摘要:

Tuberculosis (TBC) continues to be a major health problem. Between January 1, 1980, and April 30, 1986, 211 children and adolescents presented with a positive tuberculin reaction or symptoms suggestive of tuberculosis. Active disease occurred in 35 (17%); 29 of these had primary infection, whereas 4 adolescents presented with cavitary pulmonary disease and 1 infant each had Pott's disease and cervical adenitis. The proportion of patients with active disease was greater in infants and toddlers; 2 of whom also had meningitis. Two children with active disease were infected with human immunodeficiency virus, 1 of whom died with cavitary tuberculosis. Only 43% of 211 patients were born in the United States. The ethnic distribution was Hispanic 45%, Oriental 30%, Black 18% and other 7%. Bacillus Calmette-Guérin vaccination was documented in 53 (25%) patients; 5 (9%) of these developed active disease. Despite vaccination and the availability of effective drugs, tuberculosis persists and appears to be increasing. Meeting the challenge of tuberculosis in the future will require more rapid diagnostic methods and recognition of the burden of infection in human immunodeficiency disease-infected children, together with revitalization of screening and follow-up programs, especially for toddlers and adolescents.

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

In a randomized, double-blind placebo-controlled clinical trial, we evaluated the prophylactic effectiveness of rimantadine in children (ages 1 to 18 years) against infection with influenza A (H3N2) and associated illness and the prevention of transmission of infection to adult members of the child's family. One hundred ten volunteers from 29 families completed this study during a naturally occurring outbreak of influenza A (H3N2). Influenza infections, defined as a positive viral throat culture or a 4-fold increase in antibody titer, occurred in 31.0% of children in the placebo group and 7.4% in the rimantadine group (P = 0.026). Clinical illness with laboratory evidence of influenza infection occurred in 24.1% of children in the placebo group and none in the rimantadine group (P = 0.007). Rimantadine was well-tolerated by the children, with no significant difference in reported adverse effects between the placebo and rimantadine groups. A combined analysis by families of these data and those of our similarly designed 1984 study, revealed that families in whom the children were given rimantadine had a significantly lower rate of influenza A infection and influenza-like illness

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The long term clinical outcome for infants and children with the pediatric acquired immunodeficiency syndrome-related complex is unknown. This report describes our experience with 14 patients with acquired immunodeficiency syndrome-related complex who have been followed for 11 to 71 months since the onset of their symptoms. The most frequent clinical features at presentation were persistent generalized lymphadenopathy (14 of 14), hepatosplenomegaly (11 of 14) and a history of recurrent otitis media (7 of 14). Except for hypergammaglobulinemia (14 of 14) and reversed T4/ T8 ratios (9 of 14), immunologic analyses, including in vitro responses to mitogens and antibody responses following immunization, revealed no consistent abnormalities. Over the course of follow-up, none of the patients have developed serious or opportunistic infections and 12 of 14 have shown catch up or age-appropriate growth. The T4/T8 ratios have

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Thirty-four children 3 to 20 months of age ingested either 105, 104or 103plaque-forming units of rhesus rotavirus vaccine, MMU 18006, which possesses human rotavirus serotype 3 neutralization antigen. Immune responses were evaluated by a plaque reduction neutralization (PRN) assay to rotavirus serotypes 1, 2 and 3 and by a serum IgG, IgM and IgA and fecal IgA class-specific enzyme-linked immunosorbent assay. Homotypic PRN antibody seroconversions to serotype 3 rotavirus were detected in 31 of 34 children (91%), whereas rises in heterotypic PRN antibody to human rotavirus serotypes 1 or 2 were found in only 3 of 21 (14%) (p < 0.00000001). Thirty of the 34 vaccinated children (88%) had at least one class of rotavirus-specific serum antibody detected by enzyme-linked immunosorbent assay. A rotavirus-specific IgA coproantibody response was seen in 11 of 16 children (69%) following vaccination. Two children who had no evidence of PRN antibody to serotype 3 after vaccination had evidence of both a fecal and a serum rotavirus-specific IgA response, suggesting that in these children the response to the vaccine was primarily mucosal. These data show that orally

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We evaluated the performance of a new rapid solid phase enzyme immunoassay, SUDS® Group A Strep (MUREX® Corp., Norcross, GA) for the detection of Group A beta-hemolytic streptococci in a pediatric office practice. Duplicate throat swabs were obtained from 341 children with pharyngitis. One swab was used in the SUDS test and the other was cultured in the office laboratory. Office SUDS and culture (sheep blood agar plate, aerobic 24-hour incubation) were compared with culture using reference techniques (sheep blood agar plate, anaerobic 48-hour incubation) in a hospital

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A 15-month retrospective survey of 507 admissions to a neonatal intensive care unit revealed 8 patients from whom Malassezia pachydermatis was isolated from one or more clinical specimens. The fungus was cultured from blood (four patients), central venous catheter tips (three patients), urine (four patients), cerebrospinal fluid (one patient), eye discharge (one patient), ear discharge (one patient) and tracheal aspirate (one patient). Seven of the eight infants displayed an episode of one or more of the following symptoms: apnea, bradycardia, temperature instability and hepatosplenomegaly. These episodes were temporally related

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Thrombophlebitis of the internal jugular vein, an anaerobic septicemia most frequently caused by fuso-bacteria, is rarely encountered in pediatrics. Indeed in two recent prospective studies of anaerobic infections in childhood, this entity was not observed in more than 200 cases of anaerobic disease.1,2Significant morbidity is associated with embolic complications; mortality rates, which approach 20% in some series, have been caused in part by the failure of physicians to recognize this syndrome and the subsequent delay in the initiation of appropriate antibiotic therapy. This article reports our recent experience with three children with suppurative thrombophlebitis of the internal jugular vein and describes the use of ultrasonography and computed axial tomography in diagnosis and follow-up. We also analyze an additional nine cases gathered from the pediatric literature in the postantibiotic era.3–8

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1988

数据来源: OVID