Browsing by Author "Leshabari, Kelvin"

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    Case report: Xanthogranulomutouspyelonephritis presenting as "wilms’ tumor"
    (BioMed Central, 2016) Jumanne, Shakilu; Meda, John; Hokororo, Adolfine; Leshabari, Kelvin
    Background: Xanthogranulomatous pyelonephritis (XGP) is a rare renal tumor that arises as a complication of chronicobstructive pyelonephritis of uncertain etiology. It is primarily an adult tumor seen occasionally in children associated with urinary tract obstruction due to congenital urological anomalies, nephrolithiasis, and recurrent urinary tract infections. Radiologically, it may show neoplastic features such as those seen in common pediatric renal malignancies like Wilms ‘tumor and renal cell carcinoma. This overlap in radiological manifestation frequently leads to misdiagnosis and delay inappropriate intervention. We report a case of a 3 years old boy who presented with history of recurrent urinary tractinfections and a left renal mass initially thought to be Wilms ‘tumor. Case presentation: We present a case of a 3 years old boy admitted to the Pediatric oncology unit at Muhimbli National Hospital in Dar es Salaam, Tanzania with one year history of recurrent fever and urinary tract infection signs and symptoms refractory to antibiotic therapy. He was eventually found to have a left kidney mass detected at the District hospital by abdominal ultrasound performed to evaluate a flank mass that was felt by his mother. He was then referred to our unit for a suspicion of Wilms ‘tumor which finally turned out to be a left kidney Xanthogranulomatous pyelonephritis. He underwent a successful left nephrectomy and was discharged from hospital in a stable clinical condition and remains asymptomatic at the time of submission of this case report. Conclusion: This case report underscores the need for clinicians attending a febrile child with a renal mass that can be confused with common pediatric renal malignancies such as Wilms ‘tumor to broaden their differential diagnosis. The case also underlines the significance of individualized patient evaluation because this patient would have otherwise received preoperative chemotherapy under the International Society of Pediatric Oncology (SIOP) guidelines if the diagnosis of Wilms tumor was not ruled out.
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    Clinical predictors of malaria, acute bacterial meningitis and treatment outcomes among febrile children admitted with altered mental status in Northwestern Tanzania
    (Oxford University Press, 2017) Jumanne, Shakilu; Meda, John; Hokororo, Adolfine; Leshabari, Kelvin
    Background: Malaria and acute bacterial meningitis (ABM) are the leading infectious causes of febrile encephalopathy in malaria endemic settings. The clinical distinction of the two conditions is complicated by overlap in clinical features. Objective: To determine the clinical predictors for malaria, ABM and treatment outcome in febrile children aged 2 months to 12 years with altered mentation at two tertiary hospitals in Northwestern Tanzania. Methods: Prospective study of 103 children to document demographic data and physical examination findings, such as level of consciousness and meningeal irritations. Laboratory results for cerebrospinal fluid, hemoglobin, malaria and HIV were also evaluated. Results: Age>60 months and hemoglobin 5 g/dl were independent predictors of malaria; (p¼0.013 and 0.004, respectively). HIV infection was the only predictor of meningitis, p¼0.037, and mortality was high if the diagnosis was unconfirmed. Conclusions: Children with febrile encephalitic are more likely to have malaria than ABM if they have severe anemia.