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Dr. Tanu Singhal

Consultant - Paediatrics and Infectious Disease
MD Paediatrics, MSc- Tropical and Infectious Disease

Expertise

Pediatric and Infectious Disease

Services Offered

Pediatrics, Infectious Disease, Infection Control, Travel Medicine

Dr Tanu has pursued MD Paediatrics from prestigious institute of AIIMS and MSc in Tropical and Infectious Disease from London School of Hygiene and Tropical Medicine-UK

She has previously worked as Consultant Pediatrics and Infectious Disease at Hinduja Hospital, Mumbai for duration of six years.

KDAH Experience :

As a general paediatrician, she runs a well baby clinic, provides immunization services and treats routine day-to-day illnesses. She is an expert in management of common childhood infections such as malaria, dengue, typhoid, tuberculosis, urinary tract infections etc and has been involved in developing national guidelines for these illnesses.

Apart from this, she has expertise in management of antibiotic Resistant Infections, Multi Drug Resistant Tuberculosis, Hospital Acquired Infections, HIV, Immunodeficiencies, Fever of Unknown Origin and Exotic Infections in both adults and children.

She also runs a travel clinic at the hospital, which provides comprehensive services to both outbound and inbound travellers including vaccination.

She is one of the core members of the infection control committee of the hospital and integrally involved in running the infection control program.

Doctor'sScorecard

  • Disease No. of Cases Treated International Success Rate KDAH Success Rate
    MDR Tuberculosis in children >50 80% 99%

  • National Convener of the IAP Committee on Immunization 2007-2008.
  • Associate Editor of the Pediatric Infectious Disease Journal a quarterly publication of the IAP Infectious Disease Chapter
  • 65 publications in national and international peer reviewed journals, 25 book chapters and two books on immunization and rational antimicrobial therapy in Pediatrics
  • The Frederick Murgatroyd Prize for the best student in the MSc course of Tropical Medicine and International Health, 2001-2002 at the London School of Hygiene and Tropical Medicine, London, UK.
  • The Aga Khan International Scholarship 2001-2002 awarded by the Aga Khan Foundation.
  • The Dr P.N. Berry Scholarship for the year 2001-2002 awarded by The Dr P.N. Berry Educational Trust, UK.
  • The Sorel Catherine Freymann prize for the best postgraduate in Pediatrics, 1998. Awarded by the Dean, All India= Institute of Medical Sciences.
  • The Bhamashah Award for outstanding achievements in MBBS, 1994-1995. Awarded by the Maharana Mewar Foundation, Udaipur, India.
  • Eleven gold medals for highest marks and distinction in 8 subjects and the first position in the University in the First, Second and Final MBBS examinations during the MBBS course at SMS Medical College, Jaipur.

Dr. Manish Pruthi, Dr Ahmad Quazi, Dr Tanu Singhal: Allograft-vascularized fibula composite for infected non union femur

XDR tuberculosis in a 16 year old boy

A 16 year old boy presented with fever and cough for 1 month duration. The CT was suggestive of pulmonary tuberculosis with a pleural effusion. Culture samples confirmed the presence of mycobacterium tuberculosis, which was resistant to all first line drugs, quinolones and even 2nd line injectable agents. The child was started on a 2nd line drug regime with quinolones, aminoglycosides, QPAS, clofazimine and linezolid, coamoxiclav, clarithromycin and he improved. 4 months later he developed thrombocytopenia so linezolid was withdrawn. Three months later he developed tubercular meningitis. He was admitted to the hospital and treatment continued with the same drugs and meropenem and amoxiclav was added. He did not improve and then again linezolid was restarted. He developed peripheral neuropathy that was managed with coenzyme Q and drugs were continued. Effort was made t procure bedaquiline which failed. Injectable capreomycin was also started. After about 6 months he started to improve and 18 months later treatment was stopped. He is asymptomatic over the past 6 months. The predicted mortality of XDR tubercular meningitis is in excess of 80% and it was gratifying to save this child

Severe mycobacterium abscessus infection following liposuction

A 23 year old model developed multiple skin abscesses soon after liposuction surgery. She presented to another hospital where was advised radical debridement surgery for her entire back and thighs which would have been associated with very high mortality and morbidity. She took discharge from that hospital and presented to us. Here we sent her pus samples for analysis and detected infection due to mycobacterium abscessus. She was managed conservatively with repeated incision, drainage, and antibiotics including clarithromycin, linezolid and amikacin. She finally recovered after 6 months with very small residual scars and has resumed her modelling career. Mycobacterium abscessus is a rapidly growing mycobacteria that is associated with laparoscopic and cosmetic surgeries and can be managed conservatively with the right combination of antibiotics.

Unusual cause of Aseptic Meningitis in a 5-month-old infant

A 5-month-old infant presented with history of fever for 10 days. She was investigated on day 5 of fever and due to associated irritability a CSF analysis was done which showed around 100 cells predominantly lymphocytes. She was treated with IV ceftriaxone but her fever persisted and antibiotics were upgraded to piperacillin tazobactam. Fever persisted and the WBC and platelets kept rising and she was referred to us. At the time of presentation, she was extremely irritable but there were no other findings. In view of high WBC and platelet counts and high CRP and mild elevation of AST and ALT and also aseptic meningitis, Kawasaki disease was suspected and a 2D ECHO was done. It showed coronary artery aneurysms and the baby was treated with IVIG following which the fever subsided and the aneurysms have lessened over the past few years. Kawasaki disease a medium vessel vasculitis is an unusual cause of fever in children. Infants are unique that they may have none of the tell tale signs such as red lips and tongue and rash. If the diagnosis is delayed there is a 20% risk of coronary artery aneurysms with associated risks of myocardial infarction in later life. Use of IVIG in the first 10 days cuts down this risk to around 1%

Why babies are not small adults?

A 4-month-old infant had history of fever with no focus. A CBC showed high WBC count with predominant polymorphs. His CSR, urine routine and USG abdomen was normal. He was prescribed coamoxiclav with which the fever resolved. Three days later a repeat CBC showed a count of 36,000. The baby presented to the ER of our hospital and was admitted. On history taking, it revealed that the baby was finding it difficult to suck on the breast and lost neck control. An urgent MRI was done which showed a large retropharyngeal abscess that was impinging the airway for which urgent surgical drainage done. Retropharyngeal abscess is one of the occult sites of infection in infants and children along with brain abscess/ sinusitis, osteomyelitis etc. Diagnosis is delayed since the infant cannot localise the infection and are unable to communicate. This makes pediatric practice so challenging and different from adult medicine

Are we in Africa?

A 6-week-old baby presented from a small village near Amreli with fever for 10 days duration. A CBC was done and the PS showed trypomastigotes .This was shocking since trypanosomiasis is unheard of in India unlike Africa where it is fairly common and known as sleeping sickness. The parasite was sent for identification to a higher centre, which identified it, is Trypanosoma lewisi, an animal trypanosome. Review of literature revealed scattered cases in India due to close contact between animals and humans. The baby probably acquired it from contaminated rat excreta which is known to contain this trypanosomes. Since the baby was well and treatment is very toxic, treatment was deferred and the baby recovered spontaneously.

This was followed 1 year later by another case in an adult this time. He was a 48 year old African male residing in Lusaka, Zambia presenting with a progressive neurodegenerative disorder. He came to Kokilaben for neuro rehabilitation. Review of MRI was suggestive of trypanosomiasis. During an acute worsening event, PS for trypomastigotes was sent which was positive. Antimony based treatment was procured from Africa but the patient died. It was indeed surprising that the diagnosis of a disease endemic to Africa was not made there and made here. With increasing international travel and medical tourism it is important to be aware of world wide epidemiology of infectious diseases.

No. Journal Code Department Type Download
1 408 Centre for Children International -

Publication/Talk Title : Conjugate Vaccines For Enteric Fever

Journal Published : Journal Of Infection In Developing Countries

2 388 Centre for Children National -

Publication/Talk Title : Rickettsial Infections

Journal Published : Advances In Pediatrics

3 387 Centre for Children National -

Publication/Talk Title : Infectious Diseases

Journal Published : Ghai’s Essential Pediatrics

4 386 Centre for Children National -

Publication/Talk Title : Mycoplasma Infections: Treatment And Prognosis In Pediatrics

Journal Published : Treatment And Prognosis In Pediatrics

5 385 Centre for Children National -

Publication/Talk Title : Sepsis And Septic Shock In Children

Journal Published : Textbook Of Pediatric Infectious Diseases

6 384 Centre for Children National -

Publication/Talk Title : Immunodeficiency Disorders

Journal Published : IAP Textbook Of Pediatrics

7 383 Centre for Children National -

Publication/Talk Title : Rational Antimicrobial Practice In Pediatrics

Journal Published : Post graduate text book Of Pediatrics

8 382 Centre for Children National -

Publication/Talk Title : FAQ’s In Sepsis And Septic Shock

Journal Published : IAP Text Book On FAQ’s In Pediatric Infectious Disease

9 381 Centre for Children National -

Publication/Talk Title : General Recommendations On Vaccines

Journal Published : IAP Text Book On Vaccines

10 380 Centre for Children National -

Publication/Talk Title : Mycoplasma

Journal Published : Post Graduate Text Book Of Pediatrics

11 282 Centre for Children National -

Publication/Talk Title : Hand Hygiene

Journal Published : Journal Of The Indian Academy Of Pediatrics

12 280 Centre for Children National -

Publication/Talk Title : Impact Of A Multidimensional Strategy To Reduce Ventilator-Associated Pneumonia In Neonatal Intensive Care Units In 10 Developing Countries

Journal Published : Infect Control Hosp Epidemiol

13 277 Centre for Children National -

Publication/Talk Title : Delayed Diagnosis Of Infective Endocarditis In A Child With A Normal Heart

Journal Published : Indian Journal Of Pediatrics

14 276 Centre for Children National -

Publication/Talk Title : The Outcome Of Treating ESBL Infections With Carbapenem Vs Non Carbapenem Antimicrobials

Journal Published : Journal Of The Association Of Physicians Of India

15 275 Centre for Children National -

Publication/Talk Title : Tuberculosis: How Long To Treat

Journal Published : Pediatric Infectious Diseases Journal

16 274 Centre for Children National -

Publication/Talk Title : Urine Analysis And Urine Culture

Journal Published : Pediatric Infectious Diseases Journal

17 273 Centre for Children National -

Publication/Talk Title : Symposium On Infections Old And New

Journal Published : Indian Journal Of Pediatrics

18 272 Centre for Children National -

Publication/Talk Title : Blood Cultures Revisited

Journal Published : Pediatric Infectious Diseases Journal

19 271 Centre for Children National -

Publication/Talk Title : How Good Is Compliance With Surgical Antibiotic Prophylaxis Guidelines In A Tertiary Care Private Hospital In India? A Prospective Study

Journal Published : Indian Journal Of Surgery

20 270 Centre for Children National -

Publication/Talk Title : Enteric fever

Journal Published : Pediatric Infectious Diseases Journal

21 269 Centre for Children National -

Publication/Talk Title : Alleviation Of Pain Associated With Immunization Injections

Journal Published : Indian Pediatrics

22 268 Centre for Children National -

Publication/Talk Title : A 1.5 Year Old With Recurrent Fever

Journal Published : Pediatric Infectious Diseases Journal

23 267 Centre for Children National -

Publication/Talk Title : TB or Not TB

Journal Published : Pediatric Infectious Diseases Journal

24 266 Centre for Children National -

Publication/Talk Title : Management Of Drug-Resistant TB With Individualised DST-The Way Forward?

Journal Published : Journal Of Association Of Physicians Of India

25 256 Centre for Children National -

Publication/Talk Title : Mal-Absorptive Bariatric Procedure Causing Keshan’s Disease

Journal Published : Journal Of Advances In Obesity, Weight Management & Control

26 196 Centre for Children International -

Publication/Talk Title : Socioeconomic Impact On Device-Associated Infections In Limited-Resource Neonatal Intensive Care Units: Findings Of The INICC

Journal Published : International Nosocomial Infection Control Consortium

27 195 Centre for Children International -

Publication/Talk Title : Injection Practices In India

Journal Published : WHO South-East Asia Journal Of Public Health

28 194 Centre for Children International -

Publication/Talk Title : International Nosocomial Infection Control Consortium (INICC) Report, Data Summary Of 36 Countries, 2004-2009.

Journal Published : American Journal Of Infection Control

29 193 Centre for Children International -

Publication/Talk Title : International Nosocomial Infection Control Consortium (INICC) Report, Data Summary Of 30 Countries, 2005-2010

Journal Published : Infect Control Hosp Epidemiol.

30 192 Centre for Children International -

Publication/Talk Title : Impact Of An International Nosocomial Infection Control Consortium Multidimensional Approach On Central Line-Associated Bloodstream Infection Rates In Adult Intensive Care Units In Eight Cities In India

Journal Published : International Journal Of Infectious Disease

31 191 Centre for Children International -

Publication/Talk Title : The Worldwide Antibiotic Resistance And Prescribing In European Children (ARPEC) Point Prevalence Survey: Developing Hospital-Quality Indicators Of Antibiotic Prescribing For Children

Journal Published : Journal Of Antimicrobial Chemotherapy

32 174 Centre for Children International -

Publication/Talk Title : Parkinsonism In Human African Trypanosomiasis: Clinical Course, Imaging Findings And Treatment-Related Challenges

Journal Published : International Congress Of Parkinson's Disease And Movement Disorders

33 158 Centre for Children International -

Publication/Talk Title : A 4-Year Prospective Study To Determine The Incidence And Microbial Etiology Of Surgical Site Infections At A Private Tertiary Care Hospital In Mumbai, India

Journal Published : American Journal Of Infection Control

34 98 Centre for Children National Download

Publication/Talk Title : Outbreak of Burkholderia Cepacia Complex Bacteremia in a Chemotherapy Day Care Unit Due to Intrinsic Contamination of an Antiemetic Drug

Journal Published : Indian Journal of Medical Microbiology

35 86 Centre for Children National Download

Publication/Talk Title : Pioneers in Infection Prevention-Part 1

Journal Published : Journal of the Association of Physicians of India

36 81 Centre for Children National Download

Publication/Talk Title : Pioneers in Infection Prevention-Part 2

Journal Published : Journal of the Association of Physicians of India

37 80 Centre for Children National Download

Publication/Talk Title : Pioneers in Parasitology

Journal Published : Journal of the Association of Physicians of India

38 78 Centre for Children National Download

Publication/Talk Title : Pioneers in Vaccinology

Journal Published : Journal of the Association of Physicians of India

39 65 Centre for Children National Download

Publication/Talk Title : The Microbial Etiology and Antimicrobial Susceptibility of Bloodstream Infections in Patients with Cancer at a Private Tertiary Care Hospital in Mumbai,India

Journal Published : Indian Journal of Cancer

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