Objectives: This study aimed to estimate serum zinc levels in children with pneumonia according to the WHO criteria and compare them with age-, sex-, and nutrition-matched controls. Methods: The study was carried out in a pediatric tertiary care hospital from September 2014 to July 2016 after obtaining approval from the Institutional Ethics Committee. Children between 1 to 59 months of age admitted with pneumonia according to the WHO criteria were included as the case group (n = 50) and other non-pneumonia cases as the control group (n = 50). Various etiologies were analyzed, such as pneumonia, severe pneumonia, bronchiolitis, and viral infection-associated wheezing based on clinical and X-ray findings. Blood samples were collected for zinc estimation in both case and control groups. All children were investigated and treated as per our unit protocol for the particular condition. Results: Serum zinc level was significantly low in the case group (n-31; 62%) compared to the control group (n-9; 18%). The mean zinc level in the case group was 60.36 ± 29.23, and that of the control group was 80.54 ± 25.70, with a significant P value of 0.001. Conclusions: Serum zinc levels were significantly lower in children with pneumonia when compared to their age-, sex-, and nutrition-matched controls.
Mycoplasma pneumoniae is an important etiological agent in community acquired pneumonia (CAP) in children aged 3 to 15 years. Mycoplasma pneumoniae may present with varied extra pulmonary manifestations. A 5 year old child presented with cough and fever and was initially managed as CAP due to Streptococcus pneumoniae. Child continued to have fever spikes and worsening distress and developed pleural effusion. Mycoplasma immunoglobulin M (IgM) was raised and child was treated with azithromycin. After 10 days of admission, the child developed fissuring of lips and discoloration of extremities. Direct Coombs test, cold agglutination test, antinuclear antibody (ANA) and anticardiolipin antibody were positive. Suspecting small vessel vasculitis, she was started on enoxaparin and aspirin and improved well. This case of CAP due to Mycoplasma pneumoniae is presented for the rare extrapulmonary manifestation of cutaneous vasculitis.
Influenza H1N1 infection is a globally recognized epidemic and is known for several extra-pulmonary complications. Here, for the first time we report a case of a six-year old male child with severe H1N1 infection with acute kidney injury. The child was referred to our center with fever, chills, cough and cold for 2 days. Investigations revealed H1N1 infection with deranged LFT and RFT with anuria. Child was subjected to mechanical ventilation and received higher antibiotics in addition to oseltamivir. The child underwent 13 cycles of hemodialysis and renal profile normalized after a period of 35 days. Our case highlights the importance of recognizing extra-pulmonary complications of H1N1 infection in the pediatric population and the preparation required by healthcare practitioners to reduce the associated mortality.
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