Children with S Choleraesuis infections usually presented with occult bacteremia with mild gastrointestinal involvement. The mortality of S Choleraesuis infections in previously healthy children is low. Ciprofloxacin resistance among S Choleraesuis isolates from pediatric patients was lower than that of isolates from adult patients. In view of the high rate of multidrug resistance, third-generation cephalosporins seem to be the drug of choice for treatment of invasive S Choleraesuis infections.

The outcome of the infants hospitalized in the NICU with ESBL-producing enterobacterial infections was not indispensably grave, even when treated with a non-carbapenem antibiotic regimen. The risk factors for the acquisition of ESBL-producing enterobacterial infections in these infants were not identified in this series.

We describe septic arthritis of the hip in a child with typhoid fever. The aetiological diagnosis was confirmed by a positive Widal test as well as by isolation of Salmonella typhi from joint aspirate. Treatment with ceftriaxone along with surgical drainage was successful.

This case report describes necrotising fasciitis caused by Vibrio vulnificus in a child without pre-existing risk factors. Treatment with ceftazidime and doxycycline, along with surgical de´bridement, were successful. Early diagnosis and expeditious surgical intervention are life-saving for patients with such infections.Vibrio vulnificus, a halophilic organism, is a gramnegative pathogen frequently associated with overwhelming infection of sites other than the gastrointestinal tract. Patients with liver cirrhosis and haemochromatosis and those who take immunosuppressive drugs are at increased risk for V. vulnificus infection. We report a case of necrotising fasciitis caused by V. vulnificus in a child without these known risk factors.A 12-year-old schoolboy was admitted with a 1-day history of left thigh tenderness, swelling and spike fever. He had eaten some undercooked shrimps with his family a few days before onset of the symptoms. He complained of mild abdominal pain and vomiting following consumption of the seafood. The rest of the families were free of illness. There was no specific history of liver disease or drug use. On admission, he looked toxic and lethargic. His left thigh was extremely tender, and the range of motion of knee and hip was limited. The skin appeared purple, with the margin of oedema extending to the groin and down to the patella area. Results of laboratory examination were: white blood cell 9.3·10 9 /l (segmented neutrophils 84%, band forms 6%, lymphocytes 4%, monocytes 5% and eosinophils 1%), haemoglobin 13.2 g/dl, platelets 193·10 9 /l, aspartate aminotransferase 35 U/l, and C-reactive protein 265.5 mg/l. Stool culture was not performed. Oxacillin was initiated right after admission, despite which he developed hypotension and shock on the next day. Necrotising fasciitis was highly suspected and he subsequently underwent an emergency fasciotomy and de´bridement after CT scanning of the left thigh.Necrotising fasciitis was confirmed at surgery. There was extensive necrosis of subcutaneous tissue and deep fascia. The pus culture grew V. vulnificus, which was sensitive to amikacin, aztreonam, ciprofloxacin, ceftriaxone, ceftazidime and imipenem. The blood culture was negative. Medical treatment consisted of intravenous ceftazidime and doxycycline for 12 days. He required a skin graft which healed well post-surgery.Between 1985 and 1990, 28 cases of V. vulnificus infection were reported from southern Taiwan [2]. In that series, 74% of the patients had underlying diseases and 50% were associated with ingestion of seafood or exposure to salt water. The clinical course was generally characterised by acute onset of fever, the appearance of bullous skin lesions, and the development of hypotension and shock. Since our patient showed no open wound, it is believed that ingestion of seafood served as a vehicle for the entry of the pathogen with a subsequent extra-intestinal spread causing necrotising fasciitis.To our knowledge, only three cases of V. vulnificus sepsis in children have been reported...