MATERIALS AND METHODS: In this retrospective review, data collected during 2006-2015 from the medical charts of patients with evidence of infection, caused by any Salmonella serogroup or clinical form, were examined. We aimed to assess the clinical manifestations, antibiotic susceptibility, and antibiotic use in children with Salmonella gastroenteritis over the ten years' period.
RESULTS: A total of 419 patients had non-typhoidal Salmonella infection. Four-hundred (95.5%) patients were diagnosed with acute gastroenteritis, which was common in children aged <12 months (72.3%). The clinical features of patients with gastroenteritis included fever (74.5%), diarrhoea with bloody mucus (60.5%), watery diarrhoea (39.5%), and vomiting (19.8%). Serogroup B was most commonly detected in the stool specimens. The susceptibility of non-typhoidal Salmonella to ampicillin, norfloxacin, and co-trimoxazole was 36.3%, 98.0%, and 80.5%, respectively. Serogroup B was the most resistant strain, which was sensitive to ampicillin in only 21.6% of specimens, while it showed high susceptibility to norfloxacin and co-trimoxazole (98.1 and 84.0%, respectively). Third-generation cephalosporin and fluoroquinolone were most commonly prescribed.
CONCLUSIONS: Acute gastroenteritis is the most common form of Salmonella infection. Gastroenteritis caused by serogroup B is still the most common infection, which mostly occurs among infants under one year of age. The majority of stool specimens were still susceptible to antimicrobial agents, especially fluoroquinolone and cotrimoxazole; however, there was an overuse of antibiotics without proper indications.
PRESENTATION OF CASE: A 72-year-old female presented to us with right-sided abdominal pain for 3 weeks, associated with vomiting and diarrhoea. She had an appendectomy done 30 years ago and a recent myocardial infarction. Abdominal examination revealed a previous appendectomy scar and tenderness over the right lumbar region. Computed tomography showed ileocaecal intussusception. Right hemicolectomy with a double barrel stoma was performed as she was unstable intraoperatively. Histopathological examination of the tumour showed a well-differentiated neuroendocrine tumour. Subsequent PET scan showed no systemic disease and a reversal of the stoma was done. She remained disease free for a year.
DISCUSSION: Our patient had undergone a right hemicolectomy despite the high risk of mortality, as there is a high chance of malignancy. Double barrel stoma was done, as she was unstable intraoperatively. Fortunately, she recovered well and had her stoma reversed without any further recurrence of her disease.
CONCLUSION: Adult patients who present with intussusception should be managed with resection, as there is a high possibility of a malignancy. Early resection should be planned to prevent further spread of the tumour.
Methods: This study analyzed all suspected ADEs related to favipiravir reported from 2015. The reports were analyzed based on age, gender, and seriousness of ADEs at the System Organ Classification (SOC) level and the individual Preferred Term (PT) level.
Results: This study is based on 194 ADEs reported from 93 patients. Most frequent ADEs suspected to be caused by the favipiravir included increased hepatic enzymes, nausea and vomiting, tachycardia, and diarrhea. Severe and fatal ADEs occurred more frequently in men and those over the age of 64 years. Blood and lymphatic disorders, cardiac disorders, hepatobiliary disorders, injury poisoning, and procedural complications were more common manifestations of severe ADEs.
Conclusion: This study revealed that favipiravir appears to be a relatively safe drug. An undiscovered anti-inflammatory activity of favipiravir may explain the improvement in critically ill patients and reduce inflammatory markers. Currently, the data is based on very few patients. A more detailed assessment of the uncommon ADEs needs to be analyzed when more information will be available.