ABSTRACT
El episodio hipotonía-hiporrespuesta (EHH) es un tipo muy inusual de efecto adverso después de la vacunación. Se ha observado con mayor frecuencia tras las vacunas de células enteras contra la tosferina. El EHH se caracteriza por el inicio repentino de hipotonía, hiporrespuesta y el cambio de color de la piel (palidez o cianosis) en las primeras 48 horas después de la administración de una vacuna en niños. Se ha descrito que los episodios pueden durar entre 6 y 30 minutos. Se desconoce la patogénesis. Aunque se ha clasificado dentro de las reacciones adversas graves, no se han demostrado efectos a largo plazo y no se contraindica la administración de una nueva dosis de la vacuna, si así está indicado para completar el calendario de vacunación del niño. Presentamos el caso de una lactante de 5 meses de edad que presentó un EHH tres horas después de la administración de una segunda dosis de la vacuna antimeningocócica B 4CMenB (Bexsero)
Hypotonic-hyporesponsive episode (HHE) is a very unusual type of adverse effect following immunization. HHE has been observed more frequently following whole-cell pertussis vaccines. HHE is characterized by sudden onset of reduced muscle tone, hyporesponsiveness and change of skin colour (paleness or cyanosis) in the first 48 hours after the administration of a vaccine in children. It has been shown that episodes can last between 6 and 30 minutes. The pathogenesis is unknown. Although it has been classified within the severe adverse reactions, long-term effects have not been shown and it does not contraindicate the administration of a new dose of the vaccine, as well as for the vaccination schedule of the child. Introducing the case of a 5-month-old breastfeeding infant who presented a HHE 3 hours after the administration of a second dose of the antimeningococcal B vaccine, 4CMenB (Bexsero)
Subject(s)
Humans , Female , Infant , Muscle Hypotonia/chemically induced , Meningococcal Vaccines/adverse effects , Meningococcal Infections/prevention & control , Reaction Time/drug effects , Medication Therapy Management/organization & administration , Risk FactorsABSTRACT
BACKGROUND: Mycobacterium lentiflavum is considered a rare pathogen causing nontuberculous mycobacterial (NTM) lymphadenitis. METHODS: A multicenter, retrospective study was performed in immunocompetent children <14 years of age with microbiologically confirmed NTM lymphadenitis treated at 6 hospitals in Madrid, Spain, during 2000-2010. We compared children with M. lentiflavum and Mycobacterium avium-intracellulare complex infection. RESULTS: Forty-five microbiologically confirmed NTM lymphadenitis patients were identified: 19 (45.2%) caused by M. avium-intracellulare complex, 17 (40.5%) by M. lentiflavum, 1 by both and 5 by other mycobacteria. Out of 17 M. lentiflavum cases, 14 were diagnosed in the past 5 years. Regarding M. lentiflavum cases, median age was 23 months. Submandibular nodes were the most frequently involved (76.5%), with multiple locations seen in 41% of the children and spontaneous drainage in 41% of them. Drug susceptibility tests were performed in 14 isolates and showed a complete susceptibility to clarithromycin and cycloserine, whereas 93% were resistant to rifampin, 33% to quinolones and full resistance to other tested antimycobacterial drugs was detected. All but 1 child required surgery and 11 were treated additionally with various drug combinations. Total resolution was achieved in 50% of children within 6 months.Compared with M. avium-intracellulare complex cases, children were younger and laterocervical nodes were significantly less frequently involved. No statistically significant differences were found related to clinical characteristics, treatment and outcome. CONCLUSIONS: M. lentiflavum is an emerging pathogen producing NTM lymphadenitis in Madrid.
Subject(s)
Lymphadenitis/microbiology , Mycobacterium avium Complex/isolation & purification , Mycobacterium avium-intracellulare Infection/microbiology , Mycobacterium/isolation & purification , Child , Child, Preschool , Female , Humans , Infant , Lymphadenitis/epidemiology , Male , Mycobacterium avium-intracellulare Infection/epidemiology , Retrospective Studies , Spain/epidemiologyABSTRACT
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