BMC Pediatrics最新文献

{"title":"Scoping review of clinical decision aids in the assessment and management of febrile infants under 90 days of age.","authors":"Etimbuk Umana, Hannah Norman-Bruce, Thomas Waterfield","doi":"10.1186/s12887-025-05619-3","DOIUrl":"10.1186/s12887-025-05619-3","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision aids (CDA) play an important role in the management of young febrile infants (under 90 days of age) who are at risk of serious or invasive bacterial infections (SBI/IBI). Since 2010, a number of tailored CDAs have been developed that allow for lower-risk infants to be managed safely while undergoing fewer investigations and not receiving parenteral antibiotics. We aimed to map the CDAs developed since 2010, their derivation methodology, and their variable components.</p><p><strong>Methods: </strong>A scoping review based on the Joana Briggs Institute framework was conducted for studies published between 2010 and 2025. A database search was conducted using Medline, Embase, Scopus, Web of Science, Google Scholar, and the Cochrane library. Studies evaluating the derivation, validation, and application of CDAs for the assessment of febrile infants were eligible for inclusion. Two reviewers independently screened, analysed, and extracted data from the literature.</p><p><strong>Results: </strong>A total of 32 studies met the inclusion criteria. The majority of studies were conducted in North America and Canada (56%), followed by Europe (28%), and Asia (16%). Of the 32 studies, 14 were retrospective, 9 prospective and 9 secondary analysis of an available dataset. There were 32 CDAs that were either derived or validated across 32 studies. The derivation methodology was classified into four themes: (i) expert consensus and evidence synthesis; (ii) regression analysis; (iii) recursive partitioning; and (iv) machine learning. CDAs typically either identified a low-risk cohort through sequential assessment (n = 12) or predicted the risk of IBI/SBI using prediction models (n = 20). CDA sensitivity and specificity ranged from 46 - 100% and 9 - 95% respectively for SBI/IBI. The majority (n = 18) of the more complex CDA prediction models have been published in the last five years. The most common variables included within the CDAs were age, urinalysis, height of fever, C-reactive protein, and absolute neutrophil count.</p><p><strong>Conclusion: </strong>This scoping review highlights a wide range of CDAs with a trend towards prediction modelling rather than sequential assessment in the last five years. There is still variability in CDA properties, applicability, and diagnostic performance, necessitating further validation of common CDA and prediction models.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"274"},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics, and outcomes of severe neonatal thrombocytopenia: a retrospective cohort study in China.","authors":"Yuanyuan Shan, Ting Peng, Peng Zhang, Guoqiang Cheng","doi":"10.1186/s12887-025-05640-6","DOIUrl":"10.1186/s12887-025-05640-6","url":null,"abstract":"<p><strong>Background: </strong>Severe neonatal thrombocytopenia, as a rare but life-threatening disease with multiple etiologies, has limited relevant reports in China. The single-center study was performed in a severe thrombocytopenic cohort to improve the prognosis of this disease.</p><p><strong>Methods: </strong>We included all the patients diagnosed with severe thrombocytopenia (platelet counts ≤ 50 × 10³/µL) in our institution between October 2016 and February 2021, and retrospectively reviewed their electronic records. Comparisons were made according to etiology and outcome.</p><p><strong>Results: </strong>Among the 5819 inpatients, 194 with severe thrombocytopenia were included in this study, with 64.4% of the cases manifesting thrombocytopenia within 72 h of life. The highest incidence was recorded among extremely low birth weight neonates (6.5%). The main etiologies included sepsis (22.2%), genetic syndromes (14.4%), perinatal asphyxia (9.8%), necrotizing enterocolitis (NEC; 8.8%), and cytomegalovirus infection (6.7%). The median platelet nadir was 5.0 × 10³/µL [IQR:2.0 × 10³/µL-16.0 × 10³/µL], and 112 patients developed very severe thrombocytopenia (platelet counts ≤ 30 × 10³/µL), of which 21.4% were associated with late-onset sepsis. In 45 culture-positive cases, the gram-negative group had a lower level of platelets (mean [SD]: 28 [11]×10³/µL) as compared to the gram-positive group (mean [SD]: 39 [12]×10³/µL). A total of 120 cases (61.9%) exhibited evidence of hemorrhage, with patients diagnosed with NEC demonstrating the highest incidence of hemorrhage at 58.8%. The platelet counts took a median of 10 days to recover: 11 and 7 days for early and late-onset cases; 15 days without and 21 days with platelet transfusions, respectively. The overall mortality rate was 26.8%. The causes of severe thrombocytopenia in 32.7%, 19.2%, and 17.3% of patients who died were identified as sepsis, birth asphyxia, and NEC, respectively. The levels of PT (P = 0.025), APTT (P = 0.046), and lactate (P = 0.028) were lower among surviving patients.</p><p><strong>Conclusions: </strong>Sepsis, genetic syndromes, and perinatal asphyxia are the predominant etiologies of severe neonatal thrombocytopenia in China. The overall prognosis of severe neonatal thrombocytopenia is poor, but its severity and outcome were related to laboratory results (PT, APTT, and lactate) and the underlying etiology.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"275"},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling a pediatric enigma: coexisting retroesophageal right subclavian artery and congenital colonic stenosis masquerading as cow's milk protein allergy and ileus in a neonate.","authors":"Pannawat Trerattanavong, Phanthip Chaweeborisuit, Sirinat Tankruad, Aminda Hataimala, Bhannaporn Limsuksrikul, Pitchayanant Laemad, Kasidet Kittichayathon, Pakpoom Thintharua, Krai Meemon, Chinnawut Suriyonplengsaeng","doi":"10.1186/s12887-025-05642-4","DOIUrl":"10.1186/s12887-025-05642-4","url":null,"abstract":"<p><strong>Background: </strong>Double alimentary tract obstruction due to congenital anomalies is a rare clinical occurrence, with limited cases published in medical literature. This article presents a unique case of coexisting retroesophageal right subclavian artery (RRSA) and congenital colonic stenosis (CCS), conditions that have not been previously documented together in pediatric population.</p><p><strong>Case presentation: </strong>A Thai male newborn was born by cesarean section at gestational age of 41 weeks. One week before birth, intrauterine asphyxia and idiopathic bilateral intracerebral hemorrhage were diagnosed by prenatal ultrasonography. Despite postnatal interventions including a ventriculoperitoneal shunt and subsequent external ventricular drain, the intracerebral hemorrhage recurred and progressed. Concurrently, the patient experienced multiple episodes of post-feeding vomiting, intermittent abdominal distension, and regular defecation without constipation. Sepsis secondary to an infected shunt occurred, accompanied by marked abdominal distension. The physician clinically suspected non-IgE-mediated cow's milk protein allergy and ileus associated with sepsis. Tragically, the patient succumbed at seven months due to a brain abscess stemming from an infected external ventricular drain. Ultimately, postmortem examination unraveled double alimentary tract obstruction, consisting of RRSA and CCS. The RRSA, originating from proximal thoracic aorta, caused notable esophageal compression and functional stenosis which led to the frequent vomiting and reflux. The CCS involved the distal transverse colon, descending colon and proximal sigmoid colon, accounting for nearly 50% of the colon. The CCS was therefore the exact cause of intermittent abdominal distension. The stenotic colon contained submucosal and myenteric plexuses, excluding Hirschsprung disease.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic complexities of RRSA and CCS resulting in double gut obstruction and masquerading as non-IgE-mediated cow's milk protein allergy and sepsis-induced ileus. Awareness of these rare coexisting congenital anomalies can aid in early recognition, prevent misdiagnosis, enable timely management and improve outcomes for affected pediatric patients.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"271"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of inflammation on anemia in children: a cross-sectional study.","authors":"Luiz Felipe de Paiva Lourenção, Fabíola Isabel Suano-Souza, Fernando Luiz Affonso Fonseca, Tânia Mara Rodrigues Simões, Rosangela da Silva, Roseli Oselka Saccardo Sarni","doi":"10.1186/s12887-025-05639-z","DOIUrl":"https://doi.org/10.1186/s12887-025-05639-z","url":null,"abstract":"<p><strong>Introduction: </strong>The association of inflammation and iron deficiency could be related to up to 40% of anemia in young children.</p><p><strong>Objective: </strong>To describe the anemia and iron deficiency in children and verify possible associations with dietary practices, nutritional status and inflammatory markers.</p><p><strong>Methods: </strong>This cross-sectional study was conducted with one hundred and twelve children aged between 6 months and 3 years in Early Childhood Education Centers in Minas Gerais, Brazil. Nutritional status regarding iron and inflammatory markers was assessed using the reference values proposed by the World Health Organization.</p><p><strong>Results: </strong>Anemia and iron deficiency were observed in 58 (51.8%) and 89 (79.5%), respectively, of children evaluated. Hemoglobin values were directly associated with the z-score of height for age after adjusting for high-sensitivity C-reactive protein values (β-adjusted = 0.375; 95% CI 0.088 to 0.662; p = 0.011). The values of high-sensitivity C-reactive protein correlated directly with RDW (r = 0.202; p = 0.033), ferritin (r = 0.425; p < 0.001) and soluble transferrin receptor (r = 0.446; p < 0.001), and inversely with hemoglobin (r = -0.287; p = 0.002), serum iron (r = -0.580; p < 0.001) and transferrin saturation index (r = -0.528; p < 0.001). The ROC curve shows that RDW (AUC = 0.708; CI 95% 0.612 to 0.803) and soluble transferrin receptor (AUC = 0.588; 95% CI 0.481 to 0.694) were the variables that showed the better level of discrimination of anemia.</p><p><strong>Conclusions: </strong>The prevalence of anemia was higher than in national studies, and there was a correlation between inflammatory markers and biomarkers of iron nutritional status.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"272"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of combined non-pharmacological interventions on venous blood sampling pain in preterm infants: a clinical trial study.","authors":"Fatemeh Yadollahzadeh, Zahra Akbarianrad, Seyedeh Roghayeh Jafarian-Amiri, Ali Zabihi, Parvin Aziznejadroshan, Hossein-Ali Nikbakht","doi":"10.1186/s12887-025-05626-4","DOIUrl":"https://doi.org/10.1186/s12887-025-05626-4","url":null,"abstract":"<p><strong>Background: </strong>Using non-pharmacological methods to reduce the pain of hospitalized infants is one of the most important priorities in the health of newborns. Pain relief during painful procedures can help prevent unwanted physical and psychological effects. This study was conducted with the aim of investigating the effect of combined non-pharmacological interventions on venous blood sampling pain in preterm infants.</p><p><strong>Methods: </strong>In this clinical trial study, 88 preterm infants admitted to the Neonatal Intensive Care Unit of Rouhani Hospital was randomly assigned to four groups of sucrose (S), the combined group of sucrose and non-nutritive sucking (NS), the combined group of swaddle and sucrose (SS) and the combined group of sucrose, non-nutritive sucking and swaddling (NSS). In order to collect information, were used the premature Infant Pain Profile Scale (PIPP) and demographic characteristics questionnaire.</p><p><strong>Results: </strong>This study showed that during blood sampling, the difference in the mean pain score of two groups of S and NS was equal to 3.54 (95% CI = 1.85, 5.24) and in two groups S and NSS was equal to 4.68 (95% CI = 2.99, 6.38), and these differences were significant (P < 0.001). In addition, the mean pain difference in all study groups was significant in two time periods before-during and during-after blood sampling (P < 0.001). Also, the mean pain difference in the two time periods before-during and during-after in NS and NSS groups was significant compared to the control group (sucrose) (P < 0.001).</p><p><strong>Conclusions: </strong>Based on the results of this study, the use of combined non-pharmacological interventions of NSS has been more effective in reducing the pain caused by venous blood sampling than other conditions where two or one non-pharmacological intervention were used.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"273"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of one-lung ventilation in children undergoing lateral thoracotomy cardiac surgery with cardiopulmonary bypass on postoperative atelectasis and postoperative pulmonary complications.","authors":"Hualin Chen, Ting Liu, Wei Dong, Ying Sun","doi":"10.1186/s12887-025-05600-0","DOIUrl":"10.1186/s12887-025-05600-0","url":null,"abstract":"<p><strong>Background: </strong>Right lateral thoracotomy is increasingly used because of its cosmetic benefits, shorter hospital stays, rapid return to full activity, and ease of reoperation in pediatric patients with uncomplicated congenital heart disease. Currently, one-lung ventilation (OLV) is used in these children to facilitate surgical exposure. We aimed to assess the effect of OLV on postoperative outcomes.</p><p><strong>Methods: </strong>Children aged 6 months to 6 years undergoing right lateral thoracotomy cardiac surgery with cardiopulmonary bypass (CPB) were randomized into an OLV group or a control group. For the OLV group, the tidal volume was 5 ml/kg with 6 cmH₂O positive end-expiratory pressure from the incision until the end of CPB, whereas patients in the control group received two-lung ventilation, except during vena cava occlusion. Lung ultrasonography was performed twice in the supine position for each patient: first, 3 min after intubation before surgery (T₁), and second, 3 min after lung recruitment maneuvers at the end of surgery (T₂). The primary outcome was the incidence of postoperative pulmonary complications within 72 h of surgery and significant atelectasis (defined by a consolidation score of ≥ 2 in any region) at T₂.</p><p><strong>Results: </strong>Overall, 54/96 (56.3%) children developed postoperative pulmonary complications after lateral thoracotomy cardiac surgery with CPB. The incidence of postoperative pulmonary complications was 52.1% (25/48) and 60.4% (29/48) in the OLV and control groups, respectively (odds ratio: 0.712; 95% confidence interval: 0.317-1.600; p = .411). At the end of surgery, the incidence of significant atelectasis was 37.5% in the OLV group compared to 64.6% in the control group (odds ratio: 0.329; 95% confidence interval: 0.143-0.756; p = .008). The consolidation score of the left lung (dependent lung) in the OLV group was significantly lower than that in the control group (p = .007); there was no significant difference in the right lung's postoperative consolidation score between the two groups (p = .051).</p><p><strong>Conclusions: </strong>There was no significant difference in the incidence of postoperative pulmonary complications within 72 h of surgery between the two groups. However, children who underwent right lateral thoracotomy cardiac surgery with CPB in the OLV group showed a low incidence of atelectasis at the end of surgery.</p><p><strong>Trial registration: </strong>ChiCTR, ChiCTR2100048720. Registered on July 13, 2021, www.chictr.org.cn .</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"268"},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tooth decay prevention and neurodevelopmental disorder risk following childhood fluoride exposure.","authors":"David A Geier, Mark R Geier","doi":"10.1186/s12887-025-05601-z","DOIUrl":"10.1186/s12887-025-05601-z","url":null,"abstract":"<p><strong>Background: </strong>The Centers for Disease Control and Prevention (CDC) reports that water fluoridation is among the ten greatest public health achievements of the 20^thCentury. Tooth decay (TD) prevention and neurodevelopmental disorder (ND) risk were assessed in relation to childhood water fluoridation exposure.</p><p><strong>Methods: </strong>This longitudinal cohort study examined the Independent Healthcare Research Database (IHRD) composed of prospectively collected healthcare data from the Florida Medicaid system for the period 1990-2012, using logistic and frequency statistical modeling (with adjustment for covariates). A cohort of 73,254 children continuously enrolled for their first 10 years of life was examined. The yearly percentage of persons in Florida receiving fluoridated water exposure from community water systems was examined by county. The number of children diagnosed with TD, autism spectrum disorder (ASD), attention deficit-hyperactivity disorder (ADHD), intellectual disability (ID), and specific delays in development (SDD) was evaluated.</p><p><strong>Results: </strong>Fluoride exposure in the year of birth, statistically significantly and dose-dependently, slightly reduced the risk of TD, and, separately, slightly increased the risk of ASD, ADHD, ID, and SDD. During the first 10 years of life, children who were fluoride-exposed as compared to unexposed were at significantly lower risk for TD, and, separately, at significantly greater risk for ASD, ID, and SDD.</p><p><strong>Conclusions: </strong>Findings from the present study, coupled with previous studies, suggest new risk/benefit analyses of water fluoridation should be undertaken.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"265"},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric cervicofacial lymphadenitis caused by non-tuberculous mycobacteria: nation-wide overview in the period 2000-2020.","authors":"Eva Sodja, Urška Šivic, Sara Truden, Špela Klemen, Manca Žolnir-Dovč","doi":"10.1186/s12887-025-05603-x","DOIUrl":"10.1186/s12887-025-05603-x","url":null,"abstract":"<p><strong>Purpose: </strong>Cervicofacial lymphadenitis caused by non-tuberculous mycobacteria (NTM) is a rare but increasing infection in children worldwide. The purpose of this study was to analyse and evaluate all microbiologically proven cases of NTM lymphadenitis in children under the age 14 years in Slovenia.</p><p><strong>Methods: </strong>Between 2000 and 2020, we retrospectively reviewed laboratory and medical records for basic demographic and microbiological data. Different clinical samples were collected in medical centres and regional hospitals from all over Slovenia.</p><p><strong>Results: </strong>In the period before mandatory BCG vaccination was discontinued (2000-2005), we did not observe any case of paediatric NTM lymphadenitis. After discontinuation of non-selective BCG vaccination of new-borns (2006-2020), we identified 55 cases of microbiologically confirmed NTM lymphadenitis in BCG-unvaccinated children with median age 26.0 months (range: 15.0-75.0 months). Mean annual incidence of paediatric NTM lymphadenitis accounted for 1.26 (range: 0.35-2.38) per 100,000 children. The main causative agents were Mycobacterium avium (38/55; 69.1%) and M. intracellulare (9/55; 16.4%). We did not find any M. chimaera isolate. Since 2006, each year we microbiologically confirm sporadic cases of paediatric NTM lymphadenitis, a condition not diagnosed before.</p><p><strong>Conclusions: </strong>After discontinuation of universal BCG vaccination in March 2005, first cases of paediatric NTM lymphadenitis appeared. Several possible reasons could be attributed to observed trend and further multinational observational studies are warranted to explore possible causal relationships.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"270"},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of neonatal hyperbilirubinemia and associated factors at a tertiary hospital in Ghana.","authors":"Naana Ayiwa Wireko Brobby, Samuel Blay Nguah, Rafiuk Cosmos Yakubu, Gyikua Plange-Rhule, Adwoa P Boakye Yiadom, Akua Afriyie Ocran, Joyce Ashong","doi":"10.1186/s12887-025-05618-4","DOIUrl":"10.1186/s12887-025-05618-4","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal Hyperbilirubinemia (NH) is one of the most common clinical presentations in the first week of life.</p><p><strong>Aims: </strong>This study sought to determine the incidence, clinical presentation and risk factors associated with mortality, among neonates presenting with unconjugated NH at the Komfo Anokye Teaching Hospital in Ghana.</p><p><strong>Methodology: </strong>This was a hospital-based prospective analytical cohort study conducted from October to December 2020. A total of 223 newborns admitted to the nursery with NH were recruited, mothers were interviewed, and patients were followed-up until discharge. Data was collected and analyzed with R statistical software. Associations were determined as crude and adjusted odds ratios using univariate and multivariate binomial logistic regression.</p><p><strong>Results: </strong>The incidence of NH was 244 per 1000 admissions (95% CI: 21.7-27.3) with a case fatality rate of 8.1% (95% CI: 4.8-12.4). Independent predictors of increased mortality were older age at admission [AOR = 1.28(1.05-1.57), p = 0.015], gestational age between 35 and 37 weeks [AOR = 4.89(1.04-25.8), p = 0.047], and the presence of abnormal posture at admission [AOR = 6.40(1.37-35.9), p = 0.023]. The presentations associated with survival till discharge were primiparity in the mother [AOR = 0.06(0.01, 0.32), p = 0.003], and exclusive breastfeeding at the time of admission [AOR = 0.09 (0.02-0.46), p = 0.004].</p><p><strong>Conclusion: </strong>The incidence of hyperbilirubinemia among neonates admitted to the Mother Baby Unit at KATH is high and gestational ages between 35 and 37 weeks, abnormal posture and older age at presentation were identified to be significantly associated with mortality.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"267"},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryptococcus albidus fungemia and probable meningitis in very preterm newborn: a case report and review of the literature.","authors":"Sameera Mohmmed Aljehani, Tasneem Ibraheem A Zaidan, Noora Obaid AlHarbi, Shurooq Alharbi","doi":"10.1186/s12887-025-05614-8","DOIUrl":"10.1186/s12887-025-05614-8","url":null,"abstract":"<p><strong>Background: </strong>In pediatric and neonatal age groups, infections from non-neoformans Cryptococcus species, notably Cryptococcus albidus, are rarely encountered. C. albidus is an emerging fungal pathogen that causes severe diseases in immunosuppressed patients; furthermore, it has rarely been reported to cause diseases in immunocompetent patients. Several cases have been described in adults who were severely immunosuppressed. Importantly, the clinical symptoms in these reported cases include fungemia, meningitis, keratitis, pulmonary and cutaneous infections. Individuals at risk include neutropenic patients, those with indwelling intravenous devices, those on prolonged steroid or antibiotic use, and those with impaired immune systems and prematurity. The susceptibility of preterm infants with low birth weight to infections, particularly fungal ones, remains a significant concern. This report presents a rare case of fungemia and meningitis due to C. albidus in a preterm neonate, emphasizing the clinical significance and potential implications for future treatment and management. This report aims to alert physicians of the rarity of C. albidus infections in pediatric patients and to review the clinical significance, pathology, treatment, and outcomes.</p><p><strong>Case presentation: </strong>We report the first case of C. albidus fungemia and meningitis in a very low-birth-weight, preterm infant of 31 weeks. Notably, the patient was admitted for lifesaving treatment from the Alleith Hospital due to prematurity. The patient received surfactant due to ARDS, TPN, and fluconazole prophylaxis. On day 11, features of sepsis were observed and the blood culture grew C. albidus, which was sensitive to liposomal agents. CSF evaluation suggested meningitis. The patient improved following a six-week treatment regimen with liposomal formulations of amphotericin B at a dosage of 5 mg/kg body weight once daily, notably administered without 5-fluorocytosine, and experienced no sequelae.</p><p><strong>Conclusions: </strong>This case report underscores the importance of early diagnosis and appropriate antifungal treatment for managing rare fungal infections in vulnerable populations, such as preterm infants. Moreover, it highlights the need for improved diagnostic platforms and comprehensive management protocols for rare pathogens in neonatal settings.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"269"},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}