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Fever of unknown origin in children

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https://www.readbyqxmd.com/read/28437150/cost-of-cancer-related-neutropenia-or-fever-hospitalizations-united-states-2012
#1
Eric Tai, Gery P Guy, Angela Dunbar, Lisa C Richardson
PURPOSE: Neutropenia and subsequent infections are life-threatening treatment-related toxicities of chemotherapy. Among patients with cancer, hospitalizations related to neutropenic complications result in substantial medical costs, morbidity, and mortality. Previous estimates for the cost of cancer-related neutropenia hospitalizations are based on older and limited data. This study provides nationally representative estimates of the cost of cancer-related neutropenia hospitalizations...
April 24, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28427379/novel-mutation-identified-in-severe-early-onset-tumor-necrosis-factor-receptor-associated-periodic-syndrome-a-case-report
#2
Suhas M Radhakrishna, Amy Grimm, Lori Broderick
BACKGROUND: Tumor Necrosis Factor Receptor-Associated Periodic Syndrome (TRAPS) is the second most common heritable autoinflammatory disease, typically presenting in pre-school aged children with fever episodes lasting 1-3 weeks. Systemic symptoms can include rash, myalgia, ocular inflammation, and serositis. CASE PRESENTATION: Here we report an unusual presentation of TRAPS in a 7 month old girl who presented with only persistent fever. She was initially diagnosed with incomplete Kawasaki Disease and received IVIG and infliximab; however, her fevers quickly recurred...
April 20, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28392823/etiology-and-clinical-characteristics-of-fever-of-unknown-origin-in-children-a-15-year-experience-in-a-single-center
#3
Yi-Seul Kim, Kyung-Ran Kim, Ji-Man Kang, Jong-Min Kim, Yae-Jean Kim
PURPOSE: Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories. METHODS: Among the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ≥38...
March 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28365283/-epidemiological-and-clinical-characteristics-of-infants-admitted-to-hospital-due-to-human-parechovirus-infections-a-prospective-study-in-spain
#4
Fernando Martín Del Valle, Cristina Calvo, Inés Martinez-Rienda, Amaia Cilla, María P Romero, Ana Isabel Menasalvas, Leticia Reis-Iglesias, Diana Roda, María J Pena, Nuria Rabella, María Del Mar Portugués de la Red, Gregoria Megías, Antonio Moreno-Docón, Almudena Otero, María Cabrerizo
INTRODUCTION: Human parechovirus (HPeV) is one of the recently described picornaviridae viruses that have been associated with fever of unknown origin (FUO), clinical sepsis, gastroenteritis, meningitis, or encephalitis in very young infants. The aim of this study is to describe the epidemiology and clinical features of these viruses. PATIENTS AND METHODS: A prospective multicentre 3-year study was conducted in 12 hospitals in Spain. Out of 850 specimens examined, 47 were positive (5...
March 29, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28341146/-construction-of-a-diagnostic-prediction-model-of-severe-bacterial-infection-in-febrile-infants-under-3-months-old
#5
Enrique Villalobos Pinto, Marciano Sánchez-Bayle
INTRODUCTION: Fever is a common cause of paediatric admissions in emergency departments. An aetiological diagnosis is difficult to obtain in those less than 3 months of age, as they tend to have a higher rate of serious bacterial infection (SBI). The aim of this study is to find a predictor index of SBI in children under 3 months old with fever of unknown origin. METHODS: A study was conducted on all children under 3 months of age with fever admitted to hospital, with additional tests being performed according to the clinical protocol...
March 21, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27894446/fever-of-unknown-origin-in-childhood
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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-aphthosis-pharyngitis-and-adenitis-syndrome-analysis-of-patients-from-two-geographic-areas
#19
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, aphthosis, pharyngitis, and adenitis (PFAPA) syndrome is a periodic fever syndrome of childhood with an unknown etiology. Our aim was to compare the features between PFAPA syndrome patients from Turkey and those from the US, and patients with and without MEFV variants, and to test the performance of the Eurofever criteria in excluding other autoinflammatory disorders. METHODS: Seventy-one children with PFAPA syndrome, followed in Hacettepe University, in Ankara, Turkey, and 60 patients at Boston Children's Hospital in the US were enrolled...
December 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27025724/tonsillar-microbiota-in-children-with-pfapa-periodic-fever-aphthous-stomatitis-pharyngitis-and-adenitis-syndrome
#20
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
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