[Enteroviral infections in children: clinical and epidemiological findings in 530 patients (1984-1991)]. / Infecciones por enterovirus en pediatría. Casuística entre 1984-1991 (530 pacientes). Aspectos epidemiológicos y clínicos.

Between 1984 and 1991 enteroviral infections have been detected in a total of 530 patients. This type of infection was more frequent during the first years of life, among males and at the end of spring. The most common complaints (70% of the cases) included gastrointestinal manifestation, respiratory symptoms or febrile illness (viremia caused by enterovirus in two patients). Enterovirus was isolated in 25 patients with intussusception. Concurrent acute heart disease was diagnosed in six patients and Guillain-Barré syndrome in four. Enterovirus was isolated from the cerebrospinal fluid in 79 patients (15%), the majority of whom were infants under 2 months of age or children from 3 to 7 years old. Differences between these two age groups are discussed. Moreover, there were 16 patients with aseptic meningitis probably caused by enterovirus. In the spring of 1987, an epidemic outbreak of enteroviral meningitis was detected, particularly among infants. This outbreak coincided with others reported in different geographic areas of our country.

[An outbreak of neonatal meningitis caused by enterovirus]. / Brote neonatal de meningitis por enterovirus.

Six newborn infants affected by acute aseptic neonatal meningitis were attended during the months of June and July 1987. Fever, good general physical appearance and no associate focal symptomatology was the onset in five cases, whereas one of them had apnea spells. An increase in total cell count was present in CSF with polymorphonuclears predominance in two cases, being lymphocites more prevalent in the others. Enterovirus were demonstrated as a cause in three of them. After describing clinical facts and evolution, some epidemiological aspects are commented.

[Pertussis syndrome: study of 74 cases]. / Síndrome pertusoide: estudio de 74 casos.

Pertussis syndrome controversy induced us to study 74 hospitalized patients, with pertussis cough and Bordetella sp isolation in 29, other bacteria in 24 and viruses in 21. The most frequently isolated bacteria in the patients with negative culture for bordetella were Haemophilus influenzae, Streptococcus pneumoniae and Branhamella catarrhalis. The viruses with highest incidence were respiratory syncitial viruses. The negative culture for bordetella, the lack of antibiotherapy previous to obtention of the sample (29/45 cases), the clinical differences and their different seasonal distribution in relation to the patients with positive culture for bordetella, permit us to suppose that the bacteria/viruses isolated could be the etiologic agents of pertussis syndrome. Although Bordetella sp occupies an important place in the pertussis cough etiology, it is advisable to investigate the presence of viruses and other bacteria in these patients. However the difficulties to isolate bordetella implies the necessity of performing adequate isolation techniques and to study larger numbers of patients including control groups.

[Cytomegalovirus disease in immunosuppressed patients]. / Enfermedad por virus citomegálico en pacientes inmunodeprimidos.

Cytomegalovirus (CMV) infection is relatively frequent and severe in immunosuppressed patients giving rise to diagnostic and therapeutic problems. We describe a series of 7 patients, six with acute lymphoblastic leukemia and one with aplastic anemia. All patients had CMV infection at the moment of maximum immunodepression. Two patients had undergone recent bone-marrow transplant. Six had been transfused in the two months prior to the onset of infection. Diagnosis was established through isolation of CMV from blood or serological methods. Symptoms ranged from prolonged fever to multi-organic involvement. Two cases had pulmonary involvement as well as fever, hepatitis and petechial rash. Two other cases presented with fever and hepatosplenomegaly and in the remaining, 3, fever was the only sign. Clinical course was favourable in all cases including the two with pneumonitis; of these two the first received acyclovir and anti-CMV Ig and the other received no specific therapy. One of the remaining cases was also given acyclovir and specific anti CMV Ig was administered to the 3 patients with isolated fever. In conclusion, CMV infection should be suspected in immunosuppressed patients with prolonged fever.

[Cytomegalovirus infection in 32 children (author's transl)]. / Infeciones por citomegalovirus en el niño. a propósito de 32 observaciones con aislamiento virológico.

Thirty-two cases of cytomegalovirus infection are reviewed; 13 were congenital, 19 acquired. The clinical aspects of evolution and manifestation of the disease, agree with those described in other series. Virological diagnosis was based on isolating the virus from either urine or pharynx (or both) and culturing in pulmonary fibroblasts from human embryo. To obtain optimum results, fresh specimens must be used. Although several techniques are available for CMV antibody measurement, immunofluorescence is the technique of choice. Clinical manifestations differ according to age and immunological status of the patient. Late manifestations of congenital infection, monosymptomatic forms and acquired forms of the disease are at present of great interest. Importance of establishing diagnosis through virological isolation whenever a cytomegalovirus infection is suspected, is underlined.