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Fever of unknown origin in children

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https://www.readbyqxmd.com/read/27894446/fever-of-unknown-origin-in-childhood
#1
REVIEW
Michael J Chusid
Childhood fever of unknown origin (FUO) is most often related to an underlying infection but can also be associated with a variety of neoplastic, rheumatologic, and inflammatory conditions. Repeated, focused reviews of patient history and physical examination are often helpful in suggesting a likely diagnosis. Diagnostic workup should be staged, usually leaving invasive testing for last. Advances in molecular genetic techniques have increased the importance of these assays in the diagnosis of FUO in children...
February 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/27598022/role-of-whole-body-mr-with-dwibs-in-child-s-bartonellosis
#2
E Rossi, A Perrone, D Narese, M Cangelosi, S Sollai, A Semeraro, M Mortilla, C Defilippi
Cat-scratch disease (CSD) is a zoonosis in children, result of infection by Bartonella henselae, a gram-negative bacillus. Infection is generally characterized by regional and self-limited lymphadenopathy after exposure to a scratch or bite from a cat. Rarely, B. henselae is cause of fever of unknown origin (FUO), with dissemination to various organs, most often involving the reticuloendothelial system (liver, spleen, bone marrow), mimicking an inflammatory rather than a lymphoproliferative disease. Whole-body Magnetic Resonance Imaging (WBMRI), in association with diffusion-weighted imaging (DWIBS), allows a comprehensive evaluation of pediatric patients, without the risks inherent to ionizing radiation...
July 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/27578821/angiostrongylus-cantonensis-infection-a-cause-of-fever-of-unknown-origin-in-pediatric-patients
#3
Catherine E Foster, Erin G Nicholson, Angela C Chun, Maya Gharfeh, Sara Anvari, Filiz O Seeborg, Michael A Lopez, Judith R Campbell, Lucila Marquez, Jeffrey R Starke, Debra L Palazzi
Fever of unknown origin (FUO) in children is frequently caused by infectious diseases. Angiostrongylus cantonensis, while a primary cause of eosinophilic meningitis, is rarely a cause of FUO. We present 2 pediatric cases of FUO caused by Angiostrongylus cantonensis acquired in Houston, Texas, outside its usual geographic distribution.
December 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27543361/-aetiology-and-outcomes-of-potentially-serious-infections-in-febrile-infants-less-than-3-months-old
#4
Mercedes de la Torre, Nieves de Lucas, Roberto Velasco, Borja Gómez, Santiago Mintegi
BACKGROUND: Recent studies have shown changes in the aetiology of serious bacterial infections in febrile infants ≤ 90 days of age. The aim of this study was to describe the current microbiology and outcomes of these infections in Spain. MATERIAL AND METHODS: Sub-analysis of a prospective multicentre study focusing on febrile infants of less than 91 days of life, admitted between October 2011 and September 2013 to Emergency Departments of 19 Spanish hospitals, members of the Spanish Paediatric Emergency Research Group of the Spanish Society of Paediatric Emergencies (RISeuP/SPERG)...
August 16, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27489464/febrile-neutropenia-in-children-with-acute-lymphoblastic-leukemia-single-center-experience
#5
Nihal Özdemir, Gülen Tüysüz, Nigar Çelik, Leman Yantri, Ethem Erginöz, Hilmi Apak, Alp Özkan, İnci Yıldız, Tiraje Celkan
AIM: An important life-threatening complication of intensive chemotherapy administered in children with leukemia is febrile neutropenia. The objective of this study was to evaluate the clinical features and consequences of febrile neutropenia attacks in children who were treated for acute lymphoblastic leukemia. MATERIAL AND METHODS: Nighty-six children who received chemotherapy for acute lymphoblastic leukemia in our center between January 1995 and December 2010 were included in the study...
June 2016: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/27400951/adrenomedullin-predicts-high-risk-and-culture-positivity-in-children-with-solid-tumors-suffering-from-neutropenic-fever
#6
Vural Kesik, Erman Ataş, Yasemin Gülcan Kurt, Fevzi Nuri Aydın, Oğuzhan Babacan, Mustafa Gülgün, Nadir Korkmazer
AIM OF STUDY: Neutropenic fever is a source of morbidity and mortality in children with cancer. It is not possible to detect the causative agent in cultures in most cases; the research for a marker that can show the severity of the disease is ongoing. We evaluated the role of adrenomedullin (ADM) at predicting prognosis on patients with febrile neutropenia, which has been proven to be a good prognostic marker for diseases with high morbidity and mortality, such as heart failure, ischemic ventricular dysfunction, sepsis, and systemic inflammatory response syndrome...
September 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27374781/acr-appropriateness-criteria-fever-without-source-or-unknown-origin-child
#7
Sjirk J Westra, Boaz K Karmazyn, Adina L Alazraki, Molly E Dempsey, Jonathan R Dillman, Matthew Garber, Sheila G Moore, Molly E Raske, Henry E Rice, Cynthia K Rigsby, Nabile Safdar, Stephen F Simoneaux, Peter J Strouse, Andrew T Trout, Sandra L Wootton-Gorges, Brian D Coley
The cause of fever in a child can often be determined from history, physical examination, and laboratory tests; infections account for the majority of cases. Yet in 20%, no apparent cause can be found, designated as fever without source (FWS). The yield of chest radiography in children with FWS is low, and it is usually not appropriate. However, in children with respiratory signs, high fever (>39°C), or marked leukocytosis (≥20,000/mm(3)), chest radiography is usually appropriate, as it has a higher yield in detecting clinically occult pneumonia...
August 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27352870/licensed-dengue-vaccine-public-health-conundrum-and-scientific-challenge
#8
Scott B Halstead
A tetravalent live attenuated vaccine composed of chimeras of yellow fever 17D and the four dengue viruses (chimeric yellow fever dengue [CYD]) manufactured by Sanofi Pasteur has completed phase III clinical testing in over 35,000 children 2-16 years of age. The vaccine was recently licensed in four countries. During the first 2 years of observation, CYD vaccine efficacy ranged between 30% and 79% in 10 different countries with an overall efficacy of 56.8%. During year 3, there was an overall efficacy against hospitalization of 16...
June 27, 2016: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27294498/a-diagnostic-approach-to-autoimmune-disorders-clinical-manifestations-part-1
#9
Shashi Sahai, Matthew Adams, Deepak Kamat
Autoimmune disorders are not commonly encountered in a general pediatric practice, but they may mimic many other disorders. Although they occur infrequently, it is always important to pause and consider an autoimmune disorder in the differential diagnosis. A detailed history and careful physical examination play an important role in guiding laboratory evaluation for these disorders. Many autoimmune disorders present with symptoms that involve multiple organ systems. The common symptoms that may make one consider a rheumatic disorder in the differential diagnosis are fever, fatigue, joint pain, rash, ulcers, and muscle weakness...
June 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27269945/lack-of-effectiveness-of-neutropenic-diet-and-social-restrictions-as-anti-infective-measures-in-children-with-acute-myeloid-leukemia-an-analysis-of-the-aml-bfm-2004-trial
#10
Lars Tramsen, Emilia Salzmann-Manrique, Konrad Bochennek, Thomas Klingebiel, Dirk Reinhardt, Ursula Creutzig, Lillian Sung, Thomas Lehrnbecher
PURPOSE: Although nonpharmacologic anti-infective measures are widely used in children treated for acute myeloid leukemia (AML), there is little evidence of their effectiveness. PATIENTS AND METHODS: We analyzed infectious complications in children during intensive treatment of AML according to the AML-BFM 2004 trial and surveyed sites on institutional standards regarding recommended restrictions of social contacts (six items), pets (five items), and food (eight items)...
August 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27267334/guidelines-for-the-management-and-treatment-of-periodic-fever-syndromes-periodic-fever-aphthous-stomatitis-pharyngitis-and-adenitis-syndrome
#11
Maria Teresa R A Terreri, Wanderley Marques Bernardo, Claudio Arnaldo Len, Clovis Artur Almeida da Silva, Cristina Medeiros Ribeiro de Magalhães, Silvana B Sacchetti, Virgínia Paes Leme Ferriani, Daniela Gerent Petry Piotto, André de Souza Cavalcanti, Ana Júlia Pantoja de Moraes, Flavio Roberto Sztajnbok, Sheila Knupp Feitosa de Oliveira, Lucia Maria Arruda Campos, Marcia Bandeira, Flávia Patricia Sena Teixeira Santos, Claudia Saad Magalhães
OBJECTIVE: To establish guidelines based on scientific evidence for the management of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome. DESCRIPTION OF THE EVIDENCE COLLECTION METHOD: The Guideline was prepared from 5 clinical questions that were structured through PICO (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation...
January 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/27209095/diagnosis-and-management-of-undifferentiated-fever-in-children
#12
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
https://www.readbyqxmd.com/read/27143687/clinical-approach-to-fever-of-unknown-origin-in-children
#13
Ya-Li Chien, Fang-Liang Huang, Chung-Ming Huang, Po-Yen Chen
BACKGROUND/PURPOSE: Fever of unknown origin (FUO) can be caused by many clinical conditions and remains a diagnostic challenge in clinical practice. The etiology of FUO varies markedly among different age groups, geographic areas, and seasons. A four-stage investigative protocol for FUO is widely applied in clinical practice. The aim of this study was to evaluate the usefulness of this four-stage protocol for identifying the etiology of FUO in children. METHODS: We enrolled children younger than 18 years of age who were admitted to the Taichung Veterans General Hospital during the period from January 2006 to December 2014 with FUO persisting for more than 3 weeks...
October 9, 2015: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/27059542/periodic-fever-aphthous-stomatitis-pharyngitis-and-cervical-adenitis-pfapa-syndrome-analysis-of-patients-from-two-geographic-areas
#14
Ezgi D Batu, Fehime Kara Eroğlu, Paul Tsoukas, Jonathan S Hausmann, Yelda Bilginer, Margaret A Kenna, Greg R Licameli, Robert C Fuhlbrigge, Seza Özen, Fatma Dedeoğlu
OBJECTIVE: Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a periodic fever syndrome of childhood with an unknown etiology. Our aims were to compare the features between PFAPA patients from Turkey and the USA, and patients with and without MEFV variants, and to test the performance of the Eurofever criteria in excluding other autoinflammatory diseases. METHODS: Seventy-one children with PFAPA followed in Hacettepe University, Ankara, Turkey and 60 patients in Boston Children's Hospital, Boston, USA were enrolled...
April 5, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27025724/tonsillar-microbiota-in-children-with-pfapa-periodic-fever-aphthous-stomatitis-pharyngitis-and-adenitis-syndrome
#15
M V Tejesvi, M Uhari, T Tapiainen, A M Pirttilä, M Suokas, U Lantto, P Koivunen, M Renko
Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is a childhood febrile syndrome of unknown origin that is often cured with tonsillectomy. We aimed to compare the bacterial microbiota of the tonsils removed from PFAPA patients with those of controls. We used next-generation sequencing technology to investigate the bacterial microbiota of the tonsils of 30 PFAPA patients and 24 controls. We found significant differences in the presence and relative abundance of many bacteria between PFAPA cases and controls...
June 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/26887984/beh%C3%A3-et-s-disease-in-children-an-overview
#16
REVIEW
Isabelle Koné-Paut
BD is a systemic inflammatory disease with a variable vasculitis. Paediatric onset is very rare and carries a strong genetic component. Oral ulcers and fever of unknown origin are frequent at onset and difficult to distinguish from other inflammatory disorders; therefore, expert opinion is still mandatory to recognize the disease early. An international expert consensus has recently proposed new classification criteria for children with BD. The clinical spectrum of BD is heterogeneous and influenced by gender, ethnicity and country of residence...
February 18, 2016: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/26717659/-analysis-on-clinical-and-epidemioloical-characteristics-of-measles-in-hospitalized-children-in-shanghai-in-2012
#17
Shuzhen Han, Yingzi Ye, Lingfeng Cao, Jin Xu, Dongbo Pu, Hui Yu
OBJECTIVE: To investigate the main factors that influence measles morbidity and the genotype of measles virus, so as to provide evidence for scientific decision making to further control the prevalence of measles. METHOD: A retrospective analysis included 182 children in Children's Hospital of Fudan University, diagnosed with measles from January 1, 2012 to December 31. The clinical and epidemiological characteristics, including the gender, age, the incidence of seasonal trends, measles vaccine vaccination history, contact history and other clinical manifestations, laboratory test results, and so on were analyzed...
August 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/26707505/kawasaki-disease-in-a-healthcare-provider-an-adult-case-in-a-paediatric-resident
#18
Luis M Garrido-García, Martín López-Amézquita, Rodrigo Villaverde-Rosas
Kawasaki disease is a small-to-medium-vessel vasculitis of unknown origin that predominantly affects children, although the disease can occur in adults. We report the case of a 26-year-old paediatric resident with fever, exanthema, ocular changes, arthralgia, and desquamation of palms and soles. Diagnosis was established after the fever resolved, and no treatment with intravenous gammaglobulin was administered. His echocardiogram showed normal coronary arteries. Acute Kawasaki disease in adults is a rare and under-recognised condition...
June 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/26649939/search-of-unknown-fever-focus-using-pet-in-critically-ill-children-with-complicated-underlying-diseases
#19
Lung Chang, Mei-Fang Cheng, Shiann-Tarng Jou, Chi-Lun Ko, Jei-Yie Huang, Kai-Yuan Tzen, Rouh-Fang Yen
OBJECTIVES: PET/CT with F-fluorodeoxyglucose can be used to image cellular metabolism and has been used for evaluating fever of unknown origin in adults. However, there are limited studies about the role of F-fluorodeoxyglucose PET/CT in evaluation of fever of unknown origin in critically ill children, especially those presenting with complicated underlying diseases under treatment. Here, we report our preliminary experience using F-fluorodeoxyglucose PET/CT in this specific group of patients...
February 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/26498845/guidelines-for-the-management-and-treatment-of-periodic-fever-syndromes-periodic-fever-aphthous-stomatitis-pharyngitis-and-adenitis-syndrome
#20
Maria Teresa R A Terreri, Wanderley Marques Bernardo, Claudio Arnaldo Len, Clovis Artur Almeida da Silva, Cristina Medeiros Ribeiro de Magalhães, Silvana B Sacchetti, Virgínia Paes Leme Ferriani, Daniela Gerent Petry Piotto, André de Souza Cavalcanti, Ana Júlia Pantoja de Moraes, Flavio Roberto Sztajnbok, Sheila Knupp Feitosa de Oliveira, Lucia Maria Arruda Campos, Marcia Bandeira, Flávia Patricia Sena Teixeira Santos, Claudia Saad Magalhães
OBJECTIVE: To establish guidelines based on scientific evidence for the management of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome. DESCRIPTION OF THE EVIDENCE COLLECTION METHOD: The Guideline was prepared from 5 clinical questions that were structured through PICO (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation...
October 1, 2015: Revista Brasileira de Reumatologia
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