIUrl":"https://doi.org/10.1080/20469047.2026.2692840","url":null,"abstract":"","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"46 1-2","pages":"2"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A tribute on the retirement of Editor-in-Chief Dr Brian Coulter.","authors":"Bernard Brabin, James Bunn","doi":"10.1080/20469047.2026.2692838","DOIUrl":"https://doi.org/10.1080/20469047.2026.2692838","url":null,"abstract":"","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"46 1-2","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exchange transfusion for hyperleucocytosis in a critical case of pertussis.","authors":"Nihal Akçay, Demet Tosun, İlyas Bingöl","doi":"10.1080/20469047.2025.2595836","DOIUrl":"10.1080/20469047.2025.2595836","url":null,"abstract":"<p><p>An 8-week-old infant girl with pertussis-induced respiratory distress, complicated by severe leucocytosis, pulmonary hypertension and respiratory failure is reported. She was treated with mechanical ventilation, exchange transfusion and other supportive measures. A single-volume exchange transfusion significantly reduced the elevated white blood cell count and stabilised her condition. This case underscores the potential role of exchange transfusion as a life-saving intervention in critical pertussis cases with severe leucocytosis.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"3-6"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care lactate adds to prediction of outcome in children with WHO emergency signs in a low- and middle-income setting.","authors":"Clyde Kamo, Rupert Marcus, Francis Pulsan, Trevor Duke","doi":"10.1080/20469047.2026.2686565","DOIUrl":"10.1080/20469047.2026.2686565","url":null,"abstract":"<p><p>A prospective study of 96 children with one or more WHO emergency signs presenting to a children's emergency department in Papua New Guinea, the case mix included sepsis, pneumonia, malaria, diarrhoea and encephalopathy. Thirty children died during admission. Using a hand-held point-of-care device, a single capillary blood lactate level was measured at the time of presentation. Five clinical signs and capillary blood lactate predicted mortality, and lactate and a low Glasgow Coma Score were the strongest predictors. The mortality rate for a capillary lactate level <5 mmol/L was 7/45 (15%), and if lactate ≥ 5 mmol/L, the mortality rate was 22/52 (42%). When point-of-care lactate is integrated with clinical features of GCS ≤ 13, cold peripheries (or prolonged capillary refill), and low oxygen saturation (or obstructed breathing), high‑risk children can be identified and prioritised for urgent management in a paediatric intensive care unit or area of the ward.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"40-46"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis presenting as an anterior chest wall swelling: three cases.","authors":"Avanti Saoji, Nikita Shah, Husrav Sadri, Yashwant Gabhale, Radha Ghildiyal","doi":"10.1080/20469047.2025.2609057","DOIUrl":"10.1080/20469047.2025.2609057","url":null,"abstract":"<p><p>Tuberculosis (TB) is one of the most common infectious diseases in India with paediatric TB accounting for approximately 6-7% of cases. Skeletal and soft tissue are rare sites for TB. Three cases seen in a western tertiary hospital in India aged between 1 and 11 years presented with a swelling on the anterior chest wall. None had any known TB contact. Imaging demonstrated the presence of collections and underlying bony as well as pulmonary/pleural involvement. All were positive for TB on histopathology. They were commenced on anti-TB therapy and there was significant improvement on follow-up. Hence, tuberculosis with intrathoracic extension must be borne in mind as a close differential diagnosis when evaluating anterior chest wall swelling as it is treatable, especially in endemic areas.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"11-16"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}