[Thorough family history and a multidisciplinary approach are important in sudden cardiac deaths]. / Grundig familieanamnese og et multidisciplinært samarbejde er vigtigt ved udredning af årsager til pludselig hjertedød.

Sudden cardiac death (SCD) is rare, yet well-known in children and adolescents. We present two cases of aborted SCD which reminds us of the importance of comprehensive family history as it proved difficult to ask the right questions revealing the number of family members with cardiac symptoms. Earlier recognition of sudden deaths in the family might have led to more extensive multidisciplinary examinations, and earlier diagnosis.

Clinical characteristics of children with Mycoplasma pneumoniae infection hospitalized during the Danish 2010-2012 epidemic.

INTRODUCTION: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia. Pneumonia may be the most severe manifestation of respiratory M. pneumoniae infection. The most typical symptoms in children are cough and wheezing, which are often accompanied by upper respiratory tract manifestations mimicking viralrespiratory syndromes. MATERIAL AND METHODS: This was a retrospective descriptive study. We included all children hospitalized at the Department of Paediatrics, Hvidovre Hospital, Denmark, from 1 August 2010 through May 2012 who tested positive for M. pneumoniae by polymerase chain reaction (PCR). Clinical data were obtained from the medical charts. RESULTS: A total of 671 PCR analyses for M. pneumoniae were performed of which 102 tested positive (15%). Our study included 101 M. pneumoniae-positive children with a median age of six years (range: 57 days-16 years). The cases were distributed throughout the year, but with a peak from October to January. 43% were five years or younger, with 18% being 0-1 years old and almost 7% being less than one year old. Only 17% were 11-16 years old. 58% of the patients reported more than seven days of fever and/or cough prior to admission. In all, 65 of 101 M. pneumoniae-positive children were discharged within 24 hours of admission. CONCLUSION: M. pneumoniae should be kept in mind as a cause not only of community-acquired pneumonia, but also of milder respiratory infections in children younger than five years. PCR from a nasal or throat swap is an easy, reliable and quick diagnostic test in infants and children. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.

[Clinical assessment cannot predict if children are infected with Mycoplasma pneumoniae]. / Klinisk vurdering kan ikke forudsige, om børn er inficerede med Mycoplasma pneumoniae ­ en gennemgang af et Cochranereview

This meta-analysis was carried out to detect if clinical signs can predict infection with Mycoplasma pneumoniae in children. The only significant finding was that absence of wheezing was associated with M. pneumoniae-infection. The analysis does not justify changes in the recommendation regarding treatment of pneumonia in children. Empiric therapy with macrolides can only be recommended if the patient does not tolerate betalactam.

[Photo-onycholysis observed in connection with doxycycline for malaria prophylaxis]. / Fotoonykolyse ses ved brug af doxycyklin som malariaprofylakse.

We present two cases of phototoxic onycholysis secondary to doxycycline treatment as malaria prophylaxis. Onycholysis is a rare side-effect to treatment with doxycycline and other tetracyclines. Some physicians are unaware of this risk. Due to the increasing travel activity to malaria endemic regions, it is important to be aware of the side effects - including onycholysis - following the use of tetracyclines and it is essential to inform the patients of such effects. Spontaneous recovery follows within a few months after discontinuing the drug and there is no need for further treatment.

Surgical ligation of patent ductus arteriosus in premature infants.

INTRODUCTION: The objective was to evaluate the mortality and the morbidity in neonates operated for persistent ductus arteriosus at Copenhagen University Hospital in the 10-year period from 1 January 1998 to 31 December 2007, and to compare the results with results reported in extant literature. MATERIAL AND METHODS: Patient data were collected by retrospective audit of medical charts. Infants with complex heart disease were excluded. The outcomes were mortality, necrotising enterocolitis (NEC), intraventricular haemorrhage (IVH), paresis of the recurrent laryngeal nerve and chylothorax. For statistical analyses, we used Fisher's exact test and Mann-Whitney U test. RESULTS: We included 46 neonates among an initial 60 candidates. Gestational age was from 23 + 6 to 34 + 0 weeks (mean 26 + 6.5) and the birth weight ranged from 535 g to 1,793 g (mean 943.5 g). In 93% of the cases, the left atrium diameter (LAD)/aorta diameter (Ao)-ratio measured by echocardiography was greater than or equal to 1.5, and medical closure had been attempted in 93% of the cases. After surgical ligation, there were three cases of paresis of the recurrent laryngeal nerve, two cases of chylothorax, eight cases of NEC, four cases of IVH and seven deaths (15.2%). The deaths occurred between three and 119 days postoperatively. Those who died were operated at an earlier age than the remaining patients (p < 0.05) and they tended to be of lower gestational age and to have a lower birth weight (p > 0.05) than those who survived. CONCLUSION: The need for ligation of a patent arterial duct in preterm neonates is subject to considerable risk. Total mortality in this vulnerable group of patients was 15%. Although no obviously procedure-related deaths were observed, severe complications and postoperative morbidity occurred.