[Nonvaccine Streptococcus pneumoniae serotypes causing acute bacterial meningitis]. / Streptococcus pneumoniae serotipo no vacunal como agente causal de meningitis bacteriana aguda.

The pneumococcal heptavalent conjugate vaccine protects children aged less than 2 years old from invasive pneumococcal disease (IPD). Efficacy is 89-93% in the US population and 71-86% in European studies. The vaccine confers active immunization against the main serotypes causing IPD (4, 6B, 9V, 14, 18C, 19F y 23F). We describe 2 children who presented with pneumococcal meningitis caused by nonvaccine serotypes. As a result of the widespread use of the heptavalent vaccine, there may be a shift in the serotypes causing IPD.

[Asymmetrical otocraniofacial syndrome (hemifacial microsomy) in discordant monozygotic twins. Otologic aspects]. / Síndrome otocraneofacial asimétrico (microsomía hemifacial) en gemelos monocigóticos discordantes. Aspectos otológicos.

The authors present a case of otocraniofacial syndrome with asymmetric involvement (hemifacial microsomia) in monozygotic twins discordant for the syndrome. Only a few cases of discordance in monozygotic twins have been previously describe in world literature. The occurrence of discordance in identical twins indicates the significance of exogenous factors. The patient had bilateral involvement right side being more severely involved than left side. Conductive hearing loss due to middle ear abnormalities was also present. Usefulness of tomographic examination to study structural ear abnormalities is emphasized, and some comments on the otologic involvement in this syndrome are made.

[Acute pancreatitis (a Coxsackie B2?) and associated anomalies]. / Pancreatitis aguda (a coxsackie B2?) y anomalías asociadas.

Authors report one case of acute pancreatitis in an obese twelve-year-old girl. The clinical picture appeared, without antecedent causes, as acute abdomen which required operation. Reduced echodensity of the pancreas was not found. The patient improved and recovered completely, her course being uneventful two years later. Scoliosis due to hemivertebra, and renal hypoplasia were present. No pancreatic malformation according to hypothesis of commun pathogenic mechanism was identified. Antibody titer to coxsackie B2 suggesting etiologic role was obtained. Amylase creatinine clearance ratio was calculated and suitability of establishing diagnostic values for pediatric ages is emphasized.