Background Rubella infection in pregnancy can cause congenital rubella syndrome (CRS), and one common defect of CRS is hearing loss. However, hearing screening is not routinely performed in Indonesia. While the number of reported cases of CRS in Indonesia is increasing, it is still difficult to identify all CRS cases. This study aims to identify CRS cases through a newborn hearing screening. Materials and Methods This descriptive study was conducted at Dr. Sardjito Hospital, Yogyakarta, Indonesia. The subjects were recruited from September 1, 2013 to November 19, 2013. The study period was from September 1, 2013 to January 31, 2014. Newborn subjects underwent the first otoacoustic emissions (OAEs) test. Subjects with the first OAEs test REFER results underwent the second OAEs test 2 months later. Subjects with REFER result in the second OAEs test then underwent auditory brainstem response (ABR) and detection of rubella IgM in blood serum. Result There were 151 subjects who underwent the first OAEs test. Ninety subjects (60%) had REFER results, but only 29 subjects underwent the second OAEs test. In the second OAEs test, 9/151 (5%) subjects were REFER. There were 6/151 (3.9%) subjects who underwent ABR and all subjects had sensory neural hearing loss. Of them, one subject was positive for rubella IgM with a titer of 11.86 at 2.5 months of age. We found nine suspected CRS cases, one clinically-confirmed and one laboratory-confirmed CRS case. The incidence of laboratory-confirmed CRS was 1/151 (6.62/1,000) live births. Conclusion Due to the low incidence we found and the cost of screening, we recommend to strengthen surveillance of CRS. All infants less than 1 year of age with suspected CRS should be checked with rubella IgM to identify CRS cases. While universal newborn hearing screening is not mandatory in Indonesia, targeted newborn hearing screening should be performed to detect children with permanent congenital hearing loss due to CRS.
Congenital heart disease (CHD) and invasive cardiac procedures are risk factors for infective endocarditis (IE) in children. IE with Achromobacter xylosoxidans is a rare case and has a high mortality rate. This case report and literature review aim to understand the risk factors, diagnosis, therapy, and outcome of IE wirh Achromobacter xylosoxidans. We observed a 14-months-old boy with ventricular septal defect (VSD), a history of cardiac catheterization, 9 days fever and febrile convulsion; and tachycardia and pansystolic murmur on the tricuspid valve were found. Transthoracic echocardiography revealed vegetation on the tricuspid valve. Monomicrobial clinical isolates of Achromobacter xylosoxidans were consistently found in three samples of aerobic blood culture bottles. The patient was treated with definitive antibiotic therapy with 200 mg/8 hours of ceftazidime for 21 days. Bacterial growth was not found in the blood culture evaluation which was performed after 48 hours of the therapy. Also, it was found that in the follow up period the patient had no fever on the sixth day, and the vegetation size was reduced. A patient with CHD, especially with VSD as an underlying condition who had a history of cardiac catheterization and accompanied by fever and heart murmur, should be suspected of having IE. Then the definitive antibiotic therapy with ceftazidime contributed to a better clinical outcome.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.