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With antibiotic resistance on the rise and emergence of superbugs, should antibiotics such as carbapenems and colistin be used by general pediatricians_?
Yes, they can be used
No, they can be used only by critical care intensivists or PID doctors
 
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>>> Q. Mani Kant Kumar, Punit Kumar Singh

Department of Pediatrics, and Department of Dermatology , Narayan Medical College and Hospital, Jamuhar,Sasaram, Bihar, India.


Address for Correspondence: Dr Mani Kant Kumar, Assistant Professor, Department of Pediatrics, Narayan Medical College And Hospital , VPO-Jamuhar, Sasaram, Dist- Rohtas, Bihar -821305, India. Email: manikant7@yahoo.com

A 14 months old male child youngest of 2 siblings, product of non consanguineous parentage presented with abnormality of all fingernails and toenails since birth. There were no similar nail changes in any other family member in two generations. There was no history of natal teeth. Anthropometrically and developmentally the child was within normal limit age. On examination, all the fingernails and toenails were dystrophic, discolored, and thickened, with subungual hyperkeratosis causing distal elevation of nail plates with wedge-shaped deformity of the nails {Fig}. Oral cavity was normal. On investigation complete hemogram, renal function test, liver function test and urine routine were normal. Parents were couselled regarding available treatment options and asked for regular follow-up.

What is the diagnosis_?

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