La gripe es un proceso muy frecuente en la infancia que afecta al 30-40% de los niños.
Entre los niños ingresados por virus de la gripe, determinar las causas más frecuentes de hospitalización, los ...síntomas principales y el diagnóstico clínico al alta relacionados con la edad y el tipo de virus de la gripe, así como valorar el uso de métodos diagnósticos y terapéuticos.
Estudio descriptivo retrospectivo obtenido mediante la revisión de historias clínicas de niños hospitalizados con diagnóstico de gripe en el Hospital Infantil Miguel Servet de Zaragoza durante cuatro períodos epidémicos anuales (2002-2006).
Se observaron 178 casos de gripe, de los que 132 correspondieron al virus de la gripe A y 46 al B.
El principal motivo de ingreso en el hospital fue fiebre sin foco, sobre todo en menores de 6 meses, seguido por convulsión febril y dificultad respiratoria. La sintomatología predominante fue fiebre, tos y rinitis, y vómitos en mayors de 3 años, especialmente en los casos de gripe B.
Los diagnósticos principales al alta fueron infección respiratoria de vías altas, faringoamigdalitis y otitis. El diagnóstico de bronquitis/bronquiolitis fue más frecuente en los pacientes menores de 2 años.
Se realizó radiografía de tórax en el 80 %, con condensación neumónica en el 10,5 % y se administró antibioterapia en el 59 % de los pacientes, principalmente amoxicilina-ácido clavulánico.
Existe una gran variación en las causas de ingreso y presentación clínica de la gripe, en algunos casos determinado por la edad y el tipo de virus gripal.
Influenza is frequent during childhood, affecting approximately 30-40% of children.
To identify the most frequent causes of hospitalization in children admitted to hospital for influenza, as well as the main symptoms and clinical diagnoses at discharge,and to relate these factors with the type of influenza virus and patients’ age. A further aim was to evaluate the use of the diagnostic and therapeutic methods.
We performed a retrospective descriptive study through a review of the medical records of children admitted to the Miguel Servet Children's Hospital in Zaragoza (Spain) for influenza in four epidemic seasons (2002-2006).
A total of 178 influenza cases were found, 132 due to influenza A and 46 due to influenza B.
Hospital admission was mainly due to fever without focus, especially in infants aged less than 6 months, followed by convulsions and shortness of breath. The main symptoms were fever, cough, rhinitis, and vomiting. The latter was especially frequent in children older than 3 years and in patients with influenza B virus.
The main discharge diagnoses were upper respiratory tract infection, pharyngitis-tonsillitis, and otitis. Diagnosis of bronchitis was more frequent in children aged less than 2 years old.
Chest X-ray was performed in 80 % of the patients and lung consolidation was found in 10.5 %. Antibiotic therapy was administered in 59 % of the patients, mainly amoxicillin-clavulanic acid.
The causes of admission for influenza and clinical presentation of this infection vary widely, sometimes depending on age and the type of influenza virus.
Influenza is frequent during childhood, affecting approximately 30-40 % of children.
To identify the most frequent causes of hospitalization in children admitted to hospital for influenza, as well as ...the main symptoms and clinical diagnoses at discharge, and to relate these factors with the type of influenza virus and patients' age. A further aim was to evaluate the use of the diagnostic and therapeutic methods.
We performed a retrospective descriptive study through a review of the medical records of children admitted to the Miguel Servet Children's Hospital in Zaragoza (Spain) for influenza in four epidemic seasons (2002-2006).
A total of 178 influenza cases were found, 132 due to influenza A and 46 due to influenza B. Hospital admission was mainly due to fever without focus, especially in infants aged less than 6 months, followed by convulsions and shortness of breath. The main symptoms were fever, cough, rhinitis, and vomiting. The latter was especially frequent in children older than 3 years and in patients with influenza B virus. The main discharge diagnoses were upper respiratory tract infection, pharyngitis-tonsillitis, and otitis. Diagnosis of bronchitis was more frequent in children aged less than 2 years old. Chest X-ray was performed in 80% of the patients and lung consolidation was found in 10.5%. Antibiotic therapy was administered in 59% of the patients, mainly amoxicillin-clavulanic acid.
The causes of admission for influenza and clinical presentation of this infection vary widely, sometimes depending on age and the type of influenza virus.
Describir la clínica, radiología, diagnóstico y tratamiento en los niños afectados por un brote de tuberculosis en una guardería de Zaragoza.
El caso índice fue una cuidadora que fue diagnosticada ...tardíamente de tuberculosis activa. Se realizó Mantoux a todos los niños, a los positivos se hizo radiografía de tórax. En aquéllos con radiografía patológica se procedió al diagnóstico microbiológico.
De todos los niños de la guardería, 11 presentaron un Mantoux positivo. La radiografía fue patológica en 10. De ellos, 7 (70 %) estaban sintomáticos. Las imágenes radiológicas mostraban en 9 (90 %) casos una condensación parenquimatosa y en 5 (50 %) una adenopatía parahiliar. Tres niños (30 %) presentaron atelectasia lobular y precisaron broncoscopia y administración posterior de corticoides. La baciloscopia fue positiva solamente en un niño, el cultivo en siete y la detección de muestra directa para el complejo tuberculosis en otros siete. Únicamente en un niño toda la investigación fue negativa.
El diagnóstico de tuberculosis en la infancia es difícil, y a veces debe hacerse en base a unos criterios clínicos, radiológicos y epidemiológicos en niños con Mantoux positivo. Los test de detección de muestra directa para el complejo tuberculosis tienen una sensibilidad muy alta y proporcionan resultados muy rápidos. La aparición de brotes epidémicos continúa siendo un hecho frecuente en nuestro medio. El estudio de contactos en los mismos presenta un elevado rendimiento en el control de los brotes.
To describe the clinical and radiological features, diagnosis, and treatment of an epidemic outbreak of tuberculosis in a daycare centre in Zaragoza.
The index case was a teaching assistant with a late diagnosis of bacilliferous tuberculosis. Mantoux testing was carried out in all children. In those with a positive Mantoux test, a chest X-ray was performed. Children with an abnormal chest X-ray underwent microbiological investigations.
Among all the children in the daycare center, the Mantoux test was positive in 11 children. Chest X-ray was abnormal in 10 children. Of these, seven (70 %) were symptomatic. Chest X-ray showed dense opacification in nine children (90 %) and mediastinal lymph adenopathy in five (50 %). Three children (30 %) had lobar atelectasis requiring bronchoscopy and subsequent steroid therapy. Bacilloscopy was positive in only one child. Gastric juice culture was positive in seven children and the amplified
Mycobacterium tuberculosis direct test was positive in a further seven. All microbiological investigations were negative in only one child.
Establishing a definitive diagnosis of tuberculosis in children remains difficult and frequently relies on a constellation of clinical findings, radiology and epidemiology in children with a positive Mantoux test. The amplified
Mycobacterium tuberculosis direct test has high sensitivity and provides fast results. Epidemic outbreaks continue to be frequent in Spain. Study of contacts shows high efficiency in controlling outbreaks.
Nontuberculous or environmental mycobacterial disease in children has been increasingly recognized over the last decade. We present four patients who were diagnosed in the year 2000. The children ...were aged between 2 and 8 years. Three patients presented involvement of the cervical lymph nodes and one presented involvement of the inguinal nodes. Three of the children were treated with a combination of surgery and chemotherapy and one was treated with chemotherapy alone. We describe the clinical characteristics, laboratory findings, therapeutic management and complications of nontuberculous mycobacterial lymphadenitis in children.
Parasitosis by Onchocerca volvulus García-Dihinx Villanova, J; Betrián Blasco, P; De Juan Martín, F ...
Anales españoles de pediatría
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Journal Article
