Journal of Pediatric Infectious Diseases - Volume 1, issue 1
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Journal of Pediatric Infectious Diseases is a peer-reviewed medical journal, publishing articles in the field of child infectious diseases. The journal provides an in-depth update on new subjects and current comprehensive coverage of the latest techniques in diagnosis and treatment of childhood infectious diseases.
The following articles will be considered for publication: editorials, original and review articles, rapid communications, case reports, letters to the editor and book reviews.
The aim of the
Journal of Pediatric Infectious Diseases is to share and disseminate knowledge between all disciplines that work in the field of pediatric infectious diseases.
Abstract: Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) colonization and infection has emerged as a serious health problem in children. The epidemic of CAMRSA as a cause of noninvasive and invasive infections has required a change in empiric antibiotic therapy to assure appropriate coverage. The control and prevention of CAMRSA infections is important, but there is very little evidence-based information to guide physicians providing care to children in the outpatient and inpatient settings.
Keywords: Methicillin-resistant, staphylococcus aureus, children
Abstract: Since its discovery in 1970, enterovirus 71 (EV71) has increasingly been recognized as a cause of epidemics of hand-foot-and-mouth disease (HFMD) associated with severe neurological complications in a proportion of cases. There has been a large increase in EV71 epidemic activity throughout the Asia-Pacific region since 1997. Recent HFMD epidemics have been associated with a severe form of brainstem encephalitis associated with pulmonary edema and high case-fatality rates. The emergence of EV71 activity in the Asia-Pacific…region has been associated with the circulation of several distinct genetic lineages that appear to be undergoing rapid evolutionary change. In this review, I will present a synopsis of recent research into the epidemiology and evolution of EV71 in the Asia-Pacific region, the neurological diseases attributable to EV71 infection and the prospects for control of EV71 infections through public health interventions and the development of new antiviral agents and vaccines.
Keywords: Enterovirus 71, neurological disease, Asia-Pacific region
Abstract: Optimal medical care requires that patients receive medications appropriate to their clinical needs. To achieve this objective it is essential that irrational patient management practices are identified, and attempts made towards their correction. A study was done in Tehran to identify prescribing practices in common acute infections in children. Data collected from reviewing the prescriptions given to children in three different settings of ambulatory care, and from interviewing their parents, was documented on a structured…questionnaire. Five hundred prescriptions were reviewed. Three hundred and eight were for acute gastroenteritis and 192 for acute respiratory tract infection. The average number of drugs/prescription was 3.33 ± 1.2; general practitioners prescribed 3.47 ± 1.2 and pediatricians 3.2 ± 1.1 drugs, (P=0.032). Antibiotics were written in 79.4%, and 42.8% included injections. In respiratory infections, antihistamines were prescribed in 73.4%. In gastroenteritis anti-emetics were written for 62% and 61.4% were not given oral rehydration solution (ORS). General practitioners prescribed more medications and less ORS than pediatricians. The difference was statistically significant for injections, ORS and anti-emetic medications (P<0.05). More drugs/prescription and more antibiotics were given in private clinics as compared to public hospitals (P<0.05). We identified inappropriate drug use in acute respiratory and gastrointestinal infections in children receiving outpatient care in Tehran. Before planning successful intervention strategies, it is crucial to develop insight in the socio-cultural incentives that result in irrational prescriptions.
Abstract: To review the clinical features and risk factors for complications and treatment of malaria in a pediatric cohort mainly composed of immigrant children. Retrospective cohort study of all cases of malaria diagnosed between 1991 and 2001 in Montreal, Canada. We have reviewed a total of 121 cases of malaria in children. The majority of which (78%) were immigrants or foreign-born visitors. Most children were originating from African countries and mainly infected with Plasmodium falciparum (63.9%,…versus 21.0%, 5.9%, 3.4% for Plasmodium vivax), Plasmodium ovale and Plasmodium malariae} respectively). Seven patients (5.9%) were co-infected with more than one species. Median times from arrival to presentation were much shorter with P. falciparum (14 days) than other species: P. vivax (98 days), P. ovale (37 days) and P. malariae (31 days). The majority of children had fever, headache and rigors. Ten children (8.3%) had serious complications (cerebral malaria, anemia or shock). All ten patients presented within one month of arrival from their respective endemic country and all were infected with P. falciparum (P=0.03). Three patients required admission to a pediatric intensive care unit and seven required a blood transfusion. All recovered well although two children had P. falciparum recrudescence and three children infected with P. vivax or P. ovale relapsed. The number of complications observed in immigrant children was similar to that observed in travelers. Sickle cell disease was the most significant associated risk factor for serious complications of malaria (P<0.001). Immigrant children are at high risk of complications from malaria. Our study highlights sickle cell disease as a significant risk factor for serious complications of malaria in these children. It is essential to maintain a high index of suspicion in non-endemic areas in order to decrease the morbidity of malaria in immigrant children.
Keywords: Malaria, plasmodium, immigrant and traveler children
Abstract: Laboratory interpretation of susceptibility data concerning the AmpC-producing Enterobacteriaceae is confusing to clinicians. Typical organisms included in this category are Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii, Morganella morganii, and Serratia marcescens. These organisms frequently appear susceptible to extended spectrum cephalosporins by standard in vitro testing, although this is highly contested by treatment failures in cases of invasive infections. The mechanisms of resistance were postulated to be ampC induction or de-repression…during therapy. As an alternative to carbapenems, piperacillin-tazobactam has been commonly used for its apparent activities against AmpC producers. In this laboratory study, when cefoxitin was used as an ampC-inducing agent in vitro, piperacillin-tazobactam showed activity in only a limited number of AmpC producers. Most notably, a temporal disc co-diffusion method detected inducible piperacillin-tazobactam resistance in all 20 strains of S. marcescens tested. With more standardized measurement, this method improves our previous Kirby-Bauer disc approximation method for the detection of ampC-mediated inducible resistance.
Abstract: Improvements in the medical and surgical care of pediatric patients have substantially reduced the incidence of pyogenic liver abscess, which is now a very uncommon condition in children. The purpose of this study was to review five cases of pyogenic liver abscess in children presenting to our hospital. Three patients were managed by percutaneous needle aspiration under ultrasonographic guidance together with antibiotic therapy. Two patients with multiple small abscesses were managed by prolonged antimicrobial treatment…alone. All five patients survived. The etiology, diagnosis and medical and surgical management of liver abscess in children are discussed.
Keywords: Liver abscess, percutaneous drainage, clinical treatment, antibiotics, children
Abstract: Human immunodeficiency virus (HIV) associated arthropathy has been reported in HIV infected adults both from the Western, African as well as Asian countries. Arthritis in HIV infected adults has a wide spectrum of presentation ranging from mild arthralgia to severe joint disability and deformity. Rarely arthritis is the presenting manifestation of acquired immunodeficiency syndrome. Arthritis in HIV infected children is very rare and only one case of an HIV infected child with arthritis has been reported…from the Indian subcontinent. We report an HIV infected child from India who presented with polyarthropathy and dysphagia and had a very good response to antiretroviral therapy.
Abstract: A 5-month-old girl developed intractable cerebral seizures and a global mental and motor retardation after a scheduled hexavalent vaccination. In the following years, recurrent fever, hepatosplenomegaly, and a pancytopenia indicated other organ system involvement. At the age of 4 years the diagnosis of a severe systemic autoimmune disorder was made, defined by highly elevated antinuclear antibody (ANA), smooth muscle antigen (SMA), extractable nuclear antigen, and decreased complement factors C3c and C4. Moreover, a low B cell…count and an IgA and IgG2 subclass deficiency were found. After initiation of an immunosuppressive therapy as well as monthly intravenous immunoglobulin application, the clinical situation improved dramatically. Despite therapy and clinical improvement, there is still an intermittent elevation of ANA and SMA as well as decreased complement C4, a persistent low B cell count and an IgA deficiency. We propose the possibility of an underlying primary immunodeficiency with subsequent development of a severe systemic autoimmune disease possibly triggered by routine vaccination. The clinical features and laboratory tests are consistent with a systemic lupus erythematosus or lupus-like syndrome.