Journal of Pediatric Infectious Diseases - Volume 2, issue 3

Authors: Elitsur, Yoram

Article Type: Other

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 117-119, 2007

Authors: Kofoed, Poul-Erik | Ursing, Johan | Rodrigues, Amabelia | Rombo, Lars

Article Type: Research Article

Abstract: Chemotherapy remains the mainstay of malaria management. Most malaria endemic countries have national recommendations for first line therapy (treatment of uncomplicated malaria), for second line therapy (treatment of treatment failures) and for third line therapy (treatment of severe and complicated malaria). Due to the increasing resistance to the commonly used antimalarial drugs and the introduction of artemisinin containing combination therapies as first line treatment most countries in Sub-Saharan Africa are now recommending …quinine for second line treatment. Quinine, in a dose of 10 mg/kg three times daily for 7 days, has been shown to be an efficacious treatment for both complicated and uncomplicated malaria. However, there is no evidence for its efficacy as second line treatment, especially in children in whom compliance and side effects may pose particular problems. A shorter treatment with quinine is unlikely to be effective as in-vivo and in-vitro studies have indicated that at least 7-day courses are needed. However, reducing the number of doses and the total dose may be considered when quinine is recommended as second line therapy. Single daily dosing, though possibly effective, increases the risk of side effects, whereas twice daily dosing with 10 mg/kg for 7 days may be a treatment option. Using quinine as both second and third line therapy coupled with a possible poor adherence to the treatment schedule increases the risk of quinine resistance developing. In order to have an effective second line treatment and to decrease the risk of resistance to the third line treatment an alternative to quinine for second line therapy would be desirable. There is at present no obvious candidate but the re-emergence of chloroquine sensitivity in Malawi raises the possibility that chloroquine could be reintroduced. Show more

Keywords: Malaria, quinine, treatment failure

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 121-126, 2007

Authors: Sevketoglu, Esra | Karabocuoglu, Metin

Article Type: Research Article

Abstract: Ventilator-associated pneumonia is a common complication of mechanical ventilation in pediatric intensive care units, which results in excess mortality, prolonged lengths of hospitalization and increased medical care cost. Published guidelines are based on data from adults but limited data available for pediatric population. In this article, we aimed to review epidemiology, pathogenesis, predisposing factors, diagnosis, treatment and prevention approaches for ventilator-associated pneumonia specifically in pediatric patients.

Keywords: Ventilator-associated pneumonia, children, pediatric intensive care units

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 127-134, 2007

Authors: Argentieri, Marta | Sabbi, Tamara | Pansani, Laura | Torroni, Filippo | Francalanci, Paola | De Angelis, Paola | Dall'Oglio, Luigi | Menichella, Donato

Article Type: Research Article

Abstract: Resistance to antibiotics frequently used to treat Helicobacter pylori infection is one of the most important factors in treatment failure. The aims of this study were to determine the accuracy of culture and other invasive and non-invasive tests for diagnosis of H. pylori infection in children, using histological examination as the gold standard, and to evaluate rates of resistance to metronidazole, clarithromycin and amoxicillin. Between March 2003 and December 2004, gastric biopsies from 215 children were …tested by histological examination, a rapid urease test and culture. In addition, stool samples were obtained from all children for H. pylori antigen testing. Sixty-four (30%) patients were positive for H. pylori by histological examination. The H. pylori fecal antigen test revealed a sensitivity of 57.8%, a specificity of 93.4%, a positive predictive value of 78.7% and a negative predictive value of 83.9%; rapid urease test had a sensitivity of 70.3%, a specificity of 94.7%, and positive and negative predictive values of 83.3% and 88.2%; culture had a sensitivity of 90.6%, a specificity of 100%, and positive and negative predictive values of 100% and 96.2%. All positive cultures were tested for susceptibility to amoxicillin, metronidazole and clarithromycin by the E-test method. Resistance rates to clarithromycin and metronidazole were 20.7% and 27.6% respectively; no resistance to amoxicillin was observed. This study confirms the place of histological examination as the definitive test for H. pylori, and shows the importance of H. pylori culture in allowing evaluation of antibiotic resistance profiles in pediatric patients. Show more

Keywords: Culture, antibiotics resistance, pediatric age

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 135-139, 2007

Authors: Mozer-Lisewska, Iwona | Dworacki, Grzegorz | Służewski, Wojciech | Kaczmarek, Mariusz | Figlerowicz, Magdalena | Kowala-Piaskowska, Arleta | Mania, Anna | Szczepański, Mirosław | , Jan | Żeromski,

Article Type: Research Article

Abstract: The aim of this study was to investigate the impact interferon type I based anti-viral therapy on the immune system of chronically infected children with hepatitis C and B virus. Peripheral blood mononuclear cells were examined by three-color flow cytometry, using a panel of fluorochrome labeled monoclonal antibodies. It was found that the majority of white blood cell subsets were decreased in patients after termination of long-term anti-viral treatment. In particular, potentially cytotoxic, effector cell subsets, …such as natural killer, natural killer T-lymphocytes and CD8^{+} CD28^{-} T cells were significantly decreased. Moreover, plasmacytoid dendritic cells were decreased, both in percentage and in absolute values. These data suggest that interferon-α based treatment, apart from its anti-viral effect, has also remarkable impact on patient's cell-mediated immunity. Show more

Keywords: Cell immunophenotype, viral hepatitis, children

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 141-146, 2007

Authors: Nnoruka, Edith N. | Ndu, Anne N. | Ohanu, Martin E. | Uzodimma, Bertha A. | Udoh, Inieko-Philip P.

Article Type: Research Article

Abstract: Patchy hair loss in children remains a cosmetic problem for several parents in Africa, Nigeria inclusive. Tinea capitis constitutes one of the commonest acquired causes of this form of alopecia in children. The continual emergence of new mycologic flora, varying with time and from place to place formed the basis of this study; with a view to reflect the current prevalence of tinea capitis and its clinico-etiologic correlation, amongst school children of Southeastern Nigeria. Three hundred …children from seven streams of primary schools were randomly selected. A structured questionnaire was administered once parental consent was obtained. This was followed by examination of the scalp with collection of samples using the brush method. One hundred and thirty nine (48.4%) pupils had evidence of scalp infections on clinical examination such as scalines in 118 (41.1%), alopecia 19 (6.6%), kerion 9 (3.1%) while 148 (51.6%) had nothing on the scalp. Dermatophytosis concurrently affecting other sites of the body occurred in 31 (10.8%) particularly those with Tricophyton soudanense infection. Infection rate per school ranged from 5.4% to 59.3% with mean of 51.7%. Isolated dermatophytes included Microsporum audouinii (31.1%), which was associated with patchy scaly tinea capitis; T. soudanense (22.6%) and Trichophyton tonsurans (13.2%) were mostly linked to the black dot type. Other isolated species included Trichophyton yaoundei (5.6%) and Microsporum canis (1.9%) while three pupils had a mixed isolate of T. soudanense and M. audouinii. Anthropophilic organisms are still prevalent etiologic agents for tinea capitis in our region however high levels of clinical unapparent infections are still amongst some of the challenges of tinea capitis for the region. Health protocols for primary schools should endeavor to include screening for tinea capitis from time to time ensure early identification and prompt management particularly when the number of children presenting with patchy hair loss becomes significant over a period of time. Show more

Keywords: Tinea capitis, patchy hair loss, dermatphytosis, Africa

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 147-151, 2007

Authors: Tabari, Soudabeh Tirgar | Shakerian, Mohammad Ali

Article Type: Research Article

Abstract: Molluscum contagiosum is a viral skin disease commonly affects children. The purpose of this study was to determine the prevalence of molluscum contagiosum in day care centers in Babol, Northern Iran. This cross-sectional study was performed on 986 children from 19-day care centers; in the second half of 2005. Obtained data in all children were analyzed. Four hundred sixty seven girls and 519 boys aged between 1.5–5 years were evaluated. The prevalence of molluscum contagiosum in …girls was 1.7% and in the boys was 2.5% (P>0.05). Overall prevalence of molluscum contagiosum in day care centers was 2.12%. The prevalence of disease in children aged between 2–4 years was higher than those other children (3.6%) (P=0.038). The results show that the prevalence of molluscum contagiosum in day care centers is relatively low, but the prevalence in the age of 2–4 years was the highest. In view of contagious nature of the disease, it is recommended that medical examination of children should include a proper examination of the entire skin before admission into day care centers. Show more

Keywords: Prevalence, molluscum contagiosum, day care center

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 153-155, 2007

Authors: Lin, Yu-Chen | Wang, Ruay-Shyang | Huang, I-Fei | Hsieh, Kai-Sheng | Chiou, Christine C.

Article Type: Research Article

Abstract: We report four pediatric patients with penicillin and cephalosporin-nonsusceptible pneumococcal meningitis who were treated with dexamethasone for the first four days of vancomycin therapy. Serum and cerebrospinal fluid bactericidal tests were performed to measure in vivo activity of vancomycin in the presence of dexamethasone. Favorable outcome was achieved in all four patients.

Keywords: Dexamethasone, serum bactericidal test, pneumococcal meningitis, resistant, vancomycin

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 157-161, 2007

Authors: Pavone, Piero | Nicolini, Enrico | Greco, Filippo | Taibi, Rosaria | Nunnari, Giuseppe

Article Type: Research Article

Abstract: Recent infection seems to be an important and independent risk factor for neurological illness, but the mechanism linking infection and neurological involvement is still largely undetermined. Among infective agents, Mycoplasma pneumoniae is a reasonably common cause of neurological complications in childhood and it can manifest in several ways, including cerebral infarction and extrapyramidal features. Here, we report on a child who had a peripheral neuropathy chronologically, clinically and biologically related to M. …pneumoniae infection. The present report supports the hypothesis of a close causal relationship between this infective agent and the neurological symptoms experienced by this child during an acute episode of respiratory disease. Show more

Keywords: Peripheral neuropathy, childhood, Mycoplasma pneumoniae infections

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 163-166, 2007

Authors: Penazzato, Martina | Rampon, Osvalda | De Canale, Ettore | De Rossi, Anita | Mazza, Antonio | D'Elia, Ruggiero | Giaquinto, Carlo

Article Type: Research Article

Abstract: We report a case of congenital Plasmodium ovale malaria in an infant born to an human immunodeficiency virus ositive Nigerian woman living in Italy throughout pregnancy. In the fifth week of life, while on prophylactic treatment with zidovudine (ZDV), 2 mg/kg/day, the baby developed marked anemia (Hemoglobin: 6.2 g/dL) without any other symptoms. Although ZDV was immediately stopped, the anemia worsened during a second determination (Hemoglobin: 5.4 g/dL), five days later when the mother could be …contacted. Blood smear showed the presence of P. ovale, also confirmed by real-time polymerase chain reaction amplification and sequencing. The baby was hemotransfused and successfully treated with oral quinine sulphate (20 mg/kg/day) for five days and repeated blood smear became negative for malaria. Polymerase chain reaction and viral culture for human immunodeficiency virus at 4 months of age were negative. This report suggests that symptomatic congenital malaria may be present even in European countries and should be considered in the differential diagnosis of anemia in infants, born to human immunodeficiency virus positive immigrant mothers, receiving ZDV prophylaxis. Show more

Keywords: Congenital malaria, Plasmodium ovale, HIV, malaria, pregnancy

Citation: Journal of Pediatric Infectious Diseases, vol. 2, no. 3, pp. 167-169, 2007