摘要:

Background.There have been few large reports of the treatment and outcome of neuroborreliosis in children.Methods.All 203 children with symptoms, cerebrospinal fluid and serologic findings compatible with neuroborreliosis and treated at one of the four pediatric hospitals in Stockholm from 1994 through 1996 were included. Children were treated with intravenous beta-lactam antibiotics or oral doxycycline for 10 days and followed until the resolution of symptoms.Results.At the end of treatment 58% and after 2 months 92% of the children had no symptoms. Cerebrospinal fluid findings had no statistically significant influence on the outcome. Facial paralysis persisted longer than other symptoms.Conclusions.The prognosis of neuroborreliosis in children 2 months after treatment seems to be excellent with 10-day treatment regimens.

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Background.A measles epidemic occurred in the Netherlands in 1999 to 2000. We collected data on hospitalized and deceased cases to inform the public about the risks associated with measles infection.Methods.From the National Medical Registration we extracted hospital discharge diagnoses for measles-related hospitalizations (International Classification of Diseases, 9th revision, Clinical Modification Code 055) during the measles epidemic (April 1999 to May 2000). We also reviewed hospital records to assess reasons for hospitalization and severity of disease as a result of measles infection during this epidemic. In addition we estimated the total number of hospitalized cases by a capture-recapture approach using two surveillance sources.Results.Measles without mention of complication (39%) and postmeasles pneumonia (33%) were most often registered as main discharge diagnoses for the 130 cases in the National Medical Registration. Forty-seven (96%) of the 49 patients whose hospital charts were reviewed were not vaccinated. Median admission period was 5 (range, 1 to 26) days, 19 (38%) required mechanical ventilation and 14 (29%) had sequelae at the time of discharge but none was permanent. Three patients died as a result of complications. No association was observed between preexisting illness and either reason for admission (P= 0.5) or residual symptoms at discharge (P= 0.5). The estimated total number of hospitalized measles patients was 157 (95% confidence interval, 145 to 179), leading to an estimated 825 admission days during an epidemic in which 3292 cases were reported.Conclusions.Measles infection can still run a severe course even in a prosperous country.

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Objective.To evaluate the epidemiologic pattern of Kawasaki disease (KD) in California.Methods.Statewide hospital discharge data from California from 1995 through 1999 were used. Children 0 through 17 years old who had a discharge diagnosis of KD (by ICD9-CM code 446.1) were identified. Precipitation and temperature data of climate divisions of the state were used to determine their possible association with incidences of KD. Multiple regression analysis was performed to evaluate factors related to the KD incidence of the counties.Results.There were 2325 patients admitted to 194 California hospitals during the 5-year study period. The male-to-female ratio was 1.62. Median age was 30 months; peak incidence by year of age was in the second year of life. Overall annual incidence was 15.3 cases per 100 000 children <5 years old and 3.2 cases per 100 000 children 5 through 9 years old. Compared with 1995 and 1996, the incidence for children <5 years old increased by 30% in 1997 and 1998 (P< 0.01). In contrast the incidence for children 5 through 9 years old remained relatively unchanged. Asians had the highest incidence of 35.3 cases per 100 000 children <5 years old, followed by blacks (24.6) and whites (14.7) (P< 0.01). The number of cases peaked in March and had its nadir in September. In a multiple regression analysis, no association was found between KD incidence and temperature or precipitation. KD incidence was not related to average family size, proportion of Asians in the population, population density or whether the county is in northern or southern California. There was no in hospital death. The median length of hospital stay was 2 days.Conclusions.The incidence of Kawasaki disease in patients <5 years old increased in 1997 and 1998. Asians had the highest KD incidence compared with other races. Peak incidence was in March, and the lowest incidence was in September. KD incidence was not associated with temperature, precipitation, family size or population density.

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Ecthymagangrenosum is a skin lesion that is most commonly caused byPseudomonas aeruginosa. Although ecthyma gangrenosum usually develops in patients with underlying immunodeficiencies or chronic diseases, there have been reports of its appearance in previously healthy children. A review of such patients in the English literature showed that most of them had either previously undetected immunodeficiencies or transient risk factors that predisposed them to the development of ecthyma gangrenosum. We report a patient without apparent antecedent predisposing risk factors for ecthyma gangrenosum who developed chronic neutropenia 1 week after presentation. It is important for the primary care provider to recognize ecthyma gangrenosum, treat it with appropriate antimicrobial agents and investigate the patient for occult immunodeficiencies.

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:2002

数据来源: OVID