Subject(s)
Chickenpox/complications , Fasciitis, Necrotizing/etiology , Child, Preschool , Female , Humans , ImmunocompetenceSubject(s)
Mastoiditis , Acute Disease , Adolescent , Child , Child, Preschool , Humans , Infant , Mastoiditis/diagnosis , Mastoiditis/microbiology , Mastoiditis/therapy , Retrospective StudiesABSTRACT
No disponible
Subject(s)
Child, Preschool , Infant , Child , Adolescent , Humans , Mastoiditis , Mastoiditis , Retrospective Studies , Acute DiseaseABSTRACT
No disponible
Subject(s)
Humans , Child, Preschool , Female , Chickenpox , Fasciitis, Necrotizing , ImmunocompetenceABSTRACT
La mononucleosis infecciosa (MI) se complica, habitualmente, en un 10 por ciento de los casos y, rara vez, requiere hospitalización, si bien hay casos descritos asociados a malignopatías. Los síntomas iniciales pueden confundirse con los de cualquier infección vírica, por lo que la serología específica (IgM e IgG y anticuerpos heterófilos) nos ayuda a establecer el diagnóstico. Sin embargo, la serología puede dar un resultado negativo a edades tempranas, quizá por la inmadurez del sistema inmunológico, o en las formas graves, por lo que el diagnóstico puede confirmarse con la detección del ADN vírico mediante la reacción en cadena de la polimerasa en los fluidos corporales (suero, líquido cefalorraquídeo, frotis faríngeo...). Presentamos dos casos de mononucleosis infecciosa prolongada y complicada, que requirieron hospitalización y posterior seguimiento (AU)
Subject(s)
Infant , Male , Child , Humans , Infectious Mononucleosis/complications , Inappropriate ADH Syndrome/etiology , Conjunctivitis , Hepatomegaly , Splenomegaly , Abscess , Cellulite , Encephalitis , Staphylococcal Scalded Skin Syndrome , Respiratory Distress Syndrome, Newborn/etiology , Anti-Bacterial Agents/therapeutic useABSTRACT
OBJECTIVE: Our aim was to analyse clinical, diagnostic, therapeutical and evolutionary features in a pediatric population with tuberculous meningitis. PATIENTS AND METHODS: The medical records of thirteen children with this diagnosis admitted to Hospital Infantil Virgen del Rocío from Seville (Spain) between 1984 and 1999 were reviewed. RESULTS: The mean age was 2,35 +/- 2,3 years. The symptoms upon admission were: fever in 11 children, anorexia and vomiting in 8, disturbance of the consciousness in 7. Meningeal signs in 6, all of them older than 20 months, the remaining seven showed irritability and four of these ones hypertense fontanelles. Three patients were in the first stage of the disease, 9 in the second and 1 in the third, according to the Medical Research Council. CSF findings were indicative in all the cases. Five children had bacilloscopy positive and Mycobacterium tuberculosis was isolated in 6 patients, sometimes in CSF others in gastric juice. Mantoux skin test was positive in 11. Radiographic studies demonstrated abnormal chest findings in 8 patients (hiliar adenopathy, 1; miliary pattern, 2; and infiltrates, 5). Pathology cranial computed tomography showed in all the cases and the electroencephalogram was slowed down in the initial phases in 11. Two children died and the neurological complications were the most frequent, appearing in 9 patients. Without consequences cured 4 patients, the rest presented cognitive, visual and motor deficits, sensibility skin disturbance and late seizures. No case has been observed during the last 5 years. CONCLUSIONS: Fast diagnosis tests used for M. tuberculosis identification were useful to begin an antituberculous treatment in a high suspicion of meningeal affectation by this German patient. The early treatment will decrease complications and consequences by this disease. A decrease in the incidence looks to be in spite of the VIH infection increase nowadays.
Subject(s)
Tuberculosis, Meningeal/epidemiology , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies , Spain/epidemiology , Tuberculosis, Meningeal/diagnosis , Tuberculosis, Meningeal/drug therapyABSTRACT
No disponible
Subject(s)
Adolescent , Female , Child, Preschool , Infant , Male , Child , Humans , Diarrhea, Infantile/epidemiology , Salmonella/pathogenicity , Salmonella Infections/epidemiology , Socioeconomic Factors , Feces/microbiology , Ceftriaxone/therapeutic use , Drug Resistance, Microbial , Child, Hospitalized/statistics & numerical dataABSTRACT
Objetivo: Evaluar las revisiones publicadas hasta el momento actual en la década de los años noventa sobre meningitis bacteriana en pediatría en nuestro país, con el propósito de conseguir una serie de datos epidemiológicos que puedan ofrecer una visión global de esta patología. Material y métodos: Localización de la literatura disponible en bases de datos informatizadas en el periodo de enero de 1990 a diciembre de 1998; revisión de las referencias incluidas en los artículos localizados, y consulta a expertos en el tema y en aspectos epidemiológicos. Cálculo de la estadística básica de los datos seleccionados. Resultados: Se han seleccionado 12 trabajos. Se evaluaron un total de 5.277 casos, todos correspondientes a pacientes pediátricos, predominantemente del sexo masculino. En el 35 ñ 12 por ciento (intervalo: 14,5-57,1 por ciento) no se aisló el agente etiológico. Los gérmenes aislados con más frecuencia fueron: Neisseria meningitidis (67 por ciento), Haemophilus influenzae (19 por ciento) y Streptococcus pneumoniae (7 por ciento). La mortalidad media fue de un 2,3 por ciento y la tasa de complicaciones de un 4,8 por ciento. Las secuelas más frecuentes fueron retraso mental, sordera y convulsiones. Se realizó TAC en el 27 por ciento de los casos y EEG en el 34 por ciento. El antibiótico más administrado fue la cefotaxima (63,4 por ciento), seguido de ampicilina (23,8 por ciento) y penicilina (22,7 por ciento). Se usaron corticoides con mayor frecuencia en los casos de H. influenzae y S. pneumoniae. Conclusiones: Basar nuestros resultados en datos bibliográficos conlleva que éstos puedan quedar obsoletos en poco tiempo. De ahí, la relevancia de establecer vías de recogida y publicación de información general sobre meningitis bacteriana en revistas de gran difusión de modo periódico y regular (AU)
Subject(s)
Female , Male , Child , Humans , Meningitis, Bacterial/epidemiology , Spain/epidemiology , Meningitis, Bacterial/complications , Meningitis, Bacterial/microbiology , Adrenal Cortex Hormones/therapeutic use , Statistics on Sequelae and Disability , Anti-Bacterial Agents/therapeutic useABSTRACT
Objetivo: Analizar los aspectos clínicos, diagnósticos, terapéuticos y evolutivos de una población pediátrica afectada de meningitis tuberculosa. Material y métodos: Se han revisado retrospectivamente las historias clínicas de 13 niños con este diagnóstico ingresados en el Hospital Infantil Virgen del Rocío de Sevilla entre 1984 y 1999. Resultados La edad media fue de 2,35 ñ 2,3 años. Los signos y síntomas al ingreso fueron: fiebre en 11 niños, anorexia y vómitos en 8, alteración de conciencia en 7. Seis niños, todos mayores de 20 meses, tenían signos meníngeos; los 7 restantes presentaban irritabilidad, y 4 de éstos fontanela hipertensa. Se valoraron clínicamente 3 pacientes en el estadio I, 9 en el estadio II y uno en el estadio III, se gún el Medical Research Council. En todos los pacientes los hallazgos de LCR fueron orientativos. La baciloscopia fue positiva en 5 casos y se aisló Mycobacterium tuberculosis en 6 niños, bien en LCR o en aspirado gástrico. El Mantoux se positivizó en 11 casos. La radiografía de tórax fue patológica en 8 niños (adenopatía hiliar en un caso, patrón miliar en 2, e infiltrado en 5). La TAC objetivó una dilatación ventricular en todos los casos y el EEG estuvo lentificado en las fases iniciales en 11 casos. Fallecieron 2 niños y las complicaciones neurológicas fueron las más frecuentes, apareciendo en 9 pacientes. Curaron sin secuelas 4 pacientes, el resto presentaron déficit cognitivos, visuales y motores, hemiparesias y convulsiones tardías. No se ha observado ningún caso en los últimos 5 años. Conclusiones El empleo de técnicas de diagnóstico rápido en la identificación de M. tuberculosis sería útil para iniciar un tratamiento antituberculoso a un paciente con alta sospecha de afectación meníngea por este germen. La precocidad del tratamiento disminuirá las complicaciones y secuelas de esta enfermedad. Parece existir una disminución en la incidencia pese al aumento de la infección por el VIH en la actualidad (AU)
Subject(s)
Child , Child, Preschool , Male , Infant , Female , Humans , Spain , Tuberculosis, Meningeal , Retrospective StudiesABSTRACT
OBJECTIVES: To analyze the patients diagnosed of infectious mononucleosis (IM) in our institution, in order to study the symptoms and clinical evolution. MATERIAL AND METHOD: We retrospectively analyse 37 hospitalized children aged between 3 months and 14 years. Diagnosed of IM by production of immunoglobulin M (IgM) to viral capsid antigen (VCA). RESULT: In our series of 37 children, 14 were less than 4 years old. Among clinical data, lymphadenopathy (86%), fever (81%) and pharyngotonsillitis (70%) were the more striking. We found jaundice only in three of the older children. Upper airways obstruction was common, and specially severe in young children. Three patients developed pneumonia during the disease course. Only ten patients produced heterophile antibodies. Two children showed dual antibody rises to Epstein-Barr virus and cytomegalovirus. Corticotherapy was used in 7 children. The complications are presented in 68% of patients. CONCLUSIONS: Clinical aspects of IM were similar to those in the young adult, and complications occur more frequently. We found lack of heterophile antibodies, more frequent in youngest.
Subject(s)
Infectious Mononucleosis , Child , Child, Preschool , Hospitalization , Humans , Infant , Infectious Mononucleosis/complications , Infectious Mononucleosis/diagnosis , Retrospective StudiesABSTRACT
Streptococcus pneumoniae is a common pathogen in children that in recent years has shown a progressive rise in resistance to the usual antibiotics and also to the new third generation cephalosporins. We report a review of Streptococcus pneumoniae strains isolated at our hospital from pediatrics patients in whom we observed an increased incidence of resistance to cefotaxime significantly related with the rise in resistance to penicillin. The resistance of penicillin-resistant strains to various antibiotics was analyzed and the following results were obtained: cefotaxime, 0% susceptible, 83% intermediate and 17% resistant; erythromycin, 16,7% susceptible, 8,3& intermediate and 75% resistant; vancomycin, 100% susceptible; chloramfenicol, 16,7% susceptible and 83,3% resistant; and cotrimoxazole, 100% resistant.
Subject(s)
Streptococcus pneumoniae/drug effects , Child , Drug Resistance, Microbial , Humans , Microbial Sensitivity Tests/statistics & numerical data , Respiratory System/microbiology , Streptococcus pneumoniae/isolation & purificationSubject(s)
Parotitis/microbiology , Administration, Oral , Amoxicillin/administration & dosage , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Female , Humans , Infant, Newborn , Injections, Intramuscular , Kanamycin/administration & dosage , Male , Parotitis/diagnosis , Parotitis/drug therapy , Penicillins/administration & dosage , SuppurationABSTRACT
Authors present six cases of kala-azar in children under six years of age observed in the province of Seville, during a three year period. Ethiologic, clinical, evolutive and therapeutic aspects of this illness are analized. Two of the patients presented jaundice, in which a liver-spleen scan was performed and nothing else but the hepato-splenomegaly was found, as it was described in a previous case. Importance of visualizing leishmanias by bone marrow puncture for a true diagnosis is remarked.
Subject(s)
Leishmaniasis, Visceral/diagnostic imaging , Age Factors , Child , Child, Preschool , Female , Glucosamine/administration & dosage , Humans , Infant , Injections, Intramuscular , Leishmaniasis, Visceral/drug therapy , Liver/diagnostic imaging , Male , Radionuclide Imaging , Spleen/diagnostic imaging , TechnetiumABSTRACT
El síndrome de Halasz es una malformación poco frecuente y con características bien definidas. Aportamos el estudio realizado en tres niños, menores de tres años, con estudio clínico, radiográfico, isotópico y hemodinámico (cateterismo y angiocardiografía) y se revisan los casos existentes en la bibliografía de pacientes menores de 15 años; se perfilan los síntomas y signos que conducen al diagnóstico y a la orientación terapéutica (AU)
Subject(s)
Scimitar SyndromeABSTRACT
Authors studied nine cases of Reye's syndrome, seen over a period of five years. Their ages ranged from 45 days to 3 6/12 years, eight being less than a year old. Mortality rate was 55% and two of the four surviving children presented serious neurological sequelas. In all cases liver pathology was studied by percutaneous biopsy and/or necropsy. Clinical, analitical and anatomopathological findings were similar to those usually described in this syndrome. Medical literature was revised as to etiology and pathology, noting specially the tendency of this syndrome to present in groups, its possible relationship to viral epidemics and the inconsistency of the results of certain therapeutic measures widely used until now. The possible relationship between Reye's syndrome and the usual infant vaccinations, as they found in two cases, as well as the convenience of hepatic studies in the event of postvaccinal encephalopathy is suggested.
Subject(s)
Liver/pathology , Reye Syndrome/pathology , Biopsy/methods , Child, Preschool , Diagnosis, Differential , Electroencephalography , Encephalomyelitis, Acute Disseminated/complications , Encephalomyelitis, Acute Disseminated/diagnosis , Female , Humans , Infant , Male , Reye Syndrome/diagnosis , Reye Syndrome/etiology , Virus Diseases/complicationsABSTRACT
A study has been made of 79 children from zero to seven years of age admitted to hospital with fever of unknown origin (F.U.O.) of more than two weeks duration. Children in whom fever was not clinically observed after one week of hospitalization are not included. In 50 cases (63.2%), it was possible to establish a definitive diagnosis within the first fornight of admission. The most frequent cause of fever was that of infection, found in 51 children (64.5%), tuberculosis and urinary infections predominating with ten cases each. In another ten children neoplastic disease was diagnosed (mostly leucosis), and there was colagenosis in seven cases (8.8%). In another seven children, the etiology was not established. Mortality rate was 7.5%. Clinical history and exploration were of main importance in the orientation of the diagnoses. The findings of this study suggest that in all children presenting F.U.O., apart from hospitalization of at least one week, a very thorough anamnesis and clinical exploration are most important in establishing the diagnosis, along with a more or less aggressive approach to the problem according to the findings.
Subject(s)
Fever of Unknown Origin/diagnosis , Child , Child, Hospitalized , Child, Preschool , Collagen Diseases/complications , Collagen Diseases/diagnosis , Female , Fever of Unknown Origin/etiology , Humans , Infant , Infant, Newborn , Infections/complications , Infections/diagnosis , Male , Neoplasms/complications , Neoplasms/diagnosisABSTRACT
A 5 year old child with brucellosis is described who developed severe liver disease with neuropsychiatric signs and electroencephalographic changes.
