Juvenile idiopathic arthritis-type disease associated with chromosomal aberrations.

The association of certain chromosome aberrations with arthropathy has been previously described, but there is a limited number of reports in the literature. Two children are described, one with 18q- syndrome and another with supernumary marker chromosome 15, both presenting with juvenile idiopathic arthritis-type disease, aggressive progression and moderate response to inflammatory, corticosteroid and immunosuppressive treatment.

Clinical features, complications and treatment outcome of childhood brucellosis in central Greece.

OBJECTIVES: To examine the epidemiology, clinical and hematological characteristics, complications and treatment outcome of childhood brucellosis in central Greece. METHODS: Retrospective record review of all patients 0-14 years of age with brucellosis admitted during a 16-year period between 1984 and 1999. RESULTS: A total of 39 cases (23 males, median age 132 months) were recorded in which the diagnosis was confirmed by a positive culture (n=30) or detection of IgM antibodies with ELISA (n=9). About 38% of these patients came from families of farmers or shepherds who owned a few domestic animals or small herds of goats or sheep and another 43% had consumed dairy products bought from shepherds. In 41% of the cases another family member developed symptomatic infection. Most of the patients presented with fever (61%) and musculoskeletal symptoms (69%). Splenomegaly was recorded in 38% and hepatomegaly in 28% of the cases. Anemia (39%) and monocytosis (31%) were the most common hematological manifestations, followed by lymphopenia (18%). Unusual complications were detected in two patients who developed thrombocytopenic purpura and acute facial nerve palsy, respectively, but recovered without long-term sequelae. None of the 22 patients who received a combination of two or three antibiotics for > or =6 weeks and had adequate follow-up had a relapse. CONCLUSION: Childhood brucellosis remains an important public health problem in central Greece. It usually occurs in families that raise small ruminants and the development of symptomatic infection in more than one family member is common. It may cause serious complications in children and treatment with at least two antibiotics for not less than six weeks appears to be effective.

Arcanobacterium haemolyticum in children with presumed streptococcal pharyngotonsillitis or scarlet fever.

Arcanobacterium haemolyticum was cultured from pharyngeal specimens obtained from 12 of 129 children with pharyngotonsillitis, some of whom had a scarlatiniform rash. This organism should be considered to be a cause of infections that are clinically similar to those caused by beta-hemolytic streptococci.