6. TREATMENT RESULTS AND SOME FACTORS RELATED TO DEATH AND SEVERE HOSPITALIZATION OF WHITMORE CHILDREN'S PATIENTS AT THE NATIONAL CHILDREN’S HOSPITAL FROM 2017-2023
Main Article Content
Abstract
Objectives: Evaluate treatment results and some factors related to death and severe hospitalization of Whitmore children’s patients at National Children’s Hospital from 2017 to 2023.
Method: Retrospective and prospective descriptive study on 45 children diagnosed with Whitmore treated at the National Children’s Hospital from January 1, 2017 to December 31, 2023.
Results: There were 45 Whitmore pediatric patients. The number of pediatric patients ≤ 5 years old is 26 (57.8%); the male/female ratio is 2/1. Empirically correct initial antibiotics were 28.9%. The average inpatient stay was 21 ± 16 days (2-61 days). Surgical intervention was 64.4%, mainly lymph node abscess extraction or surgical drainage to drain lymph node abscess 82.8%. The cure rate was 84.4% (38/45); mortality was 15.6% (7/45), all 7 of these cases were septicemia. Some factors related to death and serious illness include: male children, age over 5 years old, clinical diseases such as sepsis, septic shock, decreased white blood cell count, decreased platelet count, CRP is over 98 mg/L and the number of specimens isolated in each case is from 2 or more types of samples.
Conclusions: Initial antibiotic prescription according to experience in Whitmore pediatric patients is still low. The mortality rate is high, especially in pediatric patients with sepsis and septic shock.
Article Details
Keywords
Whitmore in children, sepsis, septic shock
References
[2] 2. Chewapreecha C, Holden M.T.G, Vehkala M et al, Global and regional dissemination and evolution of Burkholderia pseudomallei, Nat Microbiol, 2017, 2, 16263.
[3] 3. Phuong D.M, Trung T.T, Breitbach K et al, Clinical and microbiological features of melioidosis in northern Vietnam, Transactions of the Royal Society of Tropical Medicine and Hygiene, 2008, 102, S30-S36.
[4] 4. Arjun C, Moritz B, Thyl M et al, Improving Treatment and Outcomes for Melioidosis in Children, Northern Cambodia, 2009-2018, Emerging infectious diseases, 2021, 27 (4).
[5] 5. Bộ Y tế, Quyết định số 6101/QĐ-BYT, ngày 30 tháng 12 năm 2019, về việc ban hành Hướng dẫn chẩn đoán, điều trị bệnh Whitmore.
[6] 6. Wiersinga W.J, Virk H.S, Torres A.G et al, Melioidosis, Nat Rev Dis Primers, 2018, 4 (1), 1-22.
[7] 7. Currie B.J, Mayo M, Ward L.M et al, The Darwin Prospective Melioidosis Study: a 30-year prospective, observational investigation, Lancet Infect Dis, 2021, 21 (12), 1737-1746.
[8] 8. Ian G, Vibooshini G, Mark C et al, Melioidosis: Laboratory Investigations and Association with Patient Outcomes, The American journal of tropical medicine and hygiene, 2021, 106 (1).
[9] 9. Philippa K, Simon S, Linda W et al, Clinical Utility of Platelet Count as a Prognostic Marker for Melioidosis, The American journal of tropical medicine and hygiene, 2019, 100 (5).
[10] 10. Raviraj M, Poornima B, Anil K.V et al, Risk Factors for Mortality in Melioidosis: A Single-Centre, 10-Year Retrospective Cohort Study, TheScientificWorldJournal, 2021.