Journal of Pediatric Infectious Diseases - Volume 8, issue 2

Authors: Brook, Itzhak

Article Type: Research Article

Abstract: Despite its in vitro efficacy, the increased inability of penicillin to eradicate Group A beta-hemolytic streptococci (GABHS) from patients with acute and relapsing pharyngo-tonsillitis (PT) is of great concern. This review describes the causes of penicillin failure in eradicating GABHS PT. These include the presence of beta-lactamase producing bacteria (BLPB) that "protect" GABHS from penicillins; the absence of bacteria that interfere with the growth of GABHS; co-aggregation between GABHS and Moraxella catarrhalis; and the poor …penetration of penicillin into the tonsillar tissues and the tonsillo-pharyngeal cells which allows intracellular GABHS and Staphylococcus aureus to survive. The inadequate intracellular penetration of penicillns can allow intracellular GABHS and S. aureus to persist. In the treatment of acute tonsillitis, the use of cephalosporins can overcome these interactions by eradicating aerobic BLPB (including M. catarrhalis), while preserving the potentially interfering organisms and eliminating GABHS. In treatment of recurrent and chronic PT the administration of clindamycin, or amoxicillin-clavulanic acid can eradicate both aerobic and anaerobic BLPB as well as GABHS. The superior intracellular penetration of cephalosporins and clindamycin enhances their efficacy against intracellular GABHS and S. aureus. Show more

Keywords: Tonsillitis, group A streptococci, penicillin, cephalosporins, beta-lactamase

DOI: 10.3233/JPI-130386

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 2, pp. 59-69, 2013

Authors: Tahara, Takahiro | Asano, Yoshizo | Mitamura, Keiko | Nakamura, Hidefumi | Itoh, Susumu

Article Type: Research Article

Abstract: The aim of this study was to investigate the treatment of influenza and safety of oseltamivir in infants less than 1 year of age. All-patient surveillance was conducted using centralized enrolment at 219 medical institutions. Safety data were collected for 1,663 patients less than 1 year of age who developed influenza during the 2004–2005 influenza season. Patients were stratified into three groups: patients not treated with a drug (Group A), patients treated with oseltamivir (Group B), …and patients treated with a drug other than an antiviral agent (Group C). Significant differences (P = 0.0074, P < 0.0001) were observed among incidences of adverse events in the three groups (Group A: 26.7%, Group B: 30.0%, Group C: 21.5%) and between the incidences of adverse drug reactions (ADRs) in the two drug-treated groups (Group B: 6.7%, Group C: 0.9%). The most commonly reported ADRs in patients treated with oseltamivir were diarrhoea, hypothermia, vomiting, and rash. We found that 77.2% of patients received oseltamivir and 20.0% received symptomatic treatments such as antipyretic agents. In infants less than 1 year of age, incidence of ADRs with oseltamivir treatment was higher than with symptomatic treatments, however these ADRs were treatable symptoms and consistent with the ADRs reported in young children treated with oseltamivir. Our analysis of the safety of oseltamivir in infants less than 1 year of age revealed clinical acceptance of safety issues. Show more

Keywords: Infant, under one year old, oseltamivir, influenza virus, drug safety

DOI: 10.3233/JPI-130381

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 2, pp. 71-81, 2013

Authors: Udo, Jacob Jackson | Uko, Ntia Happiness | Udo, Anah Maxwell | Ibor, Eyong Komomo | Uket, Ewa Atana | Saturday, Etuk Imaobong

Article Type: Research Article

Abstract: Mother-to-child transmission (MTCT) of HIV infection is the main mode of transmission in children. The Prevention of mother to child transmission is targeted at reducing the transmission of HIV to infants of infected mothers. However, this has not appreciably created the desired impact in some centres. The study presents a preliminary report from an immunization centre of the HIV sero-status in children whose mothers were sero- negative at antenatal booking. One hundred and fifty healthy children …of consenting mothers who were HIV sero-negative at antenatal care booking were recruited into the study. Bio data of the children and the socioeconomic status of parents were determined. All recruited infants were screened for HIV 1&2 antibodies and results analysed. All positive infants were referred for DNA-PCR. Eight (5.3%) of the 150 children tested positive to HIV. Half of the seropositive infants belong to the middle social class all mothers of seropositive infants were HIV positive. One of the five seropositive infants had positive DNA-PCR while three were lost to follow up. The sero-positivity of HIV infection among infants whose mothers were previously negative during ANC booking was relatively high. A second HIV screening should be done shortly before delivery is recommended and children presenting at immunization clinic whose mothers did not have screening late in pregnancy should be screened. Show more

Keywords: HIV sero prevalence, immunization, infants

DOI: 10.3233/JPI-130383

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 2, pp. 83-86, 2013

Authors: Khassawneh, Mohammad Y. | Khriesat, Waddah M. | Saqan, Rola M. | Hayajneh, Wail A.

Article Type: Research Article

Abstract: Pattern of bacteria that causes urinary tract infection (UTI) in infants after discharge from neonatal intensive care units (NICU) are not well described. This Study included 74 patients with first episodes of UTI in the first 3 months of life. They were divided into 2 groups, 31 case occurred during NICU stay (group 1), 43 cases with UTI that occurred after discharge from NICU (group 2, NICU graduates). Types of bacteria, its susceptibility to common antibiotics, …renal abnormalities and circumcision status were compared between both groups. Eighty two percent of patients in the both groups were male. Between 71.9%–74.4% of patients in both groups were preterm. Among NICU graduates, Incidence of UTI in infants who were preterm and those who were term was 8.2% and 2.1% respectively p < 0.001. The most common causative bacteria in both groups were Klebsiella pneumoniae and Escherichia coli. Bacteria that caused UTI in NICU graduates were highly resistant to common antibiotics and were similar (in types and the resistance) to bacteria that caused UTI in patients during stay in NICU. UTI in NICU graduates happen frequently in premature, young male infants. Their UTI were caused by bacteria that are similar in type and resistant pattern to those cause UTI in NICU patients. Show more

Keywords: Neonatal sepsis, UTI, young infants

DOI: 10.3233/JPI-130385

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 2, pp. 87-91, 2013

Authors: Ahmadu, Baba Usman | Emmanuel, Pembi | Kurna, Babagana Mustapha

Article Type: Research Article

Abstract: We describe a case of digital gangrene in a toddler with background disseminated tuberculosis based on non response to antibiotic treatment for twenty four days, lack of BCG immunization, positive contact with adult having chronic cough, favorable epidemiologic and radiologic features of tuberculosis. She presented with fever, cough, vomiting, weight loss and black discolouration of the fingers and toes. Patient was febrile (Temp 39.4°C), pale, had digital gangrene, peripheral lymphadenopathy and weighed 75% of her expected …body weight. She was dyspnoeic, tachypnoec, respiratory rate of 42 cycles per minute with crackles. Her pulse rate was 140 beat/minute (tachycardia), in addition to hepatosplenomegaly. Chest X-ray showed features of consolidation, full blood count revealed packed cell volume of 21%, eosinophilia of 8% and erythrocyte sedimentation rate (ESR) of 130 mm/Hr. Patient remarkably improved with anti-tuberculosis drugs and discharged on follow-ups. Show more

Keywords: Digital gangrene, disseminated tuberculosis, toddler, low health resource country

DOI: 10.3233/JPI-130382

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 2, pp. 93-96, 2013

Authors: Aminolsharieh Najafi, Soroosh | Tafreshi, Mona | Hasheminejad, Reyhaneh

Article Type: Research Article

Abstract: Most cases of primary Epstein-Barr virus (EBV) infection during infancy and early childhood are mild or subclinical; therefore, the diagnosis of an EBV infection is not performed easily in this age group. Infectious mononucleosis (IM) is rarely reported during infancy. We report a 40-day-old infant with cervical node enlargement, cough, and coryza symptoms who was finally identified as having a case of primary IM based on the patient's clinical features and serological tests.

Keywords: Epstein-Barr virus, infectious mononucleosis, infancy, diagnosis

DOI: 10.3233/JPI-130387

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 2, pp. 97-99, 2013

Authors: Hernandez, Lazaro E. | Shepard, Charles | Hoggard, Eric | Bryant, Roosevelt III.

Article Type: Research Article

Abstract: Anterior mediastinal abscesses of non-traumatic etiology are extremely rare in childhood and their presentation can be variable. We describe the unusual case of a previously healthy 10 year old boy who presented to the emergency department with chest pain and fever. Patient was found to have an anterior mediastinal abscess caused by Staphylococcus aureus. Even though surgical drainage was performed with significant clinical and laboratory improvement, patient developed secondary sternal osteomyelitis motivating a …longer course of intravenous antibiotic therapy (for a total of 7 weeks). We discuss the etiology, diagnosis and therapeutic options of anterior mediastinal masses in children, drawing comparison with similar cases previously reported. Show more

Keywords: Mediastinal abscess, children, chest pain, osteomyelitis

DOI: 10.3233/JPI-130388

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 2, pp. 101-105, 2013

Authors: Boyd, Mary Adetinuke | Lederman, Howard M. | Travassos, Mark A.

Article Type: Research Article

Abstract: A four-year-old African-American female with a history of asthma, a Staphylococcus aureus skin abscess, and two prolonged pneumonia episodes presented with a one-week history of productive cough, fever, and night sweats. Chest computed tomography revealed right lung consolidation, cavitation within the right azygoesophageal recess, and an enlarged paratracheal lymph node, and biopsy of the lymph node showed granulomas. Lung tissue culture grew Burkholderia cepacia. A nitroblue tetrazolium test indicated a diagnosis of …chronic granulomatous disease (CGD). CGD is a rare primary immunodeficiency in which there is a functional defect in one of the genes encoding nicotinamide adenine dinucleotide phosphate oxidase, which leads to impaired killing of catalase-producing bacteria and fungi within the phagolysosome. CGD presents most commonly as recurrent and prolonged pulmonary infections, but may also include repeated episodes of lymphadenitis, cutaneous infections, hepatic abscesses, and osteomyelitis. Staphylococcus aureus is the most commonly isolated organism, but infection with certain other bacteria such as Burkholderia cepacia is highly suggestive of CGD. Show more

Keywords: Chronic granulomatous disease, cavitary pneumonia, Burkholderia cepacia, granuloma

DOI: 10.3233/JPI-130384

Citation: Journal of Pediatric Infectious Diseases, vol. 8, no. 2, pp. 107-109, 2013