RESUMEN
To determine the common causes of persistent cervical lymphadenopathy in children and to test a diagnostic approach. This study was conducted at King Hussein Medical Center/pediatric clinic over one year period to look for all children between ages of 6 months and 14 years with persistent lymph node enlargement. Persistent enlargement is defined as a lymph node > 1 cm in diameter, and > 2 weeks duration. A management algorithm was proposed and followed in the management. One hundred and thirty children presented to infectious diseases clinic with persistent lymph nodes enlargement. In 70 children [53%] the nodes regressed in 2 weeks time, in another 30 children [23%] they regressed in 4 weeks time. Fifteen children [12%] had tuberculous lymphadenitis; 10 children [8%] had lymph node abscess; 3 children [2%] had Epstein Barr virus infection and 2 children [1.5%] had Hodgkin's lymphoma on initial presentation. Reactive lymphadenitis is the commonest cause of cervical lymph node enlargement in children. Majority of lymph nodes regress in 4 weeks time. Persisting lymph nodes more than 4 weeks warrant histological examination. Tuberculosis is a common cause of cervical lymphadenopathy among Jordanian children
RESUMEN
To describe the clinical presentation, course and management of lymphadenitis post Bacille Calmette-Guerin vaccine. This descriptive study was conducted on 17 cases who were referred to the infectious disease clinic at King Hussein Medical Center with regional lymphadenitis post Bacille Calmette-Guerin vaccine. All cases were infants between two and 12 months of age. The results of lymph node aspirate and biopsy were shown as well. Different treatment protocols used were included. The study was conducted from September 2006 to September 2007. Seventeen patients, 9 males [52%] and 8 females [48%], were studied. Constitutional symptoms were found only in one infant. All infants received the same type of vaccine used by our Ministry of Health which is the Danish strain. Unilateral axillary lymph node enlargement was seen most commonly [47%]. Cervical lymph nodes were involved in four cases [24%] followed by supraclavicular lymphadenopathy in three cases [18%], and one case had cervical and supraclavicular lymphadenopathy. Sinus formation was seen in three [18%] cases. Five cases [30%] had fluctuating lymph nodes. Only one infant had disseminated infection. The majority [65%] of cases had their symptoms starting within the first two months post vaccine. Eight [47%] infants had conservative observational management. Anti-tuberculosis medications were used in five [30%]. Surgical approach was used in four [23%] cases. All infants had complete healing by the end of the study period. Since the introduction of the new vaccine more complications are seen. This stresses the importance of early recognition and implementation of appropriate treatment protocols. Complete healing of suppurative lymphadenitis post Bacille Calmette-Guerin vaccine can be achieved using different treatment protocols
RESUMEN
To detect and evaluate the role of the newly recognized human coronavirus [HCoV]-NL63 and HCoV-HKUl as aetiologic agents of acute respiratory tract infections in hospitalized Jordanian children younger than 5 years of age. Between December 2003 and May 2004, a total of 326 nasopharyngeal aspirates were collected from Jordanian children hospitalized with acute respiratory tract infections. Total DNA and RNA were extracted using Qiagen commercial kits. HCoV-NL63 and HCoV-HKUl were detected by random reverse transcription-polymerase chain reaction using random hexamer primer for the reverse transcription step, and specific primers that target the replicase and polymerase genes to produce 215-bp and 392-bp amplicons respectively. Other potential respiratory pathogens w7ere detected according to previously published protocols. HCoV-NL63 was detected in 4 [1.2%] out of 325 examined nasopharyngeal aspirates. HCoV-NL63 was detected in two children with severe, and in two with mild to moderate acute respiratory tract infections. HCoV-NL63 was the only pathogen detected in three patients, and mixed with adenovirus in one patient. HCoV-HKUl was not detected in the 325 nasopharyngeal aspirates examined. HCoV-NL63 is a significant causative agent of acute respiratory tract infections in hospitalized Jordanian children. HCoV-NL-63 can cause the respiratory disease either alone or in combination with other potential respiratory pathogens. Further studies are required to further characterize the clinical and epidemiological features of these newly recognized HCoVs in Jordan