Download February 2010 CENSUS

UNIVERSITY OF THE PHILIPPINES - PHILIPPINE GENERAL HOSPITAL
DEPARTMENT OF PEDIATRICS
General Pediatrics 3
February 2010 CENSUS
Cecilia Galang, M.D.
Service Consultant
Jennie Santos M.D.
Service Senior
Jemmarine Arenas, M.D.
Iris Buenaventura, M.D.
Evangeline Capul, M.D.
Resident Rotators
General Pediatrics Service 3
MONTHLY CENSUS
February 2010
Number of Beds
Inherited
Patients
Admissions
Total
Discharged
Home Against
Advice
Home Per
Request
Absconded
Transfer of
Service
Mortality
Mortality Rate
Autopsy
Autopsy Rate
Endorsed
Patients
Length of Stay
Mean
Median
Mode
Number of
overstaying
patients
Number of
Nosocomial
infections
Nosocomial
Infection Rate
Consultant
Rounds
DECEMBER
15
11
JANUARY
15
12
FEBRUARY
15
15
34
45
20
1
38
50
19
0
27
42
20
0
2
0
1
0
6
0
6
0
3
5
11%
0
0
11
9
18.0%
3
33.3%
15
4
9.5%
0
0
14
9 days
5 days
1 day
8
6
1
22
11
6
7
7
16
8
6
5
18%
12%
12%
100%
100%
100%
ENDORSED PATIENTS
ENDORSED DIAGNOSIS
CN 2219307
DOA 9/23/09
DOD: 02/17/2010
Hemophilia A
Multiple bleeds (Hepatic
hematoma; Hemarthrosis of the
right hip joint and right wrist)
PRESENT WORKING
IMPRESSION/DISCHARGE
DIAGNOSIS
Hemophilia A
Multiple bleeds (Hepatic
hematoma; Hemarthrosis of the
right hip joint and right wrist),
resolved
DISPOSITION
Discharged
LOS: 147 days
AYO, ARJAY
17yo/M
Santos / Arenas
CN 1976844
DOA 9/14/09
DOT: 02/23/10
Hemophilia A
Iliopsoas bleed
Cholecystolithiasis
Acute tonsillopharyngitis,
resolved
Hemophilia A
Iliopsoas bleed
Congenital heart disease,
cyanotic, Tetralogy of Fallot
Multiple brain abscess, left
fronto-parietal and left occipital
areas
S/P left frontal tube drain of left
frontal abscess, right frontal
burrhole aspiration of right
medial frontal abscess, left
occipital burrhole aspiration of
left occipital abscess (11/14/09)
S/P left frontal tube drainage of
abscess (12/5/09)
Multiple dental caries
s/p tooth extraction
Chronic suppurative otitis
media, AU
Congenital heart disease,
Tetralogy of Fallot with severe
infundibulovalvular pulmonary
stenosis
Multiple Brain abscess, left
parieto-occipital area
Community acquired
pneumonia, resolved
Nosocomial pneumonia,
resolved
Dental caries
s/p tooth extraction
Microtia, AD
Impacted cerumen, resolved
S/P Burrhole tube drainage left
parieto-occipital abscess
(12/3/09)
S/P Burrhole tube drainage left
parieto-occipital abscess
(12/17/09)
Chronic Kidney Disease
Congenital heart disease,
cyanotic, Tetralogy of Fallot
Multiple brain abscess, left
fronto-parietal and left occipital
areas, resolving
S/P left frontal tube drain of left
frontal abscess, right frontal
burrhole aspiration of right
medial frontal abscess, left
occipital burrhole aspiration of
left occipital abscess (11/14/09)
S/P left frontal tube drainage of
abscess (12/5/09)
Multiple dental caries
s/p tooth extraction
Chronic suppurative otitis media,
AU, resolved
Congenital heart disease,
Tetralogy of Fallot with severe
infundibulovalvular pulmonary
stenosis
Multiple Brain abscess, left
parieto-occipital area
Community acquired
pneumonia, resolved
Nosocomial pneumonia,
resolved
Dental caries
s/p tooth extraction
Microtia, AD
Impacted cerumen, resolved
S/P Burrhole tube drainage left
parieto-occipital abscess
(12/3/09)
S/P Burrhole tube drainage left
parieto-occipital abscess
(12/17/09)
Chronic Kidney Disease
TOS to
Hema-Onco
LOS: 162 days
AYO, RANDY
18yo/M
Santos /
Buenaventura
CN 3501231
DOA 11/8/09
MILLARES,
NICKY
4yo/F
Santos / Arenas
CN 2954822
DOA 11/25/09
DOD: 02/10/10
ALMARIO, JOHN
DALE
6yo/F
Santos /
Buenaventura
CN 3501152
Endorsed
LOS: 112 days
Transfer to
HOC
LOS: 77 days
DOA 1/17/10
DOD 02/13/10
LAPAN, SHANIA
6yo/F
Santos / Capul
CN 3524824
DOA 1/16/10
DOD 02/01/10
CABIDOG,
Catherine
4mos/F
Santos /
Buenaventura
CN 3413938
DOA 1/24/10
DOD 02/10/10
probably rapidly-progressive
Glomerulonephritis
Abdominal Wound Dehiscence
Vaginal Labial ulcer, Right
S/P Tenchkoff catheter
insertion (11/11/09)
S/P Tenchkoff catheter
removal (12/3/09)
Community Acquired
Pneumonia
To consider Congenital heart
Disease,Acyanotic, probably
Ventricular Septal Defect
Rule out Sepsis
Rule out Child Neglect
Protein Energy Malnutrition,
Mild Stunting, Moderate
Wasting
Pineal Gland Tumor,
Germinoma with Obstructive
Hydrocephalus
Epilepsy, Generalized Tonic
Clonic, structural
Pineal Gland Tumor,
Germinoma with Obstructive
Hydrocephalus
Epilepsy, Generalized Tonic
Clonic, structural
s/p ventriculoperitoneal shunt
insertion (02/01/10)
Tuberculous Meningitis Stage
III
Community Acquired
Pneumonia with Aspiration
Component
Disseminated Tuberculosis
(CNS, skin, lungs)
Tuberculous Meningitis Stage III
s/p ventriculoperitoneal shunt
insertion (02/2010)
Community Acquired
Pneumonia with Aspiration
Component, resolved
Disseminated Tuberculosis
(CNS, skin, lungs)
Severe Pericardial Effusion
Pulmonary Tuberculosis
S/P Tube Pericardiostomy
(1/17/10)
Tuberculous pericarditis with
pericardial effusion, resolving
Disseminated Tuberculosis
(pulmonary, pericardium)
s/p tube pericardiostomy
(1/19/10) and removal
(01/27/10)
Surgical site infection, resolving
Acute Respiratory Distress
Syndrome secondary to near
drowning
Aspiration Pneumonia
Pneumothorax, Right
S/P chest tube thoracostomy,
Right 1/29/10
Rule out Sepsis
Multi-organ dysfunction (renal,
pulmonary, central nervous
system, cardiac, hepatic)
secondary to septic shock
Klebsiella ozanae sepsis
Acute respiratory distress
syndrome secondary to near
drowning
Pneumothorax, right
s/p chest tube thoracostomy,
MAMALATEO,
Neil
12/M
Santos / Arenas
CN 3531254
DOA 1/22/10
DOD 2/17/10
MIRA, Krisha
2/F
Santos / Capul
CN 3518055
DOA 1/17/10
DOD 02/02/10
POLANCOS,
Joshua
9/M
Santos /
Buenaventura
CN 3531245
DOA1/28/10
DOM 02/03/10
JACOBA, Gio
2/M
Santos / Arenas
probably rapidly-progressive
Glomerulonephritis
Abdominal Wound Dehiscence,
resolving
Vaginal Labial ulcer, Right,
resolving
S/P Tenchkoff catheter insertion
(11/11/09)
S/P Tenchkoff catheter removal
(12/3/09)
Community Acquired
Pneumonia, resolved
Congenital heart Disease,
acyanotic, Ventricular Septal
Defect
Protein Energy Malnutrition, Mild
Stunting, Moderate Wasting
Discharged
LOS: 27 days
Discharged
LOS: 16 days
Discharged
LOS: 17 days
Discharged
LOS: 26 days
Discharged
LOS: 16 days
Mortality
LOS: 6 days
PCOD: Multiorgan
dysfunction
syndrome
CN 3531402
DOA 1/24/10
DOD 02/06/10
LUMAPAS,
Christine
NB/F
Santos / Arenas
CN 3531450
DOA 1/25/10
DOD 02/21/10
DELOSO, Kent
NB/M
Santos /
Buenaventura
CN 3531294
DOA 1/30/10
DOD 02/05/10
GAMBA, Reiner
8 mos/M
Santos / Capul
CN 3531678
DOA: 1/30/10
DOD: 02/16/10
BRILATA, Bb Boy
NB/M
Santos / Capul
CN 3531075
DOA 1/17/10
DOM: 02/02/10
LAO, Julie Ann
15/F
Partial Gut Obstruction
secondary to Volvulus with
malrotation
S/P Exploratory Laparotomy,
Resection of Ileum,Jejunocolic
Anastomosis, internal jugular
Cutdown (1/24/10)
Imperforate Anus
S/P Transverse loop colostomy
(1/26/10)
Nosocomial Pneumonia
To Consider nosocomial
Sepsis
Down Syndrome
Full term 39 Weeks by
pediatric aging, 2700 grams,
Cephalic, delivered via
spontaneous vaginal delivery,
live baby boy, non-institutional
delivery
Hyperbilirubinemia probably
secondary to:
1. Sepsis
2. ABO Incompatibility
Complete Gut Obstruction
secondary to Ileal Atresia
S/P Exploratory Laparotomy,
Resection and Anastomosis of
proximal Ileus (1/30/10)
Acute Symptomatic Seizure
probably secondary to:
1.Metabolic
2.Complex febrile Seizure
Full term, 39 weeks by
pediatric aging, 1900 grams,
small for gestational age,
Cephalic, delivered via
spontaneous vaginal delivery,
live baby boy, non-institutional
delivery
Neonatal Pneumonia with
Aspiration Component
Acute Symptomatic Seizure
probably secondary to:
1. Metabolic
2. Complex febrile
Seizure
3. Central nervous
system infection
Disseminated tuberculosis
(pulmonary, gastrointestinal)
Nosocomial Pneumonia
Clinical Nosocomial Sepsis
Rule out tuberculous
Meningitis
right (01/29/10)
Partial Gut Obstruction
secondary to Volvulus with
malrotation
S/P Exploratory Laparotomy,
Resection of Ileum,Jejunocolic
Anastomosis, internal jugular
Cutdown (1/24/10)
Imperforate Anus
S/P Transverse loop colostomy
(1/26/10)
Nosocomial Pneumonia,
resolved
Nosocomial Sepsis
(Burkholderia pseudomallei),
resolving
Down Syndrome
Full term 39 Weeks by pediatric
aging, 2700 grams, Cephalic,
delivered via spontaneous
vaginal delivery, live baby boy,
non-institutional delivery
Hyperbilirubinemia
secondary to sepsis, resolved
IV burn, left hand and right foot,
resolving
Complete Gut Obstruction
secondary to Ileal Atresia
S/P Exploratory Laparotomy,
Resection and Anastomosis of
proximal Ileus (1/30/10)
Acute Symptomatic Seizure
secondary to hyponatremia,
resolved
Full term, 39 weeks by pediatric
aging, 1900 grams, small for
gestational age, Cephalic,
delivered via spontaneous
vaginal delivery, live baby boy,
non-institutional delivery
Neonatal Pneumonia with
Aspiration Component, resolved
Acute Symptomatic Seizure
secondary to hypoglycemia
secondary to being small for
gestational age
Extravasation injury (3%) right
leg, resolving
Acute Respiratory Distress
Syndrome secondary to
nosocomial pneumonia on top of
endobronchial tuberculosis
Disseminated tuberculosis
(pulmonary, gastrointestinal,
central nervous system)
Clinical Nosocomial Sepsis
Discharged
LOS: 13 days
Discharged
LOS: 27days
Discharged
LOS: 6 days
Discharged
LOS: 17 days
Mortality
LOS: 16 days
PCOD: Acute
respiratory
distress
syndrome
Santos / Capul
ADMITTED PATIENTS
Case Number
Date of Admission
Date of Discharge
CN: 298 9434
DOA: 02/01/10
DOD: 02/02/10
Santos /
Buenaventura
CN: 353 2149
DOA: 02/02/10
DOD: 02/10/10
Name of
Patient
Age/Sex
BRAO, Nelissa
12/F
CALMA,
Princess
NB/F
Admitting Diagnosis
Congenital heart disease,
acyanotic, ventricular
septal defect
Communicating
hydrocephalus probably:
1. Chiari II malformation
2. Dandy walker
malformation
Santos /
Buenaventura
CN: 352 7879
DOA: 02/03/10
DOT: 02/24/10
Santos /
Buenaventura
CN: 346 4045
DOA: 02/03/10
RIEL, Amir
2m/M
RUSEL,
Angela
5m / F
Santos / Capul
CN: 350 7619
DOA: 02/04/10
DOM: 02/ 04/10
VEGA, Seira
4m/F
Esophageal atresia, type
unknown
S/P esophagostomy, tube
gastrostomy insertion
(Batangas Regional
Hospital)
Surgical site infection of
esophagostomy and
gastrostomy site
Congenital heart disease,
cyanotic, Tetralogy of
Fallot
Chiari II Malformation
To consider Omaya
reservoir infection
s/p repair of lumbosacral
meningocoele (7-31-09)
s/p ventriculoperitoneal
shunt insertion (8-21-09)
s/p ventriculoperitoneal
shunt removal, insertion of
Omaya (9-29-09)
s/p Omaya Removal
(1/31/10)
Congenital heart disease,
cyanotic, aortic stenosis
Final Diagnosis
Congenital heart disease,
acyanotic, ventricular
septal defect
s/p cardiac catheterization
(02/01/10)
Multi-organ dysfunction
syndrome (renal, central
nervous system, cardiac)
secondary to prolonged
hypoxia secondary to
displaced endotracheal
tube
Communicating
hydrocephalus probably:
1. Chiari II malformation
2. Dandy walker
malformation
Protein energy malnutrition
Esophageal atresia, type
unknown
S/P esophagostomy, tube
gastrostomy insertion
(Batangas Regional
Hospital)
Surgical site infection of
esophagostomy and
gastrostomy site, resolved
Congenital heart disease,
cyanotic, Tetralogy of
Fallot
Chiari II Malformation
Omaya tip infection
(Pseudomonas putida and
Burkholderia mallei),
resolving
s/p repair of lumbosacral
meningocoele (7-31-09)
s/p ventriculoperitoneal
shunt insertion (8-21-09)
s/p ventriculoperitoneal
shunt removal, insertion of
Omaya (9-29-09)
s/p Omaya Removal
(1/31/10)
Myocardial failure
Congenital heart disease,
cyanotic, severe aortic
stenosis, severe tricuspid
regurgitation, moderate
aortic regurgitation
Moderate to severe
pericardial effusion
Disposition
Length of Stay
Discharged
1 day
Home per
request
8 days
TOS
21 days
Endorsed
25 days
Mortality
1 day
PCOD:
Myocardial
failure
Santos / Arenas
CN: 330 8048
DOA: 02/05/10
DOD: 02/24/10
RIBO, Drix
1/M
Community acquired
pneumonia
Congenital heart disease,
cyanotic, Tetralogy of
Fallot
Chiari II malformation
Santos / Capul
CN: 353 1946
DOA: 02/05/10
DOD: 02/19/10
Santos / Arenas
CN: 353 1700
DOA: 02/06/10
DOD: 02/15/10
ULIT, Ma.
Angela
1/F
MAGMA, Hana
Aliya
1m/F
Santos / Arenas
CN: 315 2266
DOA: 02/11/10
DOD: 02/11/10
Santos /
Buenaventura
CN: 353 6181
DOA: 02/11/10
DOD:
GRADO,
Angelica
8/F
DAUD, Sittie
Farhanna
NB/F
Empyema thoracis,
parapneumonic versus
tuberculous
Mature teratoma
(intraabdominal)
s/p exploratory
laparotomy, excision of
teratoma (02/2010)
To consider nosocomial
sepsis
Splenorenal abscess
Acute gastroenteritis with
no signs of dehydration,
resolving
Acute renal failure, prerenal
Congenital heart disease,
cyanotic, Tetralogy of
Fallot
TEODORO,
Jessalyn
17/F
Gastroschisis
s/p primary closure with
internal jugular catheter
insertion (02/11/10)
Multi-drug resistant
disseminated tuberculosis
(ileo-cecal, liver, miliary –
pulmonary)
Spontaneous bacterial
peritonitis
Santos /
Buenaventura
CN: 337 0358
DOA: 02/12/10
DOD: 02/14/10
SIOC, Jonalyn
16/F
Congenital heart disease,
cyanotic, Tetralogy of
Fallot
Discharged
19 days
Discharged
14 days
Discharged
9 days
Discharged
1 day
Santos / Arenas
CN: 342 1403
DOA: 02/11/10
DOD: 02/19/10
Nosocomial pneumonia,
resolved
Community acquired
pneumonia, resolved
Acute symptomatic
seizures secondary to
hypocalcemia, resolved
Congenital heart disease,
cyanotic, Tetralogy of
Fallot
Chiari II malformation
s/p repair of lumbosacral
meningocoele (2009)
Empyema thoracis,
tuberculous, resolved
s/p chest tube
thoracostomy and removal
(02/2010)
Nosocomial sepsis,
resolved
Splenorenal abscess,
resolving
Acute gastroenteritis with
no signs of dehydration,
resolved
Acute renal failure, prerenal, resolved
Mature teratoma
(intraabdominal)
s/p exploratory laparotomy,
excision of teratoma
(02/2010)
Community acquired
pneumonia
Grave’s disease
Methicillin resistant
Staphylococcus
epidermidis sepsis,
resolving
Gastroschisis
s/p primary closure with
internal jugular catheter
insertion (02/11/10)
Burn injury (cautery),
resolving
Upper gastrointestinal
bleeding secondary to
decompensated liver
disease secondary to liver
tuberculosis
Multi-drug resistant
disseminated tuberculosis
(ileo-cecal, liver, miliary –
pulmonary)
Spontaneous bacterial
peritonitis
Community acquired
pneumonia, resolving
Grave’s disease
Endorsed
17 days
Mortality
8 days
PCOD:
Upper
gastrointestinal
bleeding
Discharged
2 days
Santos /
Buenaventura
CN: 353 6371
DOA: 02/13/10
DOD: 02/18/10
BUSIO, Romel
16/M
Santos / Capul
CN: 249 6613
DOA: 02/15/10
DOD: 02/15/10
Santos /
Buenaventura
CN: 353 6262
DOA: 02/16/10
DOD:
Santos / Arenas
CN: 349 6669
DOA: 02/16/10
DOD: 02/28/10
To consider:
1. Chronic kidney disease
2. Renal tubular acidosis
3. Rheumatic heart
disease
4. Systemic lupus
erythematosus
Gaucher’s disease
CAMERINO,
Shaima
5m/F
PASAO,
Ezekiel
9m/M
LURENZANA,
Zaijan
NB/M
Santos /
Buenaventura
CN: 353 6800
DOA: 02/18/10
DOD:
FORMORAN,
Gerald
18/M
Santos / Arenas
CN: 353 6717
DOA: 02/18/10
DOD:
Santos / Capul
Discharged
Gaucher’s disease
Discharged
LIGSAY,
Fatima Ann
10/F
MALAPIT,
Kyrick
NB/M
5 days
1 day
Partially Treated Bacterial
Meningitis
Community acquired
pneumonia
Massive pleural effusion, L
To consider chylothorax
Congenital heart disease,
cyanotic, Tetralogy of
Fallot
s/p Blalock Taussig shunt
(1/27/10)
Santos / Capul
CN: 353 6733
DOA: 02/17/10
DOD:
Chronic kidney disease
Class E with renal tubular
disorder
Urinary Tract Infection,
complicated, resolved
To consider Neonatal
Pneumonia
Rule out Neonatal Sepsis
Central nervous system
Infection probably bacterial
meningitis
Hyperbilirubinemia
probably secondary to 1.
sepsis 2. ABO
incompatibility 3.
physiologic
Cleft Lip
Chronic kidney disease
secondary to chronic
glomerulonephritis
Community acquired
pneumonia
Imperforate anus
s/p transverse loop
colostomy (02/17/2010)
Neonatal sepsis
Full term, 37 weeks by
pediatric aging, 2700g,
appropriate for gestational
age, cephalic, delivered
via spontaneous vaginal
delivery, live baby boy,
non-institutional delivery
Partially Treated Bacterial
Meningitis with
Hydrocephalus, resolving
Community acquired
pneumonia, resolved
Massive pleural effusion, L,
chylothorax, resolved
Nosocomial pneumonia,
resolved
s/p Chest tube
thoracostomy and removal
(02/2010)
s/p Thoracentesis
(02/2010)
Congenital heart disease,
cyanotic, Tetralogy of
Fallot
s/p Blalock Taussig shunt
(1/27/10)
Neonatal sepsis, resolving
Bacterial meningitis,
resolving
Physiologic jaundice
Cleft lip
End stage renal disease
secondary to chronic
glomerulonephritis
s/p Tenckhoff catheter
insertion (02/21/10)
Community acquired
pneumonia, resolved
VACTERL (imperforate
anus, patent ductus
arteriosus)
s/p transverse loop
colostomy (02/17/2010)
Neonatal sepsis, resolved
Nosocomial Pneumonia on
top of atypical pneumonia,
resolving
To consider new onset
nosocomial sepsis
Full term, 37 weeks by
Endorsed
12 days
Discharged
12 days
Endorsed
11 days
Endorsed
10 days
Endorsed
10 days
CN: 353 6663
DOA: 02/19/10
DOD:
BERCASIO,
Rochelle
NB/F
Santos /
Buenaventura
CN: 351 8055
DOA: 02/19/10
DOD: 02/26/10
POLANCOS,
Joshua
9/M
Multiple congenital
anomalies (leaking
nasoethmoidal mass,
absent 5th digit of left
hand and constrictive band
4th digit left hand,
syndactyly right foot, low
set ears) probably
secondary to
1. neural tube sequence
2. amniotic band rupture
3. chromosomal anomaly
t/c infected nasoethmoidal
mass
Rule out sepsis
Disseminated (pulmonary,
pericardium)
s/p tube pericardiostomy
(1/19/10) and removal
(01/27/10)
Santos / Capul
CN: 255 8918
DOA: 02/20/10
DOD:
MARATILLO,
Michael
17/M
Congestive heart failure
functional capacity IV
secondary to rheumatic
heart disease
Santos / Arenas
CN: 353 7013
DOA: 02/21/10
DOD:
SALAZAR,
Edriel
2/M
Santos /
Buenaventura
CN: 3537222
DOA: 02/22/10
ROCO, Althea
9mos/F
Empyema thoracis, Left
probably 1 parapneumonic
2 tuberculosis
To consider Hospital
Acquired Pneumonia
Rule out Hospital Acquired
Sepsis
PTB V
S/P CTT insertion, Left
(02/21/10)
S/P thoracentesis, Left
(02/20/10)
Rubeola (Measles,
eruptive stage with
Pneumonia)
Santos/Buenaventura
CN: 3497923
Community Acquired
pediatric aging, 2700g,
appropriate for gestational
age, cephalic, delivered via
spontaneous vaginal
delivery, live baby boy,
non-institutional delivery
Multiple congenital
anomalies (leaking
nasoethmoidal mass,
absent 5th digit of left hand
and constrictive band 4th
digit left hand, syndactyly
right foot, low set ears)
probably secondary to
1. neural tube sequence
2. amniotic band rupture
3. chromosomal anomaly
S/P Intracranial repair of
nasoethmoidal mass
(02/24/10)
Infected nasoethmoidal
mass (Methicillin resistant
staphylococcus aureus)
Constrictive tuberculous
pericarditis
Disseminated tuberculosis
(pulmonary, pericardium)
Minimal pericardial effusion
s/p tube pericardiostomy
(1/19/10) and removal
(01/27/10)
Pulmonary effusion, L
s/p chest tube
thoracostomy (2/15/10)
s/p Pericardiectomy
(2/26/10)
Congestive heart failure
functional capacity IV
secondary to rheumatic
heart disease (severe
mitral regurgitation, severe
aortic insufficiency,
moderate pulmonary
regurgitation, mild mitral
stenosis, mild to moderate
tricuspid regurgitation)
Empyema thoracis, Left
(Methicillin resistant
staphylococcus aureus)
Hospital Acquired
Pneumonia, resolving
S/P chest tube
thoracostomy, Left
(02/21/10)
S/P thoracentesis, Left
(02/20/0)
Acute respiratory distress
syndrome secondary to
nosocomial pneumonia on
top of community acquired
pneumonia
Rubeola, resolving
Community Acquired
Endorsed
9 days
TOS to PICU
7 days
Endorsed
8 days
Endorsed
7 days
Endorsed
6 days
DOA: 02/22/10
TOLOSA,
Junjun
9mos/M
Santos/Buenaventura
CN: 3537379
DOA: 02/24/10
HALLIG,
Clarrissa
Santos / Capul
CN 3528574
DOA: 02/27/10
Santos/Capul
BERSANO,
Joshua
1/M
Pneumonia
Endobronchial TB
Acute symptomatic
seizures probably
secondary to
1. hypoxia
2. CNS infection probably
TB Meningitis
T/C Disseminated TB
R/O MDRTB
R/O Sepsis
Pneumonia
Endobronchial
tuberculosis, inadequately
treated
Acute symptomatic
seizures secondary to
hypoxia, resolved
To consider tuberculous
Meningitis
To consider disseminated
tuberculosis
Acute Symptomatic
Seizure secondary to
central nervous system
infection probably
(1) Bacterial
Meningitis
(2) Tuberculous
Meningitis
Community acquired
pneumonia
Rule out sepsis
To consider tuberculous
meningitis
Rule out Sepsis
Tuberculous meningitis
stage III
Community acquired
pneumonia
Disseminated tuberculosis
(scrofula, meningitis stage
III)
Rule out sepsis
Endorsed
6 days
Endorsed
4 days
Endorsed
1 day
MORTALITIES
Case Number
Date of Admission
Date of Discharge
CN: 342 1403
DOA: 02/11/10
DOD: 02/19/10
Name of
Patient
Age/Sex
TEODORO,
Jessalyn
17/F
Admitting Diagnosis
Multi-drug resistant
disseminated tuberculosis
(ileo-cecal, liver, miliary –
pulmonary)
Spontaneous bacterial
peritonitis
Santos /
Buenaventura
CN: 350 7619
DOA: 02/04/10
DOM: 02/ 04/10
Santos / Arenas
CN 3531075
DOA 1/17/10
DOM: 02/02/10
VEGA, Seira
4m/F
LAO, Julie Ann
15/F
Congenital heart disease,
cyanotic, aortic stenosis
Disseminated tuberculosis
(pulmonary,
gastrointestinal)
Nosocomial Pneumonia
Clinical Nosocomial
Sepsis
Rule out tuberculous
Meningitis
Final Diagnosis
Upper gastrointestinal
bleeding secondary to
decompensated liver
disease secondary to liver
tuberculosis
Multi-drug resistant
disseminated tuberculosis
(ileo-cecal, liver, miliary –
pulmonary)
Spontaneous bacterial
peritonitis
Myocardial failure
Congenital heart disease,
cyanotic, severe aortic
stenosis, severe tricuspid
regurgitation, moderate
aortic regurgitation
Moderate to severe
pericardial effusion
Acute Respiratory Distress
Syndrome secondary to
nosocomial pneumonia on
top of endobronchial
tuberculosis
Disseminated tuberculosis
(pulmonary,
gastrointestinal, central
nervous system)
Disposition
Length of Stay
Mortality
8 days
PCOD:
Upper
gastrointestinal
bleeding
Mortality
1 day
PCOD:
Myocardial
failure
Mortality
LOS: 16 days
PCOD: Acute
Respiratory
Distress
Syndrome
Santos / Capul
CN 3531245
DOA1/28/10
DOM 02/03/10
Acute Respiratory Distress
Syndrome secondary to
near drowning
Aspiration Pneumonia
Pneumothorax, Right
S/P Chest tube
thoracostomy, Right
1/29/10
Rule out Sepsis
JACOBA, Gio
2/M
Santos / Arenas
Clinical Nosocomial Sepsis
Multi-organ dysfunction
(renal, cardiac, central
nervous system)
secondary to septic shock
Klebsiella ozanae sepsis
Acute respiratory distress
syndrome secondary to
aspiration pneumonia
Acute lung injury
secondary to near
drowning
Pneumothorax, R
s/p Chest tube
thoracostomy insertion, R
(01/29/10)
Mortality
LOS: 6 days
PCOD: Multiorgan
dysfunction
syndrome
ENDORSED PATIENTS
Case Number
Date of Admission
Date of Discharge
CN: 255 8918
DOA: 02/20/10
LOS: 8 days
Name of Patient
Age/Sex
MARATILLO,
Michael
17/M
Admitting Diagnosis
Congestive heart failure
FC IV secondary to
rheumatic heart disease
Congestive heart failure
FC IV secondary to
rheumatic heart disease
(severe MR, severe AI,
mod PR, mild MS, mild to
mod TR)
Empyema thoracis, Left
probably 1
parapneumonic 2
tuberculosis
T/C Hospital Acquired
Pneumonia
R/O Hospital Acquired
Sepsis
PTB V
S/P CTT insertion, Left
(02/21/10)
S/P thoracentesis, Left
(02/20/10)
Rubeola (Measles,
eruptive stage with
Pneumonia)
Empyema thoracis, Left
(MRSA)
Hospital Acquired
Pneumonia, resolving
S/P CTT insertion, Left
(02/21/10)
S/P thoracentesis, Left
(02/20/0)
Santos / Arenas
CN: 353 7013
DOA: 02/21/10
LOS: 7 days
SALAZAR, Edriel
2/M
Santos /
Buenaventura
CN: 3537222
DOA: 02/22/10
LOS: 6 days
Santos/Buenaventura
ROCO, Althea
9mos/F
Final Diagnosis
Plan
Meds:
Furosemide,
Captopril, ISDN,
Amiodarone,
Penicillin VK
For weaning of
inotropes
For possible
discharge if ok
with Cardio
Meds:
Vancomycin
D0+1
Completion of
vancomycin for
at least 14 days
Removal of CTT
ARDS secondary to
nosocomial pneumonia on
top of community acquired
pneumonia
Rubeola, resolving
Meds:
Meropenem D2
Intubated: MV
settings 100%
30/9 45 0.6
Slow weaning
from ventilator
Wean from
inotropic support
Completion of
meropenem for
7 days
CN: 3497923
DOA: 02/22/10
LOS: 6 days
TOLOSA, Junjun
9mos/M
Santos/Buenaventura
Community Acquired
Pneumonia
Endobronchial TB
Acute symptomatic
seizures probably
secondary to
1. hypoxia
2. CNS infection probably
TB Meningitis
T/C Disseminated TB
R/O MDRTB
R/O Sepsis
Community Acquired
Pneumonia
Endobronchial TB,
inadequately treated
Acute symptomatic
seizures secondary to
hypoxia, resolved
To consider TB Meningitis
To consider disseminated
TB
Meds:
Ceftriaxone D
Amikacin D
HRZS x 6
months
Weaning from
ventilator: MV
settings 30%
22/5 30 0.45
Completion of
antibiotics for 7
days
Complete TB
work-up (TBCS,
cranial CT scan
or ultrasound,
LT)
CN: 3537379
DOA: 02/24/10
LOS: 4 days
HALLIG,
Clarrissa
Santos / Capul
Acute Symptomatic
Seizure secondary to
CNS infection probably
(3) Bacterial
Meningitis
(4) TB Meningitis
PTB V
Community acquired
pneumonia
Rule out sepsis
TB meningitis stage III
Community acquired
pneumonia
Meds: Penicillin
G (300T) D
Wean from
ventilator: MV
settings 100%
18/5 30 0.5
Completion of
antibiotics x 7
days
Continue
supportive
management:
mannitol and
dexamethasone
To start antiKochs
Complete TB
work-up
CN 3528574
DOA: 02/27/10
LOS: 1 day
Santos/Capul
BERSANO,
Joshua
1/M
T/C TB Meningitis
R/O Sepsis
Disseminated TB
(scrofula, TB meningitis
stage III)
Rule out sepsis
Meds:
Ceftriaxone D2
HRZ D1, S D1
Complete TB
work-up
CN: 353 6717
DOA: 02/18/10
LOS: 10 days
Santos / Capul
MALAPIT, Kyrick
NB/M
Imperforate anus
s/p transverse loop
colostomy (02/17/2010)
Neonatal sepsis
FT, 37 weeks by PA,
2700g, AGA, cephalic,
SVD, LBB, NID
VACTERL (imperforate
anus, PDA)
s/p transverse loop
colostomy (02/17/2010)
Neonatal sepsis, resolved
Nosocomial Pneumonia
on top of atypical
pneumonia, resolving
t/c new onset nosocomial
sepsis
FT, 37 weeks by PA,
2700g, AGA, cephalic,
SVD, LBB, NID
Meds:
Meropenem D10
Clarithromycin D
Ibuprofen 1st
dose (for
medical closure
of PDA)
Wean from
ventilator: MV
settings 30%
18/5 30 0.4
Completion of
antibiotics x 14
days
CN: 353 6663
DOA: 02/19/10
LOS: 9 days
BERCASIO,
Rochelle
NB/F
Santos /
Buenaventura
CN: 353 6733
DOA: 02/17/10
LOS: 11 days
LURENZANA,
Zaijan
NB/M
Santos /
Buenaventura
CN: 353 6800
DOA: 02/18/10
LOS: 10 days
FORMORAN,
Gerald
18/M
Santos / Arenas
CN: 353 6262
DOA: 02/16/10
LOS: 12 days
Santos / Arenas
CN: 353 6181
DOA: 02/11/10
LOS: 17 days
CAMERINO,
Shaima
5m/F
DAUD, Sittie
Farhanna
NB/F
Multiple congenital
anomalies (leaking
nasoethmoidal mass,
absent 5th digit of left
hand and constrictive
band 4th digit left hand,
syndactyly right foot, low
set ears) probably
secondary to
1. neural tube sequence
2. amniotic band rupture
3. chromosomal anomaly
t/c infected NEM
Rule out sepsis
Multiple congenital
anomalies (leaking
nasoethmoidal mass,
absent 5th digit of left
hand and constrictive
band 4th digit left hand,
syndactyly right foot, low
set ears) probably
secondary to
1. neural tube sequence
2. amniotic band rupture
3. chromosomal anomaly
S/P Intracranial repair of
NEM (02/24/10)
Infected NEM (MRSA)
T/C Neonatal Pneumonia
R/O Neonatal Sepsis
CNS Infection probably
bacterial meningitis
Hyperbilirubinemia
probably secondary to 1
sepsis 2 abo
incompatibility 3
physiologic
Cleft Lip
Chronic kidney disease
secondary to chronic
glomerulonephritis
Community acquired
pneumonia
Neonatal sepsis, resolving
Bacterial meningitis,
resolving
Physiologic jaundice
Cleft lip
Partially Treated Bacterial
Meningitis
CAP
Gastroschisis
s/p primary closure with IJ
catheter insertion
(02/11/10)
Santos / Arenas
CN: 346 4045
DOA: 02/03/10
LOS: 25 days
RUSEL, Angela
5m / F
Chiari II Malformation
To consider Omaya
reservoir infection
s/p lumbosacral
meningocoele repair (731-09)
s/p VPS insertion (8-2109)
s/p VPS removal,
insertion of Omaya (9-29-
Meds:
Ceftazidime
completed 7
days
Clindamycin D6
Completion of
antibiotics x 14
days
For possible
discharge if no
definite plan for
NEM repair c/o
plastic surgery;
shift antibiotics
to PO
Meds:
Ampicillin D11
Amikacin D11
For completion
of antibiotics x
14 days
End stage renal disease
secondary to chronic
glomerulonephritis
s/p Tenckhoff catheter
insertion (02/21/10)
Community acquired
pneumonia, resolved
Partially Treated Bacterial
Meningitis with
Hydrocephalus, resolving
CAP, resolved
MRSE sepsis, resolving
Gastroschisis
s/p primary closure with IJ
catheter insertion
(02/11/10)
Burn injury (cautery),
resolving
Chiari II Malformation
Omaya tip infection
(Pseudomonas putida and
Burkholderia mallei),
resolving
s/p lumbosacral
meningocoele repair (731-09)
s/p VPS insertion (8-2109)
For discharge
Discharged
Meds:
Vancomycin
D12
Flammazine
For completion
of vancomycin
for 14 days
Meds:
Ceftazidime D13
For VPS
insertion and IJ
cutdown
For completion
of antibiotics for
Santos / Capul
CN 3501231
DOA 11/8/09
LOS: 112 days
MILLARES, NICKY
4yo/F
Santos / Arenas
09)
s/p Omaya Removal
(1/31/10)
Congenital heart disease,
cyanotic, Tetralogy of Fallot
Multiple brain abscess, left
fronto-parietal and left
occipital areas
S/P left frontal tube drain of
left frontal abscess, right
frontal burrhole aspiration of
right medial frontal abscess,
left occipital burrhole
aspiration of left occipital
abscess (11/14/09)
S/P left frontal tube drainage
of abscess (12/5/09)
Multiple dental caries
s/p tooth extraction
CSOM, AU
s/p VPS removal,
at least 3 weeks
insertion of Omaya (9-2909)
s/p Omaya Removal
(1/31/10)
Congenital heart disease,
cyanotic, Tetralogy of Fallot
Multiple brain abscess, left
To complete Meropenem
fronto-parietal and left
D48/53 then repeat cranial
occipital areas, resolving
CT scan.
S/P left frontal tube drain of
left frontal abscess, right
For possible discharge if (-)
frontal burrhole aspiration of
abscess on repeat cranial CT
right medial frontal abscess,
scan
left occipital burrhole
aspiration of left occipital
If meropenem not available,
abscess (11/14/09)
may give oral co-trimoxazole
S/P left frontal tube drainage and ciprofloxacin
of abscess (12/5/09)
Multiple dental caries
s/p tooth extraction
CSOM, AU, resolved