Anales Espanoles De Pediatria最新文献

Background: Streptococcus pneumoniae is the most commonly reported bacterial cause of bacteremia and bacteremic pneumonia and the second most frequent cause of meningitis.

Objective: To establish the incidence, characteristics and serotypes causing invasive pneumococcal disease in children aged less than 5 years in two Autonomous Communities in Spain, the Basque country and Navarre, between 31 May 1988 and 1 June 2001.

Patients and methods: We performed a descriptive, observational and retrospective study. The study population was composed of children diagnosed with invasive pneumococcal disease in the public and private hospitals with a pediatrics departments. Invasive pneumococcal disease was defined as isolation of S. pneumoniae in blood, cerebrospinal fluid or any other sterile biological fluid. Medical records were reviewed and demographic and diagnostic variables were analyzed. Age-adjusted frequency rates were established for both regions using direct standardization. Confidence intervals were obtained by Poisson distribution. SPSS for Windows 10.0 and Epidat 2.1 were used for the analysis. Data were obtained from the 1999 municipal population census.

Results: One hundred seventy-one children aged 0-5 years were included. A total of 40.9 % (70 patients) were aged less than 12 months and 68.4 % were aged 0-2 years; 16.4 % had received drug therapy before diagnosis. The most common forms of presentation were occult bacteremia (45.6 %), bacteremic pneumonia (27.5 %) and meningitis (14.6 %). The most frequent complications involved the respiratory tract, with pleural effusion in 23 % of cases of pneumonia. The standardized annual incidence rate of invasive pneumococcal disease (cases per 100,000) in children aged 0-59 months was 58.82 (95 % CI: 27.99-89.65) in Navarre and 55.35 (95 % CI: 38.81-71.88) in the Basque Country. In children aged 0-23 months, the overall incidence was 93.49 cases per 100,000 children (95 % CI: 77.32-112.04) and in infants aged 0-11 months, it was 110,21 cases per 100,000 children (95 % CI: 85.91-139.24). The incidence rates for meningitis and bacteremia in children aged 0-23 months was 15.98 (95 % CI: 9.76-24.68) and 51.14 (95 % IC: 39.38-65.30) cases per 100.000 children. Fifty-nine strains were serotyped. The most frequent serotypes/groups were 1, 4, 6B, 14, 18C, 19 and 23F. A total of 52.15 % of the serotypes were penicillin-susceptible and 93 % were cefotaxime-susceptible. The serotypes/groups with the highest rates of resistance were 6B, 14,19, 23F and 35.

Conclusion: Our incidence rates are similar to those observed in other countries such as the United States and are higher than those reported for the rest of Europe. Vaccine coverage is similar to that described in other articles.

Aim: To report the epidemiology, clinical features, management and complications of orbital and periorbital cellulitis; to evaluate the use of imaging tests in the detection of complications.

Methods: Retrospective study of 107 pediatric patients admitted to the San Joan de Déu Pediatric Hospital with orbital or periorbital cellulitis from January 1991 to January 1999.

Results: The incidence of cellulitis was highest in the second year of life and during winter. No significant differences were found between the sexes. In 68 patients (63.6%) the cause of cellulitis was identified as sinusitis. The most frequently identified organisms were Staphylococcus aureus, Streptococcus pneumoniae and S. pyogenes. Computed tomography identified retroseptal damage in 36 patients with 23 super osteal abscesses, 3 orbital abscesses and 3 intracranial complications. Sixty nine percent of the patients were treated with a single antibiotic (cefotaxime, cefuroxime or amoxicillin clavulanic acid) while 31% underwent multiple antibiotic therapy. Only 8.4% required surgery.

Conclusions: Orbital cellulitis is a relatively common and potentially serious disease in children. The early use of CT to assess the extent of damage is important in establishing prognosis and in assessing the need for surgical therapy.

We report a new case of monosomy r13 in a male newborn infant with prenatal diagnosis. He was the fourth child of a healthy couple of normal lineage. On physical examination typical dysmorphism and multiple congenital anomalies were found. Chromosome analysis revealed a 46, XY, r(13) (p11.2q32) /45, XY,13 karyotype. Our observations are almost identical to those of previously published reports and confirm that the clinical severity of the symptoms depends on the location of the chromosome breakpoint. The clinical and cytogenetics features of this disorder are reviewed.