[Mycoplasma pneumoniae-associated mucositis in a 17-year-old girl].

Stevens-Johnson syndrome is an autoimmune condition characterised by erythematous target lesions on the skin with involvement of the oral and genital mucosa and conjunctivae. Recent case reports describe incomplete presentations with absence of the characteristic skin changes. This is caused by extrapulmonary manifestations of Mycoplasma pneumoniae lung infection and is now recognised as M. pneumoniae-associated mucositis (MPAM). This case report describes the clinical presentation of MPAM in a 17-year-old girl and highlights the importance of the recognition and the appropriate clinical management.

Antibiotic exposure in infancy and development of BMI and body composition in childhood.

BACKGROUND: It has been hypothesized that antibiotic usage in early life could contribute to development of overweight in childhood. Studies have seen association between antibiotic usage and overweight in childhood. We aimed to investigate the relationship between antibiotic exposure in infancy and development of body mass index (BMI) and body composition. METHODS: A prospective mother-child cohort study of 738 pregnant women and their 700 children, Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010). Information on antibiotic exposure was collected by interviews. Height/length and weight measures were collected at age 1, 2, 3, 4, 5 and 6 years and body composition was determined by a dual-energy X-ray absorptiometry (DXA) scan at age 3.5 and 6 years. FINDINGS: 306 (46%) of the 661 children were exposed to antibiotics before 1 year of age. There were no differences in BMI z-score development at age 1-6 years between children exposed to antibiotics compared to unexposed: z-score difference, -0.06 (95%CI: -0.17;0.06), p = 0.33, and no sex-differences (p-interaction = 0.48). Children exposed vs. not exposed to antibiotics had comparable fat percentage at 6 years of age: log(mean difference), 0.60% (95%CI: -0.212 to 1.41), p = 0.15. INTERPRETATION: Children exposed to antibiotics had similar BMI, BMI z-score and body composition between 1 and 6 years of life compared to unexposed children. Our study does not support the hypothesis that antibiotic exposure in infancy leads to development of obesity in the first 6 years of life. FUNDING: The Lundbeck Foundation, The Ministry of Health, Danish Council for Strategic Research and The Capital Region Research Foundation.

Cesarean Delivery and Body Mass Index at 6 Months and Into Childhood.

BACKGROUND AND OBJECTIVES: The prevalence of cesarean delivery (CD) is rising worldwide, and so is childhood obesity. Studies have shown associations between these factors. We examined the development of BMI from birth through childhood to determine whether CDs were associated with differences in growth and obesity. METHODS: Term children from the birth cohorts Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) and COPSAC2010 were included. Height, length, and weight measurements were collected prospectively until 5 years in COPSAC2010 and until 13 years in COPSAC2000. Dual-energy x-ray absorptiometry (DXA) scans were performed at 3.5 and 7 years. Information on relevant covariates were verified during clinical visits. Analyses were adjusted for covariates associating with CD. RESULTS: In COPSAC2010, 20% (N = 138/673) of the children were delivered by CD; 49% were girls. In COPSAC2000, 19% (N = 76/393) were delivered by CD; 51% were girls. Children delivered by CD had a higher mean BMI at 6 months compared with those delivered vaginally: COPSAC2010 ß-coefficient, .41 (95% confidence interval [CI], .12 to .69), P = .01; COPSAC2000 ß-coefficient, .16 (95% CI, -.11 to .68), P = .16; and meta-analysis ß-coefficient, .37 (95% CI, .14 to .60), P = .002. There were no differences in BMI trajectory between the 2 groups by 5 and 13 years, nor cross-sectional BMI at 5 and 13 years, nor in fat percentages from DXA scans. CONCLUSIONS: Children delivered by CD had a higher BMI at 6 months of age, but this difference did not track into later childhood. Our study does not support the hypothesis that CD leads to later overweight.