The progression of maternal RSV antibodies in the offspring.

The concentrations of maternal anti-RSV IgG antibodies were followed in 49 healthy newborns over the first six months of life. At birth, 41 mothers (83%) tested positive for anti-RSV IgG and all of their babies carried maternal anti-RSV IgG. Anti-RSV IgG positivity dropped to 73% at 1 month, 6% at 3 months, and 2% at 6 months. Between 3 and 6 months, 8% did acquire RSV infection, half of them as acute bronchiolitis and half as non-specific respiratory infection. All of the patients who acquired clinical RSV disease had an antibody concentration of <20 RU/ml which may be the cut off value for protection.

Low dose cyclosporin A treatment in generalized pustular psoriasis.

Generalized pustular psoriasis is a rare form of psoriasis, seldom seen in children. Three patients with generalized pustular psoriasis are presented, two of whom were a sister and brother and whose grandfather also had pustular psoriasis. Lesions consisted of pustular, erythematous, scaly, follicular papules located on the trunk, scalp, and extremities. The pustules in some areas coalesced to form lakes. Histologic examination of several biopsy specimens revealed the changes of pustular psoriasis, which were parakeratosis, elongation of the rete ridges, and deep spongioform pustules and Munro abscesses. All patients were treated with cyclosporin A for periods of 2-12 months. The doses ranged from 1 to 2 mg/kg/day. Clearance of psoriatic lesions occurred after 2-4 weeks of therapy.

Systemic candidiasis with acute Epstein-Barr virus infection.

Systemic Candida infections are usually encountered as opportunistic infections in a setting of immunologic depression. Sepsis or arthritis due to Candida is not expected in healthy people. Epstein-Barr virus may infect B cells, but does not cause immunosuppression of any clinical significance. As far as we know, invasive non-albicans Candida infection complicating Epstein-Barr virus infection has not been reported in previously healthy children. In this report, two previously healthy children, one with sepsis due to Candida species and the other sepsis and arthritis due to Candida parapsilosis are described. Both patients were male and were aged 2 and 9 y. The diagnosis was confirmed by culture. Both children also had coincidental acute Epstein-Barr virus infection, confirmed by Epstein-Barr virus viral capside antigen-IgM. They were both cured with fluconazole given for 21 days and 48 days, respectively.

Correlation of tuberculin induration with the number of Bacillus Calmette-Guérin vaccines.

In developing countries with a higher prevalence of tuberculous infection, usually more than one Bacillus Calmette-Guérin (BCG) vaccine is recommended. Revaccination can considerably alter the tuberculin skin test response and the diagnosis of tuberculous infection. In this study to assess the relationship between the number of BCG vaccinations and tuberculin skin reactions, 3548 children (ages 6 to 12 years) from 7 elementary schools were given 5 tuberculin units of purified protein derivative, and results were compared taking vaccination status into account. Forty-seven children were excluded from the study. Mean purified protein derivative induration size at 72 hours was 3.2 +/- 3.9 mm with no BCG scar (n = 1518), 6.3 +/- 7.8 mm with 1 scar (n = 1513), 10.7 +/- 6.2 mm with 2 scars (n = 433) and 14.8 +/- 4.3 mm with 3 scars (n = 37). In children with no scar the 90th percentile values of the size of the purified protein derivative induration were 10 mm. The 90th percentile values of children with one, two and three scars were 15, 17.5 and 20 mm, respectively. We suggest that tuberculin skin test responses be evaluated with regard to the number of previous BCG vaccinations.

Comparison of BCG vaccination at birth and at third month of life.

Tuberculosis is an important health problem in developing countries and the BCG vaccine plays an important part in preventing the disease. There are different reports about the preventive value of BCG. Some of them claim that it is satisfactory while others suggest that it provides little protection. There are also varying ideas about the optimum time to vaccinate babies, some studies suggesting that late vaccination confers a high degree of protection. This prospective controlled study has been undertaken to evaluate the value of BCG vaccine given to babies during their first three days of life versus its value when given in their third month of life. Evaluation was measured by the results of tests with purified protein derivative (PPD), by vaccine scars, that by the complications of the vaccine. It was found that BCG given at the end of the third month provides a higher rate of response and fewer complications than when given during the first three days of life.