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1.
An Pediatr (Barc) ; 80(6): 399-403, 2014 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-24286883

RESUMO

INTRODUCTION: Varicella (chickenpox) can cause serious complications and admission to hospital. Several countries included the varicella vaccine in their immunization schedules. MATERIAL AND METHODS: A descriptive and retrospective study of hospitalizations due to varicella and its complications was conducted in a referral center from 2005 to 2011. RESULTS: A total of 1192 children with varicella were seen in the emergency room, of which 99 (8.5%) required admission. The annual incidence of admissions due to varicella and varicella complications was, 19.4 and 15.3 cases per 100,000 children under 14 years, respectively. Complications were more common in children under 5 years (79.5%), and with no underlying disease (78.2%). Infection of skin and soft tissue was the most common complication (62%). The mean hospital stay was 4.5 days (SD 4). CONCLUSIONS: Varicella causes high morbidity, and is more frequent in absolute terms in healthy children under 5 years of age. Therefore, routine vaccination recommended by the Immunization Advisory Committee should be mandatory.


Assuntos
Varicela/epidemiologia , Admissão do Paciente/estatística & dados numéricos , Adolescente , Varicela/complicações , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Centros de Atenção Terciária
2.
Infection ; 42(1): 179-83, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23709293

RESUMO

The isolation of Chryseobacterium indologenes as a causative micro-organism in human diseases is rare. Risk factors for infections caused by this pathogen include very young and very old age, indwelling devices, immune suppression and recent use of broad-spectrum antibiotics. Most cases suffer from bacteraemia or nosocomial pneumonia, whilst infection of the central nervous system (CNS) is extremely rare. We present a term-born infant diagnosed prenatally with holoprosencephaly and obstructive hydrocephalus, requiring post-natal ventriculoperitoneal shunt insertion. At 6 weeks of age, he suffered from Escherichia coli meningitis, showing satisfactory clinical response with antimicrobial therapy. Aged 11 months, he suffered from hyper-drainage syndrome, resulting in the removal of the shunt system. He represented 11 days post-operatively, with low-grade fever, irritability and cerebrospinal fluid (CSF) leakage. C. indologenes from CSF was isolated and antimicrobial therapy with ceftazidime and trimethoprim-sulfamethoxazole for 3 weeks resulted in good clinical response. This is the first documented community-acquired CNS infection due to C. indologenes in an infant without concomitant indwelling device or previous antibiotic pressure.


Assuntos
Infecções do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/microbiologia , Chryseobacterium/isolamento & purificação , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/microbiologia , Infecções por Flavobacteriaceae/diagnóstico , Infecções por Flavobacteriaceae/microbiologia , Antibacterianos/uso terapêutico , Ceftazidima/uso terapêutico , Infecções do Sistema Nervoso Central/tratamento farmacológico , Líquido Cefalorraquidiano/microbiologia , Doenças Transmissíveis Emergentes/tratamento farmacológico , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Infecções por Flavobacteriaceae/tratamento farmacológico , Humanos , Lactente , Masculino , Resultado do Tratamento , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
3.
Pediatr Pulmonol ; 49(3): E78-81, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24136903

RESUMO

Churg-Strauss syndrome (CSS) is an anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis; it is extremely rare in childhood and defined according to the Chapel-Hill Consensus as an eosinophil-rich and granulomatous inflammation involving the respiratory tract and necrotizing vasculitis affecting small to medium-sized vessels. Children commonly have a history of asthma and sinusitis whilst clinical presentation typically involves pulmonary tract and less frequently skin, heart, gastrointestinal tract, and peripheral nerves. Cardiopulmonary disease is higher in children and prognosis is worse. It is associated with significant eosinophilia and raised serum IgE-levels. ANCA are only found in 25% of childhood cases. Here we report the case of a 10-year-old girl who presented to us with vomiting, abdominal pain, and weight loss, paresthesias of lower extremities and breathlessness as well as a history of asthma, sinusitis and allergic rhinitis. She was treated with corticosteroids, cyclophosphamide, intravenous immunoglobulin, mycophenolate mofetil (MMF), and rituximab. However, remission was only achieved after initiation of omalizumab therapy, a recombinant humanized anti-IgE antibody. To the best of our knowledge this is the first pediatric patient suffering from CSS successfully managed with adjuvant anti-IgE therapy resulting in the control of respiratory as well as gastrointestinal symptoms.


Assuntos
Anticorpos Anti-Idiotípicos/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Síndrome de Churg-Strauss/tratamento farmacológico , Imunomodulação , Pulmão/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Pele/patologia , Criança , Síndrome de Churg-Strauss/complicações , Síndrome de Churg-Strauss/diagnóstico , Feminino , Humanos , Omalizumab , Derrame Pericárdico/etiologia , Radiografia , Resultado do Tratamento , Ultrassonografia
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