Pediatric Infectious Disease最新文献

Sepsis is an important cause of infant mortality in India with bacterial infections being the most common causative agent. However studies related to group B streptococcus have been limited and hence a study was taken up to look for antenatal carriage of Streptococcus agalactiae in the Indian population this study revealed a carriage rate of 14.81% implying that we now need to look at group B streptococcus as a possible etiology in neonatal sepsis more actively.

Several studies have determined that Bacterial Meningitis Score (BMS) has a high sensitivity and specificity for distinguishing bacterial meningitis from aseptic meningitis. Thus, the authors conducted a cross-sectional study in 252 children with clinical suspected meningitis in the Hatyai Hospital located in the Southern part of Thailand. In this study, BMS has 100% sensitivity (95%CI; 0.799–1) and 62.1% specificity (95%CI; 0.554–0.682). Positive predictive value (PPV) was 18.5% (95%CI; 0.119–0.273) and negative predictive value (NPV) was 100% (95%CI; 0.967–1). BMS is a useful screening tool for early diagnosis of bacterial meningitis before cerebrospinal fluid culture result is known, especially when latex agglutination is not available. BMS is not recommended as a diagnostic confirmation tool because of its low specificity.

Neonatal dengue is now being increasingly reported for changing epidemiology and improved rapid detection methods. Vertical transmission with dengue virus is concordant with rules of nanomedicine and may present differently in newborns from what we normally see in older children. It may have prolonged symptomatology and protracted thrombocytopenia. There are no specific guidelines for neonatal dengue management. There is dearth of standard literature about neonatal dengue per se and most recommendations are based on experiences with older children and adults. The unique pathogen–host interaction complicates dengue vaccine development and creates provocative questions in vaccine development. We present a case report of neonatal dengue with review of literature. A day 8 old newborn with maternally acquired dengue was admitted in our NICU and had an eventful course. This congenital dengue infection case gives us good learning experiences in a not so well understood entity.

Background

To investigate the association of respiratory tract viruses with Henoch-Schönlein purpura (HSP) in children.

Methods

40 children with HSP and 42 controls with upper respiratory tract infections were enrolled in the study. In both groups, the serum IgM antibodies and viral antigens in peripheral blood mononuclear cells (PBMCs) of common respiratory tract viruses including parainfluenza virus (PIV), influenza, respiratory syncytial virus (RSV), and adenovirus were detected. Children with HSP nephritis (HSPN) received renal biopsy, and antigens of the aforementioned viruses were examined.

Results

Viral IgM antibodies in sera and antigens in PBMCs were detected in HSP and control groups (55% vs. 42.9% and 60% vs. 42.9% respectively), but the differences were not significant. The prevalence of PIV IgM antibody and antigen in PBMCs in HSP group was significantly higher than that in controls (P < 0.01). HSP children with antigens in PBMCs had higher urinary microalbumin and 24-h urinary protein than those without (P < 0.05 and P < 0.01 respectively). 22 children with HSPN received renal biopsy and 13 of them had viral antigens in the kidneys (12 for PIV and 1 for RSV). HSPN children with viral antigens in kidneys also had higher urinary microalbumin and 24-h urinary protein than those without (P < 0.05) and chiefly manifested as proteinuria (P < 0.01). However, no differences in terms of histopathological characteristics between children with or without viral antigens in the kidneys were observed.

Conclusions

The presence of respiratory tract viruses was common in HSP children. PIV may be an important contributing factor in the pathogenesis of HSP.