Typhoid glomerulonephritis and intestinal perforation in a Nigerian child.

The number of children with renal complications following salmonella infection cannot be precisely defined in the sub-Saharan Africa due to scarcity of reliable data. We report a 3-year-old boy with glomerulonephritis secondary to typhoid infection and later intestinal perforation. He presented with fever, generalized body swelling, oliguria, coke- colored urine and hypertension and had been managed 3 weeks earlier for typhoid fever in a private hospital. Laboratory investigations showed proteinuria, hematuria with red cell casturia and azotemia. Abdominal X-ray done was suggestive of typhoid intestinal perforation that was confirmed at exploratory laparotomy. He was managed aggressively with antibiotics and was discharged on the 25 th day of admission. To the best of our knowledge, this is the first documented case report of acute glomerulonephritis and intestinal perforation as co-complications of salmonella infection in Nigeria.

Pattern of chronic diarrhoea in children: a prospective analysis of causes, clinical features and outcome.

OBJECTIVES: To determine the pattern of chronic diarrhoea in children in Oman. STUDY DESIGN: This is a prospective study carried out over a 7 year period at the Sultan Qaboos University Hospital, Muscat, Oman. SUBJECTS: Sixty two children (37 M:25 F), aged 3 months to 13 years who presented with chronic diarrhoea, defined as diarrhoea persisting for more than 4 weeks, were studied. RESULTS: Principal identifiable causes in the study population include post-gastroenteritis syndrome in 50% of cases, enteric infections and infestations in 27%, and coeliac disease in 13%. On presentation 63% were malnourished, 27% were anaemic while 39% were dehydrated. The median duration of hospital admission was 50 days. Majority of the patients responded to conservative therapy with correction of dehydration, and careful nutritional supplementation, in addition to specific therapy where necessary. Mortality was low (1.5%) resulting from immunodeficiency and gram-negative septicaemia. CONCLUSION: Chronic diarrhoea remains an important cause of morbidity especially malnutrition in children and early and adequate nutritional rehabilitation plays a pivotal role in the management.

Birthweights of preterm Nigerian infants of 26-36 weeks' gestation.

The birthweights of 678 liveborn singleton preterm infants born at between 26 and 36 weeks of gestation are analysed. The mean (SD) birthweights and the centile chart are supplied. We believe the data may be of value to paediatricians in tropical countries who manage preterm low birthweight infants.

Multiple births in Igbo women.

In a prospective study of multiple births conducted at three hospitals, a University Teaching Hospital, an urban Maternity Hospital and a Community Hospital, in Eastern Nigeria, the average incidence was found to be 35 per 1000 births. The twinning rate was found to increase progressively with both birth rank and maternal age, with an indication that parity plays the more important role.

Candida albicans and otorrhoea in children. Case reports.

5 cases of Nigerian children, all below 2 years of age are presented. Common to all is a history of treated ear infections with subsequent development of otorrhoea. Both smears and cultures of the ear swabs documented candida albicans, and all the patients responded well to oral Nystatin. There is as yet little emphasis in published works on the relationship between candida albicans and draining ears.

Anaemia in non-sickling Nigerian children around Enugu.

Severe anaemia often assumes emergency dimensions in West Africa. Previous studies in Nigeria and Ghana incriminate malaria as the main single cause of anaemia in early infancy. This prospective study was conducted to verify this for the Enugu region. The series included 50 anaemic patients aged between 4 months and 10 years admitted to the children's ward. Our results rank poor nutrition much more then malaria among the causes in children under 2 years of age. Hookworm infestation may be a more common cause in children over 2 years.

[Juvenile spongy dystrophy of CNS with necrosis of the medulla. A. complication of hydroxyquinoline therapy (author's transl)]. / Juvenile spongiöse Dystrophie des ZNS mit Medullanekrose. Komplikation einer Hydroxychinolin-Behandlung?

A girl of 10-5/12 years is described, who had diabetes mellitus from the age of 5 years on and who developed bilateral ptosis, pigment degeneration of the retina and bilateral impairment of hearing at the age of nine years. A few weeks before death she suffered from an acute gastrointestinal infection which was successfully treated by a hydroxyquinoline derivative. In the days following a severe encephalopathy and signs of cardiac involvement appeared. A month later the girl died of bulbar paralysis and acute heart failure. Histology showed remnants of a granulomatous inflammation in the heart, the kidneys, the pancreas and the skeletal muscles. Furthermore there was a widespread spongiosis in the white substance of the brain, with large astrocytes, and partly also in the basal ganglia, the brain stem and the cerebellum. Foci of sudanophilic tissue necrosis resembling Wernicke's Encephalopathy were found in the medulla oblongata and the spinal cord. The peripheral nerves appeared partially demyelinated and showed axonal lesions. This case is classified as a Juvenile Type of so-called Canavan's Disease. It shows some resemblence to the "Progressive Chronic Ophthalmoplegia with Spongiform Encephalopathy described by Daroff, Kearn and Sayre. The possible neurotoxical effects of the hydroxyquinoline therapy are discussed.