Background. Paediatric intensive care units (PICUs) are high-risk settings for healthcare-associated infections. Invasive fungal infection (IFI) is one of the common causes of healthcare-associated infections.
Objective. To describe the prevalence and short-term outcomes of children with IFI, and to offer a basis for the efficient prevention and treatment of IFI.
Methods. A retrospective study was conducted in children under the age of 12 years over a two-year period. Participants were categorised according to pre-defined microbiology criteria into IFI if they had a positive culture from blood or other sterile sites. Data collected included demographics, invasive procedures, length of stay and mortality.
Results. One thousand and forty-two children were admitted during the study period. Of the total, 56.8% (n = 592) were male. Median length of stay was 18 days (mean ± SE 18.6±8.9). IFI was identified in 35 cases per 1 000 admissions, with 77.7% of these infants under the age of one year. The mean length of stay was 18.6 days compared with 7.5 days for children with bacterial infections. The in-hospital mortality for invasive fungal infection was 36% compared with 16% for all admissions. Findings confirmed that colonisation was more prevalent than IFI.
Conclusion. IFIs are common among infants, and these patients have a higher mortality rate and prolonged hospital stay. Therefore we recommend early diagnosis and timely treatment with high-performance antifungal drugs to improve the prognosis in children with IFI. Keywords. Healthcare-associated infections, South Africa, neonates, mortality, sepsis.
Pulmonary arteriovenous malformations (PAVMs) are caused by abnormal connections between arteries and veins, which lead to right-to-left shunting of deoxygenated blood. Here, we report an 11-year-old male who presented with signs suggestive of intracranial pathology.
The patient displayed signs of a chronic illness, possibly congenital malformation that was complicated by PAVM and multiple brain
abscesses. This case illustrates the importance of doing a detailed examination and investigations, especially if the history alone is not helpful
in making a diagnosis.
Lower airway obstruction commonly presents with wheezing but is not always caused by asthma. Considering the case history and course
of illness is of utmost importance in determining the cause of wheezing. We present two cases admitted to the paediatric intensive care unit,
in which a double aortic arch was found to be the cause of wheezing. The cases illustrate the importance of a systematic approach when
investigating a patient with persistent wheeze, especially when there is a poor response to conventional therapy.
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