Journal of Pediatric Infectious Diseases - Volume 2, issue 4
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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: Japanese encephalitis (JE) is an important mosquito-borne infection. As a zoonosis, JE cannot be eradicated, but reduction of the human disease burden can be achieved through routine childhood vaccination in endemic countries, which is a low cost, high benefit measure. This article will review the worldwide epidemiology, vector transmission, genetics and molecular biology of JE, as well as present the pathophysiology, clinical manifestations and complications, diagnosis, treatment and prevention of JE.
Abstract: Osteomyelitis and septic arthritis show similar problems in diagnosis and treatment. The majority of bone or joint infections are caused by spread of the bacteria through the bloodstream or occasionally by entry of organisms through an open wound, by puncture or by extension of infection from adjacent tissue. The most common causative organism is Staphylococcus aureus but many other organisms may be responsible for a bone or joint infections. Successful treatment of osteomyelitis and septic arthritis…in infancy and childhood depends on early recognition and prompt institution of therapy. Inappropriate or delayed treatment may result in chronic osteomyelitis or irreversible joint destruction. This article reviews current information regarding pathogenesis, epidemiology and microbiology of pediatric osteomyelitis and septic arthritis and the clinical presentation, diagnosis and treatment of these infections.
Abstract: Severe malaria has varying patterns and the relative contributions to individual symptoms to mortality differ with endemicity, geographic locations, access to health services, age but the clinical spectrum has not been described in our study area. Between January 2005 and February 2006, symptoms and signs of severe malaria and the fatality rate among 124 febrile children less than 5 years in Agbor, Delta State, Nigeria were investigated using World Health Organization (WHO) criteria for severe malaria,…microscopic parasitemia and standard hematological methods. Fever (100%) was the most frequent symptom encountered among the children diagnosed as severe malaria, while muscle and joint pains (16.1%) were the least common symptoms. The most common sign was severe anemia (100%), while abnormal posture (10.5%) was the least frequent sign in these children. They also had malnutrition (96.8%) associated with severe malaria. Using the WHO criteria for definition of severe malaria, eight clinical features namely severe anemia (100%), malnutrition (96.8%), prostration (87.1%), respiratory distress (55.6%), splenomegaly (38.7%), multiple seizures (44.4%), jaundice (27.1%), and impaired consciousness (20.2%) were reported among the children. Patients were hypoglycemic as reflected in the mean blood glucose of 61.7 ± 0.2 mg/dL. The fatality rate among the children was 6.5% comprising 2/60, (3.3%) children below 12 months and 6/64, (9.4%} children above 12 months. The multivariate analysis showed that children below 12 months old had increased risk of hepatomegaly [Odds ration (OR)=2.1, 95% confidence interval (CI) 2.0–3.5], splenomegaly (OR=0.43, 95% CI 0.0–0.71), impaired consciousness (OR=0.37, 95% CI 0.0–0.88), while children above 12 months of age had increased risk in respiratory distress (OR=0.19, 95% CI 0.0–0.71) and multiple seizures (OR=0.27, 95% CI 0.0–0.89). Hypoglycemia malnutrition, prostration, multiple seizures, respiratory distress, leukopenia and severe anemia with poor prognostic values are predictors of fatal outcome of severe malaria in our locality study.
Keywords: Severe malaria, Plasmodium falciparum, child, hematological parameter, Nigeria
Abstract: Viral gastroenteritis is considered a significant cause of death and is a common cause of hospitalization worldwide. This study was performed to assess the role of rota, adeno and astrovirus in children with acute diarrhea in one main children's hospital in Amirkola, Babol North of Iran. In this cross-sectional study, stool specimens from 208 children suffering from acute diarrhea referred to Amirkola children's hospital were tested for the presence of rota, adeno and astrovirus by a…monoclonal antibody-based enzyme immunoassay. Demographic data were gathered by a questionnaire. The prevalence of viral causes of acute gastroenteritis was reported by relative frequency. Rota, adeno and astrovirus antigens were detected in 61.1%, 2.9% and 2.4% of patients respectively. Infants between 6 and 12 months of age were most frequently affected by rotavirus (29.8%) (P< 0.03). Rotavirus infection was significantly less frequent in summer and spring than winter and autumn (P< 0.0001). No significant difference was observed in rotavirus infection between male and female but the prevalence of adenovirus in girls was significantly higher than boys (P< 0.05). Rotavirus can be regarded as a major etiologic agent of acute diarrhea in children less than two years old at Amirkola children's hospital, Babol. Immunization may protect the children before their first symptomatic infection.
Abstract: Tinea capitis is a dermatophytic infection of the scalp. It is frequent in Tunisia especially in children. We retrospectively report a six-year study involving children seen in the Habib Thameur teaching Hospital of Tunis with the diagnosis of tinea capitis. The purpose of the current study was to determine the prevalence, clinical types, and causative species of childhood tinea capitis in Tunis. Our study was conducted from January 2000 to December 2006. Patients included in…this study fulfilled the following criteria: they were younger than 18 years and have an evocative clinical aspect of tinea capitis. Skin scrapings and hair roots were collected from each patient. According to these data, our patients were divided into three groups: tinea capitis superficialis, tinea capitis profunda (kerion celsi) and favus. Two-hundred and four patients were enrolled in the study. Pre-school children were affected in 47% (96/204) of the cases. Trichophyton violaceum and Microsporum canis were the two most causative dermatophytes. Cats were found to be reservoir in 26 (13%) patients. Tinea corporis was simultaneously present in 27 (13% patients. Treatment was based on griseofulvin (20 mg/kg/day for 5 weeks) and was efficient in 192 (94%) patients. Tinea capitis remains a common affection in Mediterranean children. The causative fungi vary with geography and time. In Tunisia, thanks to improvement in socio-economic conditions, favus becomes a very rare affection. T. violaceum, the most predominant causative agent of tinea capitis since the eighties is currently caught by M. canis. This is probably related to a frequent cohabitation with pets. Griseofulvin remains the reference regarding first line treatment of tinea capitis in our country.
Abstract: Brucellosis is a common infection of children in Iran. Considering the prevalence of complications in children, early diagnosis and treatment are crucial for prevention of morbidity and mortality. We retrospectively (1996–2005) studied all children who were diagnosed with brucellosis in one of the largest referral pediatric hospitals in Tehran, Iran. Inclusion criteria were positive Wright test (⩾ 1/80 in Iranian population) and 2-mercaptoethanol (⩾ 1/20) or isolation of brucella in sterile body…fluids. Clinical manifestations, serologic, radiologic and other laboratory findings were analyzed. Data were evaluated on medical reports of 54 children with brucellosis during 1996–2005. The clinical manifestations varied: fever in 40 patients (72%), arthralgia in 27 (50%), hepatosplenomegaly in 18 (32%) and gastrointestinal involvement in 17 (31%). One third of patients had anemia and 25 of them (46%) had low mean corpuscular volume values. Erythrocyte sedimentation rate was more than 20 in 34 (75%) of examined patients. Wright was performed in all patients, 26 (48%) of whom had titers equal or more than 1/320. Coombs Wright was 1/320 in 18 (33%), and 2-mercaptoethanol was positive in all patients (⩾ 1/20). Common antibiotic regimens were co-trimoxazole plus rifampin, co-trimoxazole plus streptomycin and co-trimoxazole plus rifampin and gentamicin. Brucellosis presents with variable manifestations, so diagnosis may be difficult, resulting in~delay of treatment. Therefore, early diagnosis and treatment by more effective combinations will be useful for decreasing the rate of morbidity, mortality and relapse.
Abstract: Necrotizing fasciitis is a bacterial infection of the soft tissues with a fulminant course and a high mortality rate. It is rare in children and early recognition with aggressive treatment can help in improving the survival in these cases. During the study period 12 children with mean age of 35 months developed necrotizing fasciitis. Common initiating factors observed were varicella infection and minor injury. The trunk was the most common site of involvement. Tissue culture was…positive in 10 cases, of which three were polymicrobial. Blood cultures were positive in three cases. Staphylococcus aureus was the most common pathogen. All the cases were treated with parenteral antibiotics and 10 cases required surgical intervention. Complications included thrombocytopenia, shock, acute renal failure, septicemia, disseminated intravascular coagulation and multiorgan failure. Two patients died (mortality rate 16.7%). Early diagnosis and aggressive treatment in a Pediatric Intensive Care Unit may have contributed to decreased mortality compared with earlier studies.
Keywords: Necrotizing fasciitis, Staphylococcus aureus, children
Abstract: We report the case of a 12-year-old girl who had returned to the UK from Nigeria two days prior to presenting with fever and breathing difficulties. She had high-grade pyrexia, was mildly dehydrated and lethargic but there were no abnormal findings on auscultation. Initially she required 5l/min of oxygen to maintain adequate oxygenation. The chest X-ray showed bilateral shadowing consistent with pulmonary edema and early acute respiratory distress syndrome (ARDS). The patient was admitted to pediatric…intensive care unit and intubated six hours later due to increasing oxygen requirement and deteriorating level of consciousness. Thin blood films revealed Plasmodium falciparum infection with high-grade parasitemia (13%. commenced on intravenous quinine. No further complications were observed, apart from mild renal impairment. She made a remarkable recovery, was extubated after four days of ventilation and discharged without residual problems five days later. Lung function tests at follow up revealed no abnormalities. Acute lung injury (ALI) secondary to P. falciparum malaria, which includes pulmonary edema and ARDS at the severe end of the spectrum, is not uncommon in adults, and has been reported to occur in up to 30% of malaria patients who require admission to the intensive care unit. In contrast, ALI is a relatively rare complication in pediatric patients. Many of these patients with ALI simultaneously develop other complications of malaria including acute renal failure, hypotension and cerebral malaria. Adult studies have reported overall mortality rates of approximately 50% in patients with ALI secondary to malaria; however, the majority of survivors have no long-term respiratory sequelae.
Abstract: We report a case of Salmonella typhimurium encephalopathy in a 7-year-old girl. The patient presented with abrupt onset of coma following a brief history of diarrhea, vomiting and fever. Despite aggressive and appropriate management, she developed acute renal failure and coagulopathy and irreversible neurological compromise. No adequate alternative explanation was found for her disease. A summary of published cases is presented and postulated pathogenic mechanisms are discussed, which includes an endotoxin triggered…inflammatory response.
Abstract: Streptococcus pneumoniae is a rarely recognized cause of neonatal sepsis. A case of early-onset neonatal sepsis due to penicillin susceptible pneumococci and maternal endometritis is herein described. A male infant was born at 33 weeks of gestation. The baby developed S. pneumoniae bacteraemia and recovered completely following treatment with antibiotics. Four days after partum, the mother was readmitted with fever. S. pneumoniae was recovered from an endometrial sample. Isolates from mother and child were…both serogroup 1 and confirmed to be identical on the basis of BOX-polymerase chain reaction typing and pulse-field gel electrophoresis. Perinatal transmission of S. pneumoniae had probably occurred due to ascending infection from the maternal genital tract.
Keywords: Streptococcus pneumoniae, neonatal sepsis, box-typing, pulsed-field gel electrophoresis, endometritis
Abstract: We describe an 18-month-old boy with Guillain-Barré syndrome and serological evidence of both Lyme disease and infectious mononucleosis. Only rare manifestations of these infections were present. After treatment with penicillin and immunoglobulin, the boy had a protracted, but complete recovery. In patients with severe non-characteristic neurological symptoms, it is important to include an expanded panel of investigations, including serological tests. However, the validity of these may be limited. In conclusion, neuroborreliosis may…present as Guillain-Barré syndrome in children.
Abstract: We report a patient who presented with symptoms and signs of brucellosis and pseudotumor cerebri. Brucellosis is a common and endemic disease in Isfahan. Different patterns and manifestations, which are seen in this disease, may complicate the diagnosis. Pseudotumor cerebri has been reported in limited number of articles as an early sign for brucellosis. We report more details about the patient's signs, symptoms and serologic diagnosis of this condition in this article. We treated our patient…with rifampin and doxycycline and gentamicin for 6 months. She had a complete recovery after 3 months.