Journal of Pediatric Infectious Diseases - Volume 6, issue 2

Authors: Sabra, Ahmed | Benger, Jonathan

Article Type: Research Article

Abstract: Meningococcal disease is a global burden with an estimated annual death rate of 170000 worldwide. The disease has an overall mortality greater than 10%. Despite these figures, several studies demonstrate that the management of children with severe meningococcal sepsis and septic shock is suboptimal. Most children received inadequate fluid resuscitation and inotropic support during their admission. Hence, this paper presents a review of relevant literature of prediction studies and discusses clinical and methodological …issues, which may have influenced the results. It concludes that several studies have investigated the predictors of a poor clinical outcome in this condition, but there is a lack of studies that consider prediction of fluid and inotrope requirements as an outcome measure. The identification of such predictors would allow treatment to be directed to those children most likely to benefit, with a long term goal of improving patient outcome. Show more

Keywords: Meningococcal disease, prediction, clinical outcome, inotrope, children

DOI: 10.3233/JPI-2011-0305

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 91-101, 2011

Authors: Bhattarakosol, Parvapan | Kowitdamrong, Ekasit | Praisuwanna, Pramote

Article Type: Research Article

Abstract: The intrauterine transmission rates of cytomegalovirus (CMV) and herpes simplex virus (HSV) were determined in non human immunodeficiency virus (HIV)-infected and HIV-infected mothers. Mother-to-child transmission was defined as polymerase chain reaction positive viruria, and/or viremia. Of 60 mothers, 43 were HIV seropositive. The intrauterine transmission rates of CMV and HSV as shown in non HIV-infected mothers were 47.06% and 42.86%, respectively, and in HIV-infected mothers were 40.48% and 66.67%, respectively. No statistically …significant difference was observed between these two groups (p =0.77 and 0.19, respectively). All intrauterine HSV transmission occurred in 2 HIV- infected mothers with HSV primary infection while one non-HIV-infected mother did not transmit. The incidence of symptomatic congenital CMV infection was found to be 0.04% and none with HSV infection. This study indicated that co-infection of HIV in pregnant women did not affect the intrauterine transmission rates of either CMV and HSV. Screening in utero infection by DNA detection in urin}, white blood cells and plasma of newborns was recommended. Show more

Keywords: Intrauterine transmission, HSV, CMV, HIV, co-infection

DOI: 10.3233/JPI-2011-0304

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 103-110, 2011

Authors: Arrieta, Antonio C. | Ashouri, Negar | Vargas-Shiraishi, Ofelia | Singh, Jasjit

Article Type: Research Article

Abstract: The introduction of Streptococcus pneumoniae 7-valent conjugate vaccine has decreased pneumococcal infections in children. Recently a resurgence of invasive pneumococcal infections has been reported. Delineating populations at risk and microbiological changes responsible for this is important to develop new preventive strategies. We conducted a retrospective review of medical records of children hospitalized with pneumococcal bacteremia from July 1st 2005 through February 28th 2010 in a large tertiary care center in Southern California. …We identified 74 subjects (mean age 5 yr; range 32 days to 21 yr and 2 mo) of which the majority (58.1%) had underlying medical conditions associated with increased risk for pneumococcal infections for whom pneumococcal polysaccharide vaccine is recommended after 2 yr of age. Seventy-seven isolates were recovered from 76 positive blood cultures; serotype was available for 57 isolates, 5 (6B, 14, 23F and two were 19F) were 7-valent conjugate vaccine isolates. Forty were included in the 23-valent polysaccharide vaccine. Nineteen (35.2%) were 19A. Pneumonia was common particularly among previously healthy children (74%). New vaccines, targeted against serotypes that have emerged following the introduction of the 7-valent conjugate vaccine and better utilization of existing vaccines in patients at risk should further decrease invasive pneumococcal disease. Show more

Keywords: Pneumococcus, bacteremia, immunization

DOI: 10.3233/JPI-2011-0311

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 111-115, 2011

Authors: Khriesat, Wadah | Al-Zoubi, Sireen | Makhloof, Fakhri | Altaa'ni, Dima | Lataifeh, Isam

Article Type: Research Article

Abstract: We studied neonatal septic arthritis in the North of Jordan and investigated the pattern of causative microorganisms. In 27 neonates, 27 episodes of septic arthritis were identified between January 2003 and December 2004. The diagnosis of septic arthritis was made based on clinical and radiological findings plus the result of culture of the aspirated pus from the affected joint (s). The mean age of presentation was 20.1 ± 5.7 days. Male to female ratio …was 1.25:1 and most of the neonates (85%) had been admitted and discharged previously to the same neonatal intensive care unit. Hip joints were involved in 70% of the cases. Elevated erythrocyte sedimentation rate and positive C-reactive protein were found in all cases. Microorganism was grown in blood or synovial fluid samples from 59% of the neonates. Klebsiella pneumoniae was the most frequent genus isolated (30%), followed by Staphylococcus aureus and Enterobacter (22% and 7%, respectively). Gram-negative organisms continues to be the most commonly encountered bacteria causing septic arthritis in the neonates of North of Jordan. The high incidence of primary septic arthritis makes the early diagnosis essential. Previous admission to neonatal intensive care unit was the main risk factor. Show more

Keywords: Neonate, septic arthritis

DOI: 10.3233/JPI-2011-0300

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 117-120, 2011

Authors: Rodríguez-Martín, M. | de Paz, N. Merino | Ferrer, P. Contreras | Aller, T. Virgós | Perera, I. González | Martín, B. Rodríguez | Noda-Cabrera, A.

Article Type: Research Article

Abstract: Molluscum contagiosum (MC) is a frequent viral infection in paediatric population. Destructive therapies for MC are poorly tolerated in children, so in this study, we have assessed the efficacy and tolerability of a non-painful treatment intervention with topical cantharidin. A prospective case series was conducted in which 30 pediatric patients were recruited. Diagnosis of MC was made by dermatologist. Cantharidin collodion 0.2% was applied by dermatologist in an office setting, with a follow-up at 2 and …4 wk. Patients were evaluated about their experience with cantharidin and other treatments for MC (if they had been treated before). Pain experienced with cantharidin technique was measured using a visual analog scale called "Faces Pain Rating Scale." The results of this prospective study have demonstrated that cantharidin could be considered a front line therapy for MC in children. Show more

Keywords: Therapy, viral infection, Molluscum contagiosum, cantharidin

DOI: 10.3233/JPI-2011-0306

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 121-123, 2011

Authors: Soltan Dallal, Mohammad Mehdi | Ranjbar, Reza | Pourshafie, Mohammad Reza

Article Type: Research Article

Abstract: Shigellosis is one of the major causes of morbidity in children with diarrhea in Iran. The aim of this study was to investigate antimicrobial resistance of Shigella flexneri (S. flexneri) strains isolated from clinically diagnosed cases of gastroenteritis and acute diarrhea in Tehran, Iran. Shigella strains were isolated from stool samples of patients who visited the several major hospitals in Tehran. S. flexneri was preliminarily identified by biochemical tests as well as by API20E. …Antimicrobial resistance testing was performed according to the standard guidelines of the Clinical and Laboratory Standards Institute. All strains were resistant to streptomycin. More than 96.4% of the strains were resistant to tetracycline and amoxicillin, 89% to co-trimoxsazole, 72.6% to ampicillin, 33.3% to chloramphenicol, 9.5% to kanamycin, 1.2% to cefixime, amikacin and furazolidone. None of the tested isolates were resistant to ceftriaxone, ceftizoxime, ceftazidime, gentamicin, ciprofloxacin, cephalothin, cefotaxime, cephalexine, nalidixic acid and nitrofurantoin. More than 96% of the strains showed multi-drug resistance phenotype. Seventeen resistance patterns were identified among the strains, however the most prevalent phenotype (36.9%) was R6 (streptomycin/amoxicillin/tetracycline/co-trimoxsazole/ampicillin). This study indicates an increase in incidence of multiple drug resistance among the strains of S. flexneri isolated in Tehran, Iran. Show more

Keywords: Shigella flexneri, antibiotic resistance, multi drug resistance, Iran

DOI: 10.3233/JPI-2011-0307

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 125-129, 2011

Authors: Lopardo, Horacio | Ruvinsky, Silvina | Casimir, Lidia | Bologna, Rosa | Mecikovsky, Debora | Hozbor, Daniela

Article Type: Research Article

Abstract: Bordetella bronchiseptica is a well-known animal pathogen sporadically found associated with human infections, especially in immunocompromised hosts. We report a fatal case of sepsis caused by Bordetella bronchiseptica in a girl with laryngotracheitis and AIDS.

Keywords: Bordetella bronchiseptica, AIDS, laryngotracheitis

DOI: 10.3233/JPI-2011-0308

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 131-134, 2011

Authors: Kurahatti, Ratna A. | Molla, M.A. Maleque

Article Type: Research Article

Abstract: During the pre-Hib (Conjugated Haemophilus influenzae type b) vaccination era, bacteremic facial cellulitis was often attributed to Haemophilus influenzae type b and less frequently with Streptococcus pneumoniae. Here we present a case of bacteremic facial cellulitis with Moraxella catarrhalis.

Keywords: Facial cellulitis, Moraxella cattarrhalis, bacteremia

DOI: 10.3233/JPI-2011-0301

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 135-136, 2011

Authors: Misra, Saheli | Chakrabartty, Subroto

Article Type: Research Article

Abstract: Neurological complications of falciparum malaria are quite common. Guillain Barre Syndrome (GBS) as a complication of malaria is rare especially in children but has been reported from other developing countries. We report a case of an 8 year old girl who had developed an ascending paralysis following an attack of Plasmodium falciparum} malaria. She was diagnosed with GBS. The clinical presentation and nerve conduction velocity studies were helpful in taking a definitive approach. She was treated …with immunoglobulin and improved remarkably. Show more

Keywords: Plasmodium falciparum malaria, Guillain Barre Syndrome

DOI: 10.3233/JPI-2011-0313

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 137-139, 2011

Authors: Shah, Kunal M. | Pratt, Ellen L. | Al-Rahawan, Mohamad M. | Abraham, Roshini S.

Article Type: Research Article

Abstract: In this case report, we describe for the first time the identification of a compound heterozygote mutation in the β2 integrin gene (ITGB2), which is associated with Leukocyte Adhesion Deficiency type 1 (LAD-1). The patient was a 6-year-old male referred for evaluation of multiple recurrent infections. Laboratory evaluation revealed persistent leukocytosis with normal immunoglobulins, complement, mannose-binding lectin, and vaccine antibodies. There was also a complete absence of the integrins – CD18 and CD11a on monocytes, granulocytes …and lymphocytes, and CD11b on monocytes and lymphocytes with normal expression on granulocytes. Gene sequencing showed two heterozygous mutations, one being a missense mutation, G284S in exon 7 (c.850G>A), and the second, a single base-pair deletion resulting in a premature stop codon (c.2070delT). Based on the clinical and laboratory findings, a diagnosis of LAD-1 was reached, but it was delayed by an apparent lack of early recognition of the clinical features. LAD-1 should be considered as a potential diagnosis and aggressively pursued in any patient who presents with leukocytosis, delayed umbilical cord separation and non-purulent recurrent infections. Key diagnostic work-up includes flow cytometry for CD18, CD11a and CD11b on white blood cells followed by appropriate confirmatory gene sequencing analysis. Show more

Keywords: Leukocyte adhesion deficiency syndrome, innate immunity, leukocyte adhesion receptors, CD18 integrin, hematopoietic stem cell transplantation

DOI: 10.3233/JPI-2011-0312

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 141-148, 2011

Authors: Badugu, Srinivasarao | Udassi, Jai Prakash | Arwa, Saidi | Slamon, Nicholas

Article Type: Research Article

Abstract: With the widespread use of antibiotics, cases of pneumococcal pericarditis in infants and children have decreased significantly. Since the implementation of routine heptavalent pneumococcal immunization in 2000, these cases have become even rarer. While rare and life threatening, patients with invasive pneumococcal infections usually have a good outcome if diagnosed early and treated adequately. Since 1980, we found reports of only 13 children with pneumococcal pericarditis in PubMed. We describe another case of invasive …pneumococcal infection in an infant with purulent pericarditis leading to tamponade and constrictive pericarditis. Show more

Keywords: Pneumococcus, pericarditis, infant, tamponade

DOI: 10.3233/JPI-2011-0310

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 149-154, 2011

Authors: Aggarwal, Nidhi | Faridi, Mohammad Moonis Akbar | Bhargava, Anuja

Article Type: Research Article

Abstract: A 3 year old boy presented with fever, pain and discharge from the right ear. On examination, swelling and redness were present behind the right ear and pus like discharge was found oozing from a tiny opening present in the right ear on the anterior margin of the helix. A diagnosis of congenital pre-auricular sinus with superimposed bacterial infection was made. Patient was treated successfully with a course of antibiotics. A similar uninfected pre-auricular sinus was …present on the helix of the opposite ear. Both mother and younger sibling also had uninfected congenital bilateral pre-auricular sinuses. Show more

Keywords: Pre-auricular sinus, ear discharge, congenital malformation

DOI: 10.3233/JPI-2011-0309

Citation: Journal of Pediatric Infectious Diseases, vol. 6, no. 2, pp. 155-157, 2011