: Dengue remains a major problem in the tropics. Several Asian countries have reported an increasing trend in the proportion of infants with dengue fever. However, most studies are limited to case reports or small case series from isolated outbreaks. We planned this study to look at clinico-laboratory profile, outcome, and predictors of severity in a large cohort of infants over a decade. Electronic medical records of infants admitted at a tertiary center of South India, with laboratory confirmed dengue infection between 2009 and 2019 were reviewed. Diagnosis was based on detection of NS-1 antigen and/or immunoglobulin M antibody against DENV(dengue virus) or positive DENV RNA polymerase chain reaction in infants presenting with acute febrile illness and clinical features consistent with dengue. Of 395 children with dengue admitted during study period, 99 (25%) were infants. A cyclical incidence pattern was noted, with higher cases in alternate years. Fever (99%) was most common, followed by gastrointestinal symptoms (vomiting, diarrhea—28%) and upper respiratory symptoms (cough, coryza—22%). Fifty-three infants had severe dengue, and 39 had shock. Fourteen children had multiorgan dysfunction syndrome, and 13 died. Infants with severe dengue were older than those with nonsevere disease, had lower serum albumin and greater frequency of severe thrombocytopenia, and had coagulopathy. On multivariable analysis, low serum albumin predicted development of severe dengue [P = 0.003, odds ratio 12.4 (95% confidence interval: 2.42–63.7)]. Dengue in infants may be challenging to recognize because of its undifferentiated presentation, with gastrointestinal and upper respiratory symptoms that are similar to other viral illness. Severe dengue is common in this sample, and lower serum albumin at presentation was predictive of severe disease.

Scrub typhus is a zoonotic rickettsial disease caused by the bacterium Orientia tsutsugamushi. The non-specificity of presentation, low index of suspicion and the poor availability of diagnostic tests often lead to delayed diagnosis and significant morbidity and mortality. Temperature, humidity, rainfall and Normalized Difference Vegetation Index (NDVI) on the spatio-temporal clustering of scrub typhus cases in children in three contiguous administrative districts in South India over 5 years were studied. A total of 419 children were diagnosed with scrub typhus during the study period. A surge of children with scrub typhus was noted when the NVDI ranged between 0.6 and 0.8 µm. Temperature, humidity and rainfall had a major role in the incidence of scrub typhus.

Background: Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disorder causing chronic oto‐sino‐pulmonary disease from birth. Since diagnosis is often delayed into childhood or adulthood, early‐life disease burdens remain poorly described. Methods: This retrospective study analyzed disease burdens until 2 years of age and outcomes at 6‐7 years of age in children diagnosed with PCD near birth at two Canadian PCD centers. Results: Thirty‐five infants (median diagnostic age 34 days) were included. All received daily chest physiotherapy, while 52% received daily inhaled hypertonic saline therapy (IHS) from diagnosis. By 2 years of age, 66% experienced outpatient respiratory exacerbations, 29% had inpatient respiratory exacerbations, 60% required emergency room visits for respiratory illness, and 14% had Pseudomonas aeruginosa in sputum cultures. Abnormal audiology occurred in 91% screened, and 49% required tympanostomy tubes. Despite early diagnosis and therapy, spirometry showed a trend towards obstruction (mean FEV₁/FVC ratio Z‐score ‐1.43) by 7 years of age. Infants on daily IHS from birth (n = 18, mostly at one center) had significantly fewer Pseudomonas aeruginosa sputum isolates (0% vs. 29%, p = 0.02) but significantly increased inpatient respiratory exacerbations (44% vs. 12%, p = 0.04) compared to infants not on regular IHS ( n = 17). Conclusion: Despite early diagnosis, ongoing respiratory surveillance, and regular airway clearance, infants with PCD develop frequent respiratory infections and have high clinical care burdens. Infants have markedly increased risk of hearing loss, warranting universal screening and close follow‐up. Inhaled hypertonic saline may influence early Pseudomonas acquisition and hospitalization risk, warranting prospective study of this commonly prescribed therapy.

Early diagnosis of cystic fibrosis (CF) through newborn screening (NBS) improves clinical outcomes, but in countries like India, delayed diagnosis increases morbidity, mortality, and likely underestimates infant deaths from CF. We performed a retrospective study at a single center in south India from 2017 to 2025 reviewing children diagnosed with CF before one year of age. Patient demographic, clinical, and genetic data were analyzed to characterize early clinical features and identify factors linked to mortality. Of 56 infants diagnosed with CF, 59% survived (median current age 55 months) while 41% died (median age of death 5 months). Key clinical indicators included sibling death with CF-like symptoms, rapid weight loss, and persistent respiratory or nutritional complications. Mortality risk under one year was significantly linked to hypoalbuminemia (OR 9.7), severe malnutrition (OR 4.4), severe anemia (hemoglobin < 7 g/dL) requiring blood transfusions (OR 3.0), and peripheral edema (OR 4.2). A triad of anemia, hypoalbuminemia, and edema was found to strongly predict death (OR 4.2). Integrating clinical checklists of these manifestations into primary healthcare may improve prompt referrals for earlier diagnosis and treatment. Continued education and advocacy for NBS are essential to reduce potentially preventable CF-related deaths in young children.