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Fever without focus in pediatrics

Roberto Velasco, Helvia Benito, Rebeca Mozun, Juan E Trujillo, Pedro A Merino, Mercedes de la Torre, Borja Gomez, Santiago Mintegi
BACKGROUND AND OBJECTIVES: Guidelines from the American Academy of Pediatrics define urinary tract infection (UTI) as the growth of greater than 50,000 ufc/mL of a single bacterium in a urine culture with a positive urine dipstick or with a urinalysis associated. Our objective was to evaluate the adequacy of this cutoff point for the diagnosis of UTI in young febrile infants. METHODS: Subanalysis of a prospective multicenter study developed in RISeuP-SPERG Network between October 11 and September 13...
October 4, 2016: Pediatric Emergency Care
Sarah S Long
The incidence and likely causes of fever of unknown origin (FUO) have changed over the last few decades, largely because enhanced capabilities of laboratory testing and imaging have helped confirm earlier diagnoses. History and examination are still of paramount importance for cryptogenic infections. Adolescents who have persisting nonspecific complaints of fatigue sometimes are referred to Pediatric Infectious Diseases consultants for FUO because the problem began with an acute febrile illness or measured temperatures are misidentified as "fevers"...
July 5, 2016: Journal of Infection
Serap Ural, Figen Kaptan, Nurbanu Sezak, Sibel El, Bahar Örmen, Nesrin Türker, Tuna Demirdal, İlknur Vardar, Pınar Özkan Çayıröz, Fulya Çakalağaoğlu
Visceral leishmaniasis (VL, kala-azar) is a zoonotic infection caused by Leishmania species which are transmitted to humans by the bites of infected female phlebotomine sandflies. Leishmania infantum is the responsible species of VL in Aegean, Mediterranean, and Central Anatolia regions of Turkey mainly observed sporadically in pediatric age groups. The aim of this study was to evaluate the clinical and laboratory findings of adult patients with VL who were admitted to our hospital. A total of 10 patients (3 female, 7 male; age range: 18-67 years, mean age: 39...
October 2015: Mikrobiyoloji Bülteni
Yasumasa Nishiyama, Tatsuya Fujii, Yasuhiro Kanatani, Yasuhiko Shinmura, Hiroyuki Yokote, So Hashizume
BACKGROUND: In Japan, production of smallpox vaccine LC16m8 (named LC16-KAKETSUKEN) was restarted and was determined to be maintained as a national stockpile in March 2002. OBJECTIVE: To conduct a post-marketing surveillance study of the vaccination of freeze-dried live attenuated smallpox vaccine prepared in cell culture LC16-KAKETSUKEN using attenuated vaccinia strain LC16m8. The study complied with Good Clinical Practice, focusing on a comparison between primary vaccinees and re-vaccinees...
November 9, 2015: Vaccine
Bethany Beard, Joseph Turner
BACKGROUND: Emergency department workup of pediatric fever typically focuses on ruling out serious bacterial infection, but other disease processes can cause fever. Congenital leukemia is a rare but important cause of fever in neonates. We review the presentation, pathophysiology, and potential complications of congenital leukemia presenting to the emergency department as pediatric fever. CASE REPORT: We report a case of a 4-week-old infant brought to the emergency department for fever and "not acting normally...
June 2015: Journal of Emergency Medicine
Hiroki Iwasaki, Toshiaki Takeda, Tadashi Ito, Yuko Tsujioka, Hiroya Yamazaki, Mitsuhiko Hara, Yukihiko Fujita
BACKGROUND: Susceptibility-weighted imaging is a novel high-spatial-resolution three-dimensional gradient-echo magnetic resonance imaging technique with phase postprocessing that accentuates the paramagnetic properties of blood products. The use of susceptibility-weighted imaging for epileptic focus localization in the acute stage of encephalopathy in a child has not been documented. PATIENTS: We report three pediatric patients with status epilepticus in the setting of fever, in whom susceptibility-weighted imaging showed transient prominence of the focal venous vasculature...
February 2014: Pediatric Neurology
Giselle de Melo Braga, Gabriel Hessel, Ricardo Mendes Pereira
The liver is one of the organs most affected by paracoccidioidomycosis, a systemic mycosis endemic in some Latin American countries. The majority of articles focused on adult populations and failed to describe any detailed experience of liver abnormalities in pediatric patients. Therefore, the aim of this study was to describe the frequency and characteristics of liver involvement in children with paracoccidioidomycosis. This study comprised 102 patients less than 16 years of age (median 104.3 months) diagnosed with paracoccidioidomycosis from 1980 to 2010...
October 2013: Mycopathologia
Justin J Clark, Sidney M Johnson
PURPOSE: Postoperative abscesses after appendectomy occur in 3% to 20% of cases and are more common in cases of perforated appendicitis. Smaller abscesses are often amenable to antibiotic therapy, but surgical drainage remains the mainstay of treatment for larger collections. Surgical options generally include percutaneous drainage and open laparotomy. Laparoscopic drainage of these abscesses has not been well characterized in the pediatric population. OBJECTIVE: The aim of this study was to describe our experience with laparoscopic drainage of postappendectomy abscesses that were not amenable to percutaneous drainage...
July 2011: Journal of Pediatric Surgery
Joseph L Mathew, Sunit C Singhi
Breathing difficulty and respiratory distress is the most common cause of admission to the Pediatric Emergency. Respiratory distress presents as altered breathing pattern, forced breathing efforts or obstructed breathing, and chest indrawing; respiratory failure is defined as paCO(2) >50 mmHg (inadequate ventilation) and/or a paO(2) < 60 mmHg (inadequate oxygenation). Rapid assessment is aimed to ascertain adequacy of airway patency, breathing, and circulation. Immediate care is directed at (a) restoration of airway patency- by positioning (head tilt -chin lift), cleaning the oropharynx, and/or insertion of oropharyngeal airway; (b) supporting breathing- with high flow oxygen and assisted ventilation (with bag and mask or endotracheal intubation and ventilation), and (c) restoration of circulation- using fluid boluses and inotropes, if necessary...
September 2011: Indian Journal of Pediatrics
S Fouzas, L Mantagou, E Skylogianni, A Varvarigou
OBJECTIVE: to estimate the incidence of reactive thrombocytosis among febrile young infants and to asses the utility of platelet count as a potential predictor of serious bacterial infection (SBI). DESIGN: retrospective study between January 2005 and December 2008. SETTING: tertiary care pediatric unit. PARTICIPANTS: all infants 29 to 89 days of age, admitted with rectal temperature > 38oC without a focus of infection...
November 2010: Indian Pediatrics
(no author information available yet)
JUSTIFICATION: Revised National Tuberculosis Control Program (RNTCP) has focused on adults with smear positivity a tool not so well used in children with tuberculosis. There is a need to redefine standardization of diagnosis and management protocols for childhood tuberculosis. PROCESS: Indian Academy of Pediatrics constituted a Working Group to develop consensus statement on childhood tuberculosis (TB). Members of the Group were given individual responsibilities to review the existing literature on different aspects of the childhood TB...
January 2010: Indian Pediatrics
Shan Yin, Jennifer L Trainor, Elizabeth C Powell
OBJECTIVES: The purpose of this study was to describe the incidence of serious bacterial infections (SBIs) in febrile outpatient pediatric heart transplant recipients and to assess the utility of using white blood cell (WBC) indices to identify patients at low risk for bacteremia. METHODS: A retrospective study was conducted on all heart transplant recipients followed at a single children's hospital. All outpatient visits from January 1, 1995, to June 1, 2007, in which fever was evaluated were reviewed...
October 2009: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Shih-Yen Chen, Chi-Neu Tsai, Ming-Wei Lai, Chih-Yen Chen, Kuang-Lin Lin, Tzou-Yien Lin, Cheng-Hsun Chiu
BACKGROUND: Norovirus and rotavirus cause outbreaks of diarrheal disease worldwide. This prospective observational study was undertaken to investigate the clinical characteristics and complications, with a focus on convulsive disorders, of gastroenteritis caused by norovirus and rotavirus in hospitalized pediatric patients in northern Taiwan. METHODS: Children hospitalized with acute gastroenteritis in Chang Gung Children's Hospital from August 2004 through January 2007 were enrolled in the study...
April 1, 2009: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Christine Whyte, Eric Tran, Monica E Lopez, Burton H Harris
BACKGROUND: Interval appendectomy may be advisable after successful nonoperative treatment of perforated appendicitis. To reduce the perceived morbidity of interval appendectomy, we sought to determine if the operation could be done on an outpatient basis. This study is focused on patient comfort and safety after laparoscopic interval appendectomy (LIA). METHODS: This is a retrospective review of the clinical course and length of stay of 24 children who had LIA during a 4-year period...
November 2008: Journal of Pediatric Surgery
S A Karmarkar, Satinder Aneja, Shashi Khare, Arun Saini, Anju Seth, B K Y Chauhan
OBJECTIVE: To study the etiological profile of patients with acute febrile encephalopathy syndrome focusing chiefly on the viral etiology, and to correlate clinical and radiological features of patients with viral encephalitis. METHODS: A prospective hospital based study conducted on the consecutive patients admitted in a pediatric unit during the period of 1(st) February 2004 to 31st January 2005 based on the following inclusion criteria: (1) Age more than 1 month and less than 18 years and (2) A diagnoses of acute febrile encephalopathy, based on the following criteria: (i) fever (ii) acute depression of consciousness or mental deterioration for more than 12 hours with or without motor or sensory deficit and (iii) Total duration of illness at the time of admission 1 week or less...
August 2008: Indian Journal of Pediatrics
Alessandro D'Addessi, Luca Bongiovanni, Marco Racioppi, Emilio Sacco, PierFrancesco Bassi
Removal of urinary calculi is an essential element in the successful treatment of patients with urinary stone disease. The new generation of lithotriptors allows the treatment without the need for general anesthesia. The patients, often outpatients, have a faster discharge from the hospital with a reduction of hospitalization time and operating costs. Shock wave lithotripsy (SWL) is currently considered a safe technique for treatment of pediatric urinary lithiasias, with a low percentage of complications and subsequent surgical retreatments...
April 2008: Journal of Pediatric Surgery
Henry M Feder
Methicillin-resistant Staphylococcus aureus (MRSA) infections have become more common over the last decade. Recently, severe MRSA infections including necrotizing pneumonia, purpura fulminans, and rapidly progressive skin abscesses have been reported. These severe infections frequently have been associated with the virulence factor Panton-Valentine leukocidin (PVL). Two unusual cases of occult deep tissue abscesses in children who had family members with a history of severe MRSA skin abscesses are presented in this article...
March 2008: Clinical Pediatrics
R Soloaga, A Salinas, M Poterallo, A Margari, B Suar, N Lucero, M Turcos, A Procopio, M Almuzara
Brucella canis and other species of the genus Brucella can cause human disease. However, this species infrequently cause human disease, including in countries where dogs population is highly infected. A 15 years old male was admitted to the hospital with 15 days history of fever without visible focus. Physical examination revealed pain at liver palpation and axillar, cervical and inguinal lymphoadenomegalies. Abdominal ultrasonography showed spleenomegally, the chest Rx and the trans thoracic echocardiogram were normal...
April 2004: Revista Argentina de Microbiología
J U Rüggeberg, K Ketteler, C R MacKenzie, R Von Kries, R R Reinert, H Schroten
BACKGROUND: Recent pediatric surveillance studies suggest the incidence of pneumococcal bacteremia, but not meningitis, is lower in Germany than in most developed countries. Suboptimal case assessment in routine clinical practice has been suspected of contributing to this apparent discrepancy. METHODS: We aimed to assess the blood culture sampling rate at a German pediatric university hospital and the disease burden associated with pneumococcal bacteremia in children under 5 years of age...
April 2004: Infection
S Hellerstein
This review focuses on antibiotic treatment of acute urinary tract infections (UTIs) in children who are neurologically and anatomically intact. Neonates younger than 28 days with a febrile UTI should be hospitalized, given supportive care and treated with parenteral amoxicillin and cefotaxime. Following a good response to 3 to 4 days of parenteral antibacterial therapy, outpatient treatment with an oral antibiotic should be given to complete 14 days of therapy. Infants from 28 days to 3 months who appear clinically ill with a febrile UTI should be hospitalized, receive supportive care and parenteral administration of a 3(rd) generation cephalosporin or gentamicin...
October 2003: Minerva Pediatrica
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