ABSTRACT
OBJECTIVE: To document the number of infants with spontaneous pneumothorax (SP) and determine the association of any underlying pathologic processes in the lung with SP. DESIGN: Retrospective chart review of infants admitted with SP from January 1985, to December 1994. SETTING: Patients admitted to The Children's Medical Center, Dayton, Ohio. PARTICIPANTS: Children aged greater than 28 days but less than 1 year with the primary admitting diagnosis of SP. MAIN OUTCOME MEASURES: The number of infants with SP and description of underlying conditions associated with SP. RESULTS: Six infants were identified with the admitting diagnosis of SP. All of the patients had underlying conditions that predisposed to SP: febrile seizures, anatomic abnormalities (one with an intrathoracic cystic hygroma and one with a cystic adenomatoid malformation of the lung), bronchiolitis, and two patients with Pneumocystis carinii pneumonitis. The children with SP identified in this survey accounted for one admission per 10,000 hospitalized children and 3.4 admissions per 10,000 hospitalized infants. CONCLUSIONS: SP in infancy is uncommon. The data indicate that infants who present with SP have associated conditions predisposing to the development of a pulmonary air leak.
Subject(s)
Pneumothorax , Adult , Age Factors , Child , Child, Preschool , Female , Hospitalization , Humans , Incidence , Indiana/epidemiology , Infant , Infant, Newborn , Male , Ohio/epidemiology , Pneumothorax/epidemiology , Pneumothorax/etiology , Pneumothorax/therapy , Retrospective StudiesABSTRACT
Bloodstream infection due to herpes simplex virus (HSV) is rare in the immunocompetent host but may be important in the pathogenesis of disseminated HSV infection in the immunocompromised patient. Using a simple blood-culture method, we detected herpes simplex viremia in eight immunologically compromised or immature children: two neonates, two oncology patients, and four transplant recipients. Only two patients initially exhibited evidence of mucocutaneous HSV infection. Blood was cultured for HSV because of perinatal exposure, for routine surveillance, or for the evaluation of fever, esophagitis, or oral lesions in immunocompromised patients. In five cases HSV was recovered only from the blood; in two other instances blood cultures for HSV were the first positive cultures. The time required for the detection of HSV by blood culture ranged from 1 day to 12 days. In one case viremia was transient and cleared without specific therapy. The other seven cases were treated with intravenous acyclovir; in four of these cases, therapy was initiated because of the positive blood culture. The detection of HSV in blood may promote early initiation of antiviral therapy and thereby improve prognosis.
Subject(s)
Herpes Simplex/etiology , Viremia/etiology , Antiviral Agents/therapeutic use , Child, Preschool , Female , Herpes Simplex/complications , Herpes Simplex/drug therapy , Humans , Immunocompromised Host , Infant , Infant, Newborn , Male , Neoplasms/complications , Neoplasms/immunology , Organ Transplantation/adverse effects , Viremia/complications , Viremia/drug therapySubject(s)
Candida albicans/isolation & purification , Candidiasis/drug therapy , Fluconazole/therapeutic use , Mycoses/diagnosis , Mycoses/drug therapy , Pichia/isolation & purification , Accidents, Traffic , Amphotericin B/therapeutic use , Blood Transfusion , Child, Preschool , Drug Resistance, Microbial , Drug Therapy, Combination/therapeutic use , Humans , Klebsiella Infections/drug therapy , Male , Microbial Sensitivity Tests , Pseudomonas Infections/drug therapy , Wounds and Injuries/therapyABSTRACT
The adult health care provider who is susceptible to varicella zoster virus (VZV) represents a risk to her or himself and to patients. Nineteen percent of employees at this Children's Hospital had no or uncertain prior experience with VZV, and of these, 28% were found to be VZV susceptible, representing 5% of the total population of 2,730 hospital employees. During the 12 months of study, six of the potential 135 to 137 VZV-susceptible individuals acquired varicella. VZV-susceptible health care providers should be aware of their potential to both acquire and transmit VZV.
