Borrelial Lymphocytoma in Children Arnež, Maja; Ružić-Sabljić, Eva
The Pediatric infectious disease journal
34, Številka:
12
Journal Article
Recenzirano
The aim of this study was to investigate demographic features, clinical characteristics, laboratory findings and posttreatment course of the disease in children with borrelial lymphocytoma (BL).
...Between 2008 and 2014, we prospectively studied 33 children younger than 15 years with untreated BL. Data on demographic and clinical features were collected by means of a questionnaire. Serological testing and Lyme borrelia blood cultures were performed. All patients were treated with recommended antibiotics. Patients were followed up at least 3 months after inclusion into the study.
Twenty-two boys and 11 girls, aged 2-13 (median, 5.5) years, fulfilled the inclusion criteria. A tick bite at the site of BL was recalled by 30%. The median incubation period was 10.5 (range, 1-38) days. The median duration of BL before the initial examination was 10 (range, 0-270) days. In 88% of patients, BL was localized on ear lobe. The color/shape of BL was more often red (73%) and puffy (91%). Median size was 1.5 (range, 0.5-3) cm. The initial disease was mild in 82%. Associated symptoms were reported in 36% of patients. Concomitant solitary erythema migrans and meningitis were detected in 9% and 3% of patients, respectively. Serum borrelial antibodies were present in 40% of patients. In 7%, Borrelia afzelii was isolated from blood. Posttreatment course of the disease revealed the median duration of BL and systemic symptoms for 16 (range, 2-46) and 15 (range, 3-40) days, respectively.
BL in children, treated with recommended antibiotics, is a mild disease with a good prognosis.
We determined levels of tick-borne encephalitis (TBE) virus (TBEV) RNA in serum samples obtained from 80 patients during the initial phase of TBE in Slovenia. For most samples, levels were within the ...range of 3-6 log
copies RNA/mL. Levels were higher in female patients than in male patients, but we found no association between virus load and several laboratory and clinical parameters, including severity of TBE. However, a weak humoral immune response was associated with a more severe disease course, suggesting that inefficient clearance of virus results in a more serious illness. To determine whether a certain genetic lineage of TBEV had a higher virulence potential, we obtained 56 partial envelope protein gene sequences by directly sequencing reverse transcription PCR products from clinical samples of patients. This method provided a large set of patient-derived TBEV sequences. We observed no association between phylogenetic clades and virus load or disease severity.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
BACKGROUND:Information on the etiology of Lyme neuroborreliosis (LNB) in children in Europe and the influence of Borrelia burgdorferi sensu lato species isolated from cerebrospinal fluid (CSF) on ...clinical presentation of LNB in children are limited.
METHODS:The study was monocentric. During its 17-year period, children younger than 15 years with presentation suggestive of LNB or confirmed Lyme borreliosis that had B. burgdorferi sensu lato isolated from CSF and had species of B. burgdorferi sensu lato identified by pulsed-field gel electrophoresis were included. Demographic and medical data were compared for children infected with Borrelia garinii to those infected with Borrelia afzelii.
RESULTS:One hundred and fifty-three children had B. burgdorferi sensu lato isolated from CSF. In 71/113 (62.8%) and 42/113 (37.2%) patients, B. garinii and B. afzelii, respectively, were identified. Patients infected with B. garinii did not report symptoms suggestive of central nervous system (CNS) involvement or any other symptoms more often than patients infected with B. afzelii. Compared with children infected with B. afzelii, children infected with B. garinii had erythema migrans less often (18.3% vs. 45.2%) but had positive meningeal signs (69.0% vs. 38.1%), CSF lymphocytic predominance (97.1% vs. 75.0%), and elevated albumin CSF/serum quotient (80.6% vs. 50.0%) more often.
CONCLUSIONS:In Slovenia, LNB in children is more often caused by B. garinii, followed by B. afzelii. The clinical picture of LNB in children caused by B. garinii is not more often suggestive of CNS involvement, but CNS inflammation is more pronounced in children infected with B. garinii, compared with children infected with B. afzelii.
BACKGROUND:Comparison of clinical efficacy and adverse effects of treatment with azithromycin and amoxicillin in children with solitary erythema migrans (EM).
METHODS:Consecutive patients younger ...than 15 years with untreated solitary EM referred to our institution 2002–2003 were included in this unblinded prospective clinical study in which patients were alternatively treated with either azithromycin for 5 days or amoxicillin for 14 days. The efficacy of treatment of acute disease, development of minor and major manifestations of Lyme borreliosis and adverse effects of treatment were surveyed by follow-up visits during the first year after inclusion.
RESULTS:Eighty-four patients received azithromycin and 84 amoxicillin. Pretreatment characteristics in the 2 groups were comparable with the exception that patients in azithromycin group more often reported a tick bite at the site of later EM (69% versus 52%; P = 0.0400), had more often EM on the trunk (50% versus 26%; P = 0.0025) and reported longer duration of symptoms (median 3 versus 2 days; P = 0.0283). The posttreatment period revealed no significant differences between azithromycin and amoxicillin groups including the duration of EM (median 3 days; P = 0.8984) and the appearance of minor (12% versus 21%; P = 0.2146) and major manifestations (2.6% in each group) of Lyme borreliosis. Adverse effects of treatment were observed in 21% of patients treated with azithromycin and in 16% treated with amoxicillin, and the appearance of Jarisch–Herxheimer reaction was recorded in 7% and 15%, respectively (P = 0.1438).
CONCLUSIONS:Comparison of azithromycin and amoxicillin for the treatment of children with solitary EM revealed comparable efficacy and adverse effects of treatment.
Leta 2021 smo se v Sloveniji soočili z izbruhom hantavirusnih okužb, ki povzročajo hemoragično mrzlico z renalnim sindromom. Pri otrocih je bolezen redka. V prispevku prikazujemo štirinajstletno ...dekle s hemoragično mrzlico z renalnim sindromom, ki jo je povzročil virus Puumala.
Abstract Laboratory confirmation of Lyme borreliosis (LB) relies mainly on the demonstration of anti-borrelial antibodies. In recent studies, a novel VlsE protein IR6 peptide-based assay has been ...introduced. Our aim was to evaluate the IR6 peptides from three Borrelia burgdorferi sensu lato genospecies in the serodiagnosis of European and North American patients. Five VlsE protein IR6 peptide variants representing sequences from B. burgdorferi sensu stricto, B. garinii , and B. afzelii were used as antigens in both IgG and IgM enzyme-linked immunosorbent assays (ELISA). Serum antibodies of 187 patients at different stages of LB from Europe and the United States were evaluated for serodiagnosis. For comparison samples were tested with one of the commercial IR6 ELISAs. Three B. afzelii IR6 variant peptides revealed antibodies that were concordant with each other. B. burgdorferi sensu stricto peptide antibodies mostly paralleled B. afzelii peptide antibodies, and positive values were also obtained in the majority of European sera. For several sera, B. garinii IR6 peptide antibodies were discordant to B. afzelii peptide antibodies. The commercial IR6 peptide antibody assay (C6 ELISA) results correlated better with B. burgdorferi sensu stricto IR6 than with B. garinii IR6 peptide IgG results, especially in sera from patients with facial palsy. Thus, antibody specificity to IR6 peptides may vary according to the infecting Borrelia species. In some manifestations of the disease, C6 ELISA may not cover all LB cases. Evidently, the methodological aspects in ELISA design for peptide antibody measurements are important as well as the amino acids sequence of the antigen.
A 13-year-old boy who presented with a red left eye, painful eye movement, blurred vision, photophobia and increased lacrimation, was diagnosed with 1-sided panuveitis with optic disk edema. ...Diagnostic work-up revealed borrelial antibodies in serum. Diagnosis of Lyme borreliosis was substantiated by demonstration of lymphocytic pleocytosis, intrathecal borrelial antibody synthesis, improvement after treatment with ceftriaxone and exclusion of other causes.
Dojencek z vrocino in polzevim vsadkom Arnez, Maja; Gros, Anton
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
02/2014, Letnik:
83, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The article provides recommendations for evaluation and treatment of children with cochlear implants. An illustrative case of an infant with Haemophylus inuenzae type e bacterial meningitis eighteen ...days following cochlear implant placement is reported. Indications for implantation and criteria to be fullled before implantation of cochlear implants are described. The importance of appropriate vaccination of children with cochlear implants as well as treatment of both acute otitis media and bacterial meningitis in these children is stressed. PUBLICATION ABSTRACT
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