The Italian Society for Pediatric Infectious Diseases created a registry on children with infective endocarditis (IE) hospitalized in Italy.
A cross-sectional survey was conducted on patients ...hospitalized due to IE in Italian paediatric wards between January 1, 2000, and June 30, 2015.
Over the 15-year study period, 47 IE episodes were observed (19 males; age range, 2-17 years). Viridans Streptococci were the most common pathogens among patients with predisposing cardiac conditions and Staphylococcus aureus among those without (37.9% vs. 5.5%, p = 0.018, and 6.9% vs. 27.8%, p = 0.089, respectively). Six of the 7 (85.7%) S. aureus strains were methicillin-resistant. The majority of patients with and without predisposing cardiac conditions recovered without any complications.
In Italy, paediatric IE develops without any previous predisposing factors in a number of children, methicillin-resistant S. aureus has emerged as a common causative agent and the therapeutic approach is extremely variable.
Abstract A child referred to Infectious Disease Unit for varicella complicated by pneumonia with pleural effusion. Due to not improvement, laboratory search was extended to uncommon pathogens, ...revealing Nocardia transvalensis infection. It is likely that varicella induced immunodepression, facilitating opportunistic infection in an otherwise healthy and immunocompetent child. To our knowledge, our report is the first case of Nocardia infection in varicella.
Re-emergence of measles in young infants Bozzola, Elena; Quondamcarlo, Anna; Krzysztofiak, Andrzej ...
The Pediatric infectious disease journal
30, Issue:
3
Journal Article
Human parvovirus B19 (HPV-B19) is usually a self-limiting infection in immunocompetent children. In this case report, instead, we describe an immunocompotent child with evidence of persistent HPV-B19 ...infection, arthritis and neurological impairment. He was first admitted to hospital for HPV-B19 infection and sent home in good clinical condition after anti-inflammatory therapy. Eight months later he was re-admitted to hospital for episodes of arthritis and weakness, myalgia, tremors in his legs and hands, and was unable to walk unaided. In both plasma and serum, HPV-B19 DNA, detected by polymerase chain reaction, was still present. For neurological symptoms, he underwent magnetic resonance, which showed increased signal intensity at the spinal roots in the lumbar region, compatible with polyradiculoneuritis. After immunoglobulin therapy he had an excellent response in clinical and radiological terms, suggesting an association between neurological impairment and HPV-B19 infection. Eleven months after the second admission, the patient was still in good clinical condition.
Abstract We report the case of an immunocompetent child with spondylodiscitis as a result of staphylococcal sepsis, which was successfully treated with linezolid. The patient was admitted with fever ...and circumferential swelling in the paradorsal region, which was evident only in the flexed back position. A chest X-ray showed a pleural effusion with pneumonitis and dorsal kyphosis. Following the yield of Staphylococcus aureus from blood cultures, the initial therapy of ceftriaxone and amikacin was changed to vancomycin. However, the dorsal swelling increased further and imaging investigations showed destruction of the vertebral bodies D8–D10 and surrounding tissue swelling. Vancomycin was changed to linezolid, and the patient began to improve; a full recovery was made. Our case suggests that even if spondylodiscitis is rare in the pediatric age-group, particularly as a complication of staphylococcal sepsis, early diagnosis and prompt and appropriate therapy are important to prevent severe complications.
In HIV-1-infected children, active cytomegalovirus (CMV) infection can cause severe clinical manifestations and accelerate progression of HIV disease. However, sufficient quantities of blood samples ...may not be available either for culture or detection of CMV DNA or antigens in white blood cells. The aim of this study was to investigate the diagnostic and prognostic significance of detecting CMV DNA in serum samples from HIV-1-infected children.
Sera from 55 children (18 boys), aged 2-130 months (mean, 49.8 months), with perinatal HIV-1 infection and clinical manifestations attributable to CMV infection were tested for CMV DNA by nested polymerase chain reaction and for class-specific CMV antibodies immunoglobulin (Ig) G, IgA, IgM by enzyme-linked immunosorbent assay. The children were followed up for 2 days to 59 months (mean, 25.5 months).
CMV infection was demonstrated in 43 children (74.5%), 18 of whom (42%) were positive for CMV DNA. During the follow-up, 13 children with CMV infection (30.2%) died, including 11 (84.6%) who were positive for CMV DNAemia just before death. Of these children, seven died soon after hospitalization without antiviral treatment, and four died despite therapy with ganciclovir or foscarnet. Post-mortem CMV inclusions were revealed in seven out of eight children who underwent autopsy. The two other children who died also had progressive CMV disease and received ganciclovir until death. In comparison with CMV-seropositive children without CMV DNAemia, children with CMV DNAemia showed significantly shorter mean survival time (42.5 versus 60 months; P < 0.01), lower final CD4+ T-cell count (218 versus 499 x 10(6)/1; P < 0.01) and higher mortality rate (P < 0.0001).
The detection of CMV DNA in serum is of value for diagnosis of active CMV infection in HIV-1-positive children, and CMV DNAemia is a good prognostic indicator of severe outcome of HIV disease.
Mucocutaneous diseases are more frequent in HIV/AIDS-infected children than in the normal population. We analyze mucocutaneous disorders with atypical presentations in a large population of ...HIV-infected children, with or without full-blown AIDS, compared to a population of HIV seroreverted children. The majority of these cutaneous disorders have an infectious etiology and their frequency is related to the degree of deterioration of the immune system. Some diseases commonly observed in adults are rare in children; neoplasms are an exception.
PDF
