High protein levels (>100 mg/dL) before the re-insertion of a VPS may be a risk factor for VPS re-infection.

BackgroundThe emergence of infections related to multidrug-resistant Gram-negative bacilli (MDR-GNB) reintroduced the use of colistin, an antibiotic that was previously abandoned due to adverse effects. However, because of its limited use in neonatal intensive care units, there is very little data about the effectiveness and safety of colistin in children and newborns. In this study, which will be the largest case study in the literature, we aimed to evaluate the effectiveness and safety of colistin in full-term and preterm newborns.Material/MethodsThe study included patients admitted into 2 level 3 neonatal intensive care units between January 2013 and June 2015. The medical records of patients diagnosed with sepsis, meningitis, pneumonia, and urinary tract infection based on the diagnostic culture results and treated with colistin were analyzed retrospectively. The patients whose infections were not verified were excluded from the study.ResultsThe study included 65 patients (18 term, 47 preterm). The most frequently isolated pathogens were Klebsiella pneumoniae and Acinetobacter baumannii followed by Pseudomonas aeruginosa and Enterobacter cloacae. Mean colistin treatment time was 15±3.5 days. All patients treated with colistin were being treated with at least 1 other antibiotic. While a complete clinical response was achieved in 51 (72.3%) patients, 14 (21.5%) patients died during treatment. Four (7.7%) patients died during as a result of another infection. Three patients developed renal toxicity, another 3 patients had seizures, and apnea was observed in 3 patients.ConclusionsColistin was found to be effective and safe for treatment of MDR-GNB infections in preterms and infants with very low birth weight. Given the severity of the infection, the adverse effects of colistin were at acceptable levels.

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Toxic hepatitis or drug-induced liver injury encompasses a spectrum of clinical disease ranging from mild biochemical abnormalities to acute liver failure. The advantages of a long half-life, wide spectrum, high tissue penetration rate, and a good safety profile, make ceftriaxone, a third-generation cephalosporin, a frequent choice in the treatment of childhood infections. Previous studies have reported a few cases of high aspartate aminotransferase and alanine aminotransferase levels, along with three cases of hepatitis caused by ceftriaxone. Here, we report a case of drug-induced toxic hepatitis in a patient who was treated with ceftriaxone for acute tonsillitis.

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Infant botulism is a rare condition caused by intestinal colonization with Clostridium botulinum. The enteric toxin causes intestinal immobility and progressive descending paralysis due to the eff ect on acetylcholine release at the neuromuscular junction and other cholinergic nerve terminals, particularly in the gut. Herein, we report an infant with infantile botulism because of rare clinically entity, with early diagnosis and appropriate treatment recover no squeal.Key Words: Botulism, Clostridium botulinum, Infant pitosis Özetİnfant botilismus Clostridium botulinum ile barsakta kolonizasyon sonucu meydana gelen nadir bir klinik durumdur. Bu enterik toksin barsağa ulaştığın-da öncelikle intestinal motiliteyi durdurur, daha sonra ise başta barsak olmak üzere nöromuskuler kavşaktaki asetilkolin salınımına neden olarak ilerleyici, aşağıdan başlayan yukarıya doğru ilerleyen paraliziler meydana getirir. Burada çok nadir rastanan bir infantil botilismus vakası sunulmaktadır. Erken tanı ve uygun tedavinin sekelsiz iyileşmede önemi vurgulanmaktadır.

Datura stramonium is a widespread annual, leafy herbaceous plant that is a powerful hallucinogen. It can cause severe anticholinergic poisoning after inappropriate and unconsciously usage. We would like to present an approach, accompanied by literature, to the poisoning case for a 6-year-old child who initially presented with altered mental status, abnormal/incoherent speech and agitation, and had an only response to physostigmine. It is essential to consider anticholinergic plant-based ingestions in the differential diagnosis of children presenting with altered mental state, hallucination, and agitation. Health care workers and parents should be aware of toxicities and potential risks of these plants.

We report a rare presentation of periorbital cellulitis caused by B thuringiensis.