RESUMO
We retrospectively reviewed data on 260 hospitalized pediatric patients with symptomatic urinary tract infection (UTI). To ascertain the colony-forming units (CFU)/mL compatible with the diagnosis of UTI, a culture from a catheterized urine specimen containing >1,000 CFU/mL was considered diagnostic of UTI and resulted in imaging by renal ultrasound, voiding cystourethrography, and renal nuclear scan with Tc99m dimercaptosuccinic acid (DMSA). A positive DMSA renal scan is indicative of pyelonephritis. We used logistic regression analysis to determine which patient characteristics were predictive of pyelonephritis. We determined that, in hospitalized pediatric patients, the colony count of the positive urine culture, the type of organism grown in culture, and the voiding cystourethrography (VCUG) result (positive or negative for vesicoureteral reflux) did not predict which patients had pyelonephritis. In females, advancing age of the patient and positive renal ultrasound results were predictive of which patients had pyelonephritis when we controlled for other factors. We feel this emphasizes the importance of a thorough evaluation of hospitalized symptomatic patients, including patients with colony counts of 1,000 to 50,000 CFU/mL, to locate the level of infection and plan appropriate therapy.
Assuntos
Pielonefrite/diagnóstico , Infecções Urinárias/diagnóstico , Fatores Etários , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Rim/diagnóstico por imagem , Rim/fisiopatologia , Modelos Logísticos , Masculino , Razão de Chances , Valor Preditivo dos Testes , Pielonefrite/diagnóstico por imagem , Pielonefrite/microbiologia , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Fatores Sexuais , Ácido Dimercaptossuccínico Tecnécio Tc 99m , Tomografia Computadorizada de Emissão , Ultrassonografia , Urinálise , Infecções Urinárias/microbiologia , Refluxo VesicoureteralRESUMO
A case of acute gastric volvulus has been presented. Although this disorder can occur in a chronic intermittent fashion, the potentially catastrophic acute form should be diagnosed early and surgically corrected. Careful attention to presenting signs and a high index of suspicion lead to prompt recognition and treatment.
Assuntos
Volvo Gástrico , Doença Aguda , Pré-Escolar , Humanos , Masculino , Volvo Gástrico/diagnóstico , Volvo Gástrico/patologia , Volvo Gástrico/cirurgiaRESUMO
A five-year-old girl with severe abdominal pain secondary to Henoch-Schönlein purpura (HSP) was given steroid therapy. Symptoms continued to recur. Intravenous immunoglobulin (IVGG) use was followed by cessation of symptoms. Further studies with IVGG in HSP are warranted.
Assuntos
Vasculite por IgA/terapia , Imunoglobulinas Intravenosas/uso terapêutico , Pré-Escolar , Feminino , Glucocorticoides/uso terapêutico , Humanos , RecidivaRESUMO
In clinical practice, determining which patients with urinary tract infection have upper urinary tract involvement is difficult yet important for proper management. This report indicates that the 99mtechnetium dimercaptosuccinic acid (DMSA) scan is a useful test in making this determination.
Assuntos
Infecções Bacterianas/diagnóstico por imagem , Nefropatias/diagnóstico por imagem , Rim/diagnóstico por imagem , Compostos de Organotecnécio , Succímero , Infecções Urinárias/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Cintilografia , Ácido Dimercaptossuccínico Tecnécio Tc 99mRESUMO
A varicella infection in a previously healthy young girl was complicated by bacterial sepsis, arthritis, and osteomyelitis in multiple locations. This secondary complication caused by Staphylococcus aureus was associated with a transient defect in granulocyte function and an alteration in the representation of CD4 and CD8 positive lymphocyte subpopulation. The mechanism responsible for secondary bacterial infections following varicella may be due to transient defects in granulocyte function.
Assuntos
Artrite Infecciosa/imunologia , Atividade Bactericida do Sangue , Varicela/imunologia , Granulócitos/imunologia , Choque Séptico/imunologia , Infecções Estafilocócicas/imunologia , Criança , Feminino , Humanos , Tolerância Imunológica , Staphylococcus aureus/imunologiaAssuntos
Agranulocitose/etiologia , Varicela/complicações , Neutropenia/etiologia , Aciclovir/uso terapêutico , Anticorpos Antivirais/análise , Doenças do Sistema Nervoso Central/etiologia , Varicela/tratamento farmacológico , Varicela/imunologia , Criança , Herpesvirus Humano 3/imunologia , Humanos , Leucopenia/etiologia , Hepatopatias/etiologia , MasculinoRESUMO
The author's experience with lethargy in pediatric patients with intussusception was reviewed retrospectively over a 10-year period and proved to be a symptom elicited on admission in half of the patients. The results indicate that lethargy is an important symptom in patients with intussusception when occurring in association with vomiting, melena, or a palpable abdominal mass, or all three.
