Journal of Pediatric Infectious Diseases - Volume 2, issue 2
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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: Today there are as many as 16–30 million cases of enteric fever per year, almost exclusively in the developing world caused mainly by unhygienic conditions and poor sanitations, with a mortality rate of 10%. Typhoid fever is important surgically because abdominal complications such as intestinal perforation, bleeding, cholecystitis and pancreatitis represent the most serious complications of the illness. Typhoid perforation of the ileum is one of the most common causes of bowel perforation in the developing…world. This review will focus on surgical complications and management in children. Persistent or severe enteric fever usually culminates in some surgical complications in the form of hemorrhage, perforation, cholecystitis, pancreatitis, hepatitis, abscess etc. Morbidity and mortality are significantly high in children than in adults. Timely and proper surgical intervention are pivotal in reducing morbidity and mortality from surgical complications of enteric fever. Hypovolemia and sepsis must be corrected by hydration and antibiotics followed by definitive treatment of the underlying complication. Enteric fever continues to be a menace for children in third world countries. Underestimated incidence is due to the lack of a simple diagnostic test for enteric fever. Perforations and hemorrhage are the complications to be managed meticulously. Early diagnosis of perforation and surgical intervention reduces morbidity as well as mortality.
Abstract: The therapy of pediculosis remains a common problem in pediatric clinical practice. As resistance to commonly used chemical pediculicides, such as permethrin, is constantly increasing, there is a need for the development of new compounds that are effective in causing mortality in adult lice and their eggs. Natural products have been used in traditional medicine for thousands of years and recently have been of increasing interest, since the costs are usually lower and they are considered…less toxic by the public. Here we present a review on plant compounds used for the treatment of head lice. An overview is given on published evidence on the use of natural product pediculicides and ovicides in clinical trials and in vitro studies. We conclude that several plant products offer promise for new compounds to treat head lice infestation. However, the number of clinical studies is very limited, and there is an urgent need to increase research assessing the effectiveness and safety of promising compounds. Over the counter natural products should be supported by in vitro data and by adequately designed comparative trials that evaluate cure rates and safety.
Keywords: Head lice, pediculosis, natural product, essential oil, efficacy, therapy
Abstract: There are no reports of the use of an integrated care pathway (ICP) to facilitate the management of pleural empyema in children. Our aim is to assess pleural empyema management in our institute, to establish an ICP and to review the impact of this on the patient journey. Data were collected about management strategies, pain control and length of hospital stay from children admitted in 2000 with a diagnosis of pleural empyema. An integrated care pathway…was developed to facilitate change in practice and provide greater consistency in management. This incorporated the use of intrapleural urokinase and guidelines on pain control. This was followed by data collection in 2004 to review the impact of the integrated care pathway. The 2000 review revealed that the majority of children (eight of 13) underwent a primary surgical intervention. Urokinase was not used. The median length of stay was 11.5 days (range 4–49 days). Implementation of the pathway led to a reduction in the number of children who underwent surgery (one of 18) with no adverse impact on clinical outcome. Median length of stay was 9 days (range 2–28 days). Children had a smoother patient journey, with prompter investigation and intervention. Children on the pathway had smaller chest drains inserted, received urokinase and had a clearly recorded analgesia strategy. Pleural empyema in childhood requires multi-disciplinary management. The implementation of an integrated care pathway is a valuable tool for managing a condition that requires multi-disciplinary input.
Keywords: Integrated care pathway, pleural empyema, intrapleural urokinase
Abstract: The aim of this cross-sectional study was to determine the prevalence and types of oro-facial lesions and their relationship with the degree of immune suppression in human immunodeficiency virus (HIV)-infected children. This was compared with the prevalence among healthy HIV-negative children. The study was carried out in a tertiary institution in Southwestern Nigeria from May 2005 to March 2006. None of the children in the study had ever been treated with antiretroviral drugs. Thirty-four (87.2%) of…39 HIV infected children and two (9.5%) of the 21 HIV-uninfected children had oro-facial lesions (Fisher's exact, P=0.0001). In the HIV-infected children, lymphadenopathy was the commonest lesion (82.1%) followed by oral candidiasis (43.6%), gingivitis (25.6%) and bilateral parotid enlargement (25.6%). The most common form of candidiasis was pseudomembranous. All the oro-facial lesions were more common in children with severe immune suppression and were not related to the age, gender or socioeconomic class of the children. It is therefore concluded that there is a high prevalence of oro-facial lesions in HIV-infected children in this study particularly in those with severe immune suppression. These lesions could serve as surrogate markers of HIV infection and aid in initiating prompt diagnosis where routine laboratory investigation for all children at risk is economically not feasible.
Abstract: We conducted an epidemiologic study on the incidence of Salmonella infections and the associated risk factors in children aged <1 in the state of Michigan. Data on laboratory-confirmed cases of salmonellosis from 1995–2001 were abstracted from the records of Michigan Department of Community Health. We computed the incidence of the disease by sex, race, and area of residence and analyzed the relationships between selected demographic characteristics and Salmonella infection using Poisson regression…analysis. Based on a total of 690 cases, an overall incidence of 73.3/100,000, with an incidence of 84.3/100,000 in male children and 64.9/100,000 in female children, were found. The final covariate-adjusted Poisson model showed that children aged 1–5 months are at higher risk for salmonellosis compared to children aged 6–11 months (RR: 1.80, CI: 1.54–2.10), African-American children are at higher risk than their Caucasian counterparts (RR: 2.63, CI: 2.16–3.19), and male children more commonly represented among cases (RR: 1.30, CI: 1.12–1.51). These findings should be considered by healthcare authorities in Michigan and in states with similar population demographics to investigate possible risk factors that may be associated with the high incidence of salmonellosis in African-American children and in children <6 months.
Abstract: The 7 valent conjugate pneumococcal vaccine (PCV7) has been shown to have a broad impact on the rate of invasive pneumococcal disease in children as well as the frequency of colonization and disease with other common respiratory bacterial pathogens like Moraxella catarrhalis. This study investigated whether these changes have translated to changes in M. catarrhalis bacteremia. We screened all children with blood cultures performed at our center in the years pre- (1997–1999) and post- (2001–2004) PCV7…institution. There were six cases of M. catarrhalis bacteremia (pre-PCV7: 2, post-PCV7: 4) or a rate of 11/10,000 blood cultures. PCV7 had no discernable effect on frequency. In comparison to matched patients with Streptococcus pneumoniae bacteremia, children with M. catarrhalis had lower fever and white blood cell counts with better outcomes. There was no discernable change in frequencies of M. catarrhalis bacteremia due to the introduction of PCV7.
Abstract: Over the past two decades, reports of pertussis have increased considerably in the United States of America (USA) in people of all ages. The most striking increases have taken place among adolescents and adults. The aim of this study is to evaluate pertussis awareness among internists and family practice physicians in the state of Michigan in the USA. This study consists of a survey of internists and family practice physicians in the state of Michigan. The…survey instrument is a questionnaire containing one clinical vignette that presents an adult who has prolonged afebrile cough and normal physical examination, followed by three multiple-choice questions. The first question was about the differential diagnosis; pertussis was included among the choices in this question. The other two questions were about antibiotic prescribing for the patient as well as the family members. Out of 500 physicians, 148 (30%) responded to our survey. Fifty-five physicians (37.2%) included pertussis among their differential diagnosis. Only seven (4.7%) selected pertussis as a single diagnosis. Among the physicians who selected pertussis, 49 (89%) prescribed antibiotics to the patient and forty-seven (85%) prescribed antibiotics to the family members. This study demonstrates that two out of three (or 63%) of internists and family practice physicians in the state of Michigan in the USA who responded to our survey overlooked the diagnosis of pertussis in adults. Though the number of the physicians who responded to this survey was relatively small, still it is an important finding and it merits more studies to shed the light on this imperative issue. It is important for the clinicians who treat adults to be aware of the resurgence of pertussis, to be familiar with its diagnosis and treatment, and to understand the options for prevention.
Keywords: Pertussis awareness, internists, family practice physicians
Abstract: Vertically infected children may progress rapidly to acquired immunodeficiency syndrome or progression of disease is much slower as demonstrated in our case report. This is a report of a 14-year-old boy with vertically transmitted slow progress human immunodeficiency virus (HIV) and pulmonary tuberculosis presented with a low-grade fever, chronic cough and weight loss for 2 months. He was treated with antituberculous drugs followed by highly active antiretrovirals with dramatic improvements. The prognosis of…pediatric acquired immunodeficiency syndrome has improved with more widespread availability and use of combination antiretrovirals. These findings have implications for health, education, and other support-service provision. Many services can aid in the prevention of mother-to-child transmission of HIV and the care of HIV-infected mothers and their children.
Keywords: Slow progression, HIV, tuberculosis, prevention of mother to child transmission
Abstract: Cutaneous tuberculosis is a major cause of morbidity in children in India. Lupus vulgaris is one of the commonest manifestations. The clinical recognition of lupus vulgaris may be difficult with atypical presentation. It is important to have a high index of suspicion to recognize and treat these children to prevent morbidities. The buttocks are common but often neglected sites for lupus vulgaris in children. We present a case report of lupus vulgaris occurring on the buttocks,…and discuss our approach in diagnosis and treatment.