Abhimanyu Sharma; Meera Sikka; Sunil Gomber; Satendra Sharma
Abstract
Background & Objectives: In sepsis, enhanced fibrin formation, impaired fibrin degradation, and intravascular fibrin deposition lead to a prothrombotic state. The current study aimed at measuring various coagulation parameters to predict an early marker for disseminated intravascular coagulation ...
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Background & Objectives: In sepsis, enhanced fibrin formation, impaired fibrin degradation, and intravascular fibrin deposition lead to a prothrombotic state. The current study aimed at measuring various coagulation parameters to predict an early marker for disseminated intravascular coagulation (DIC). Methods: The current prospective study was conducted from January 2012 to April 2013 on 50 children aged 1-10 years with clinically suspected sepsis referred to the Department of Pediatrics of a tertiary care center in New Delhi, India. Patients were evaluated in accordance with criteria for acute infection (i e, symptoms less than seven days) confirmed in all patients in the laboratory. Patients receiving antibiotics 24-48 hours preceding the admission were excluded from study. Prothrombin time, activated partial thromboplastin time, plasma fibrinogen, and D-dimer were measured at the time of admission in 50 patients and 50 controls. Results: D-dimer was positive in 36 (72%) patients and negative in all controls. The difference was statistically significant (P <0.01). Plasma fibrinogen was significantly (P <0.01) higher in patients compared with the controls. It was decreased in 6% and increased in 8% of the patients, and normal in all controls. PT and APTT were significantly (P <0.01) higher in patients compared with the controls. Conclusion: Though none of the current study patients developed overt disseminated intravascular coagulation, the high positivity for D-dimer suggested that it should be measured in children with sepsis for early identification of DIC. This can aid better management as additional coagulation based therapy such as recombinant anti-thrombin and thrombomodulin may help to improve prognosis.
Alireza Abdollahi; Hedieh Moradi-Tabriz; Baharak Mehdipour Aghabagher
Volume 6, Issue 3 , June 2011, , Pages 139-142
Abstract
Newborns’ bacterial infections due to group B Streptococcus (GBS) happen in two forms including early-onset disease or late-onset disease. In this paper, we report a case of early-onset GBS infection in a male infant. A 22-year-old primigravid woman delivers a term normal looking male infant. Nasal ...
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Newborns’ bacterial infections due to group B Streptococcus (GBS) happen in two forms including early-onset disease or late-onset disease. In this paper, we report a case of early-onset GBS infection in a male infant. A 22-year-old primigravid woman delivers a term normal looking male infant. Nasal flaring, grunting, and poor feeding presented soon after birth. An empiric treatment with intravenous ampicillin and amikacin initiated. On the second day, he was transferred to Newborn Intensive Care Unit (NICU). The intravenous antibiotics were changed to tazocin and vancomycin in NICU. The blood culture (BC) was positive for GBS. After 48 hours, respiratory distress symptoms disappeared, BC was negative, and ABG and CBC became normal. Finally, the infant was discharged after 15 days.GBS is a normal flora of women's gastrointestinal and genitourinary tracts. Infants with early-onset GBS sepsis need very close observation including repeated vital signs evaluation.
Abolfazl Khoshdel; Mahdi Mahmoudzadeh; Soleiman Kheiri; Reza Imani; Ghorbanali Shahabi; Ebrahim Saedi; Elham Taheri
Volume 3, Issue 4 , September 2008, , Pages 203-207
Abstract
Background and Objective: According to the fact that neonatal infection is a challenging diagnosis field, several studies have tried to test sensitivity and specificity of diagnostic tests. This study was conducted to evaluate the sensitivity and specificity of procalcitonin (PCT) as a single ...
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Background and Objective: According to the fact that neonatal infection is a challenging diagnosis field, several studies have tried to test sensitivity and specificity of diagnostic tests. This study was conducted to evaluate the sensitivity and specificity of procalcitonin (PCT) as a single early marker of neonatal sepsis. Materials and Methods: In this study, 150 neonates admitted to NICU and neonatal ward in Shahrekord Hajar hospital were enrolled. A full workup including blood cultureand other tests and PCT was conductede. Sensitivity, specificity, positive and negative predictive values for PCT was determined. Results: It was found out that 8 patients had definite infection, 15 patients had possible infection, and 127 patients had no infection. Although PCT was not able to significantly differentiate between those with definite and possible infections (p>0.05), but there was a significant difference for frequency of abnormal PCT between non-infectious patients and other patients. Sensitivity, specificity, positive and negative predictive values of PCT was 87.5%, 87.4%, 30.4%, 99.1%, and 87.41% respectively. Conclusion: Beside the limitation of the sample size, the satisfactory diagnostic characteristics of PCT highlight it as a good measure for diagnosis of neonatal sepsis. Further studies are essential to be carried out.
