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Fever of unknown origin in children

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https://www.readbyqxmd.com/read/29648910/usefulness-of-positron-emission-tomography-ct-for-diagnosis-of-primary-bone-marrow-lymphoma-in-children
#1
Kyoko Moritani, Naoko Nakano, Sachiko Yonezawa, Fumihiro Ochi, Hisamichi Tauchi, Minenori Eguchi-Ishimae, Mariko Eguchi, Eiichi Ishii, Kozo Nagai
Primary bone marrow lymphoma (PBML) is hard to diagnose in children, due to the difficult identification of malignant cells in bone marrow. The first case, a 5-year-old boy, showed knee swelling with an intermittent fever. The second case, a 12-year-old girl, showed fever of unknown origin without lymphadenopathy or hepatosplenomegaly. In both cases, the diagnosis was not confirmed despite the repeated bone marrow aspirations. Finally, bone marrow aspiration and biopsy at the positive site by positron emission tomography (PET)-CT contributed to definitive diagnosis of PBML...
April 12, 2018: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29616457/presepsin-as-a-diagnostic-marker-of-bacterial-infections-in-febrile-neutropenic-pediatric-patients-with-hematological-malignancies
#2
Ahmad Baraka, Marwa Zakaria
Febrile neutropenia (FN) is often observed in hematological malignancies (HEM). Presepsin is also known as soluble CD14 subtype; it is a glycoprotein fragment derived from monocytes and macrophages. We aimed to evaluate the significance of presepsin and other biomarkers for diagnosis of bacteremia in children with HEM. Sixty pediatric patients with different HEM (acute lymphoblastic leukemia 36, acute myeloid leukemia 12, non-Hodgkin lymphoma 10, and Hodgkin disease 2). Thirty age and sex-matched healthy children serving as control were enrolled in this study...
April 3, 2018: International Journal of Hematology
https://www.readbyqxmd.com/read/29614573/-eperythrozoonosis-complicated-with-hemophagocytic-syndrome-report-of-four-cases-and-review-of-literature
#3
J G Li, D Zhang, Z X Zhou, S N Li, M Kang, J M Lai
Objective: To analyze the clinical characteristics of eperythrozoonosis complicated with hemophagocytic syndrome (HPS) in 4 children. Methods: Four patients diagnosed with eperythrozoonosis complicated with HPS in the Children's Hospital Affiliated Capital Institute of Pediatrics during the period from June 2014 to July 2016 were enrolled. The clinical manifestations, laboratory examination data and therapeutic strategies were analyzed. A literature search (search terms included 'eperythrozoonosis' and 'hemophagocytic syndrome') was conducted using CNKI, Wanfang database, Chinese biomedical literature database and PubMed to include recently published studies (searched from the database establishment to January 2017)...
April 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29500522/multigene-sequencing-reveals-heterogeneity-of-nlrp12-related-autoinflammatory-disorders
#4
Mikhail M Kostik, Evgeny N Suspitsin, Marina N Guseva, Anastasia S Levina, Anastasia Y Kazantseva, Anna P Sokolenko, Evgeny N Imyanitov
NLRP12-related autoinflammatory disease (NLRP12-AID) is an exceptionally rare autosomal dominant disorder caused by germline mutations in NLRP12 gene. Very few patients with NLRP12-AD have been identified worldwide; therefore, there is a scarcity of data on phenotypic presentation of this syndrome. Here we provide evidence that NLRP12-AID may have clinical manifestations characteristic for primary immune deficiencies (PID). 246 children with periodic fever (PF) of unknown origin were subjects to the next generation sequencing (NGS) analysis; 213 of these patients had signs of primary immunodeficiency (PID) manifested by recurrent infections, while 33 kids had isolated PF...
March 2, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29487087/etiology-and-resource-use-of-fever-of-unknown-origin-in-hospitalized-children
#5
James W Antoon, David C Peritz, Michael R Parsons, Asheley C Skinner, Jacob A Lohr
BACKGROUND: Fever of unknown origin (FUO) is a well-known pediatric presentation. The primary studies determining the causes of prolonged fever in children were performed 4 decades ago, before major advances in laboratory and diagnostic testing. Given that the distribution of diagnosed causes of adult FUO has changed in recent decades, we hypothesized that the etiology of FUO in children has concordantly changed and also may be impacted by a definition that includes a shorter required duration of fever...
March 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29483801/evaluation-of-febrile-neutropenic-attacks-of-pediatric-hematology-oncology-patients
#6
Yeter Düzenli Kar, Zeynep Canan Özdemir, Özcan Bör
Aim: Febrile neutropenia is an important cause of mortality and morbidity in hematology-oncology patients undergoing chemotherapy. The objective of this study was to evaluate febrile neutropenic episodes in children with malignancy. Material and Methods: Sixty-eight children who received chemotherapy for malignancy between 2010 and 2015 were retrospectively reviewed. The demographic characteristics, laboratory data, infection foci, and frequency of microorganisms grown in culture were examined...
December 2017: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/29396941/etiology-of-fever-of-unknown-origin-in-children-from-mumbai-india
#7
Amruta Avinash Landge, Tanu Singhal
This descriptive study evaluated 49 children with fever lasting for more than 7 days at a tertiary hospital in urban Mumbai. Etiologic diagnosis could be established in 88% of the cases. Infections were the causein 34 (79%)patients, 6 (14%) were diagnosed as collagen vascular diseases, and 3 (7%) had other cause.
January 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29189130/nuclear-medicine-imaging-in-fever-of-unknown-origin-the-new-paradigm
#8
Christopher J Palestro, Charito Love
Fever of unknown origin, or FUO, is a challenging condition for patients and clinicians. In up to 50% of cases no diagnosis is established. Patient workup begins with comprehensive history, physical examination and laboratory tests. Radionuclide imaging has been a second-line procedure. Gallium-67 citrate, which accumulates in infection, inflammation, and tumor, was for many years, the radionuclide test of choice in the workup of FUO. The 24-72 hours between injection and imaging, relatively high radiation dose to patients, and suboptimal image quality are significant disadvantages; imaging results are variable...
November 29, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29177510/disseminated-cryptococcosis-presenting-as-miliary-lung-shadows-in-an-immunocompetent-child
#9
Javed Ismail, Muthu Chidambaram, Jhuma Sankar, Shipra Agarwal, Rakesh Lodha
Disseminated cryptococcosis is infrequent in immunocompetent children. Pulmonary and central nervous system are the commonly involved sites of infection in an immunocompromised host. We report a fatal case of disseminated cryptococcosis in an immunocompetent host presenting as fever of unknown origin with miliary shadows on chest radiograph, mimicking tuberculosis. In countries with the heavy burden of tuberculosis, a high index of suspicion is needed for early diagnosis of its close mimics like disseminated cryptococcosis...
November 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29159070/primary-cytomegalovirus-infection-in-immunocompetent-adults-in-the-united-states-a-case-series
#10
Nathanial Nolan, Umme-Aiman Halai, Hariharan Regunath, LPatrick Smith, Christian Rojas-Moreno, William Salzer
Primary Cytomegalovirus (CMV) infection is often not suspected as a cause of fever of unknown origin (FUO) in immune-competent adults. We present a case-series of symptomatic primary CMV infection in immunocompetent adults presenting as fever of unknown origin (FUO). All patients with CMV serology tested between November 2008 and June 2016 underwent chart review. Cases were defined as those between 18 and 65 years of age with documented fever and elevated serum anti-CMV IgM. Exclusion criteria were organ specific CMV disease, positive serum anti-EBV IgM, or presence of any immunocompromising condition...
2017: IDCases
https://www.readbyqxmd.com/read/28862659/fever-in-children-pearls-and-pitfalls
#11
REVIEW
Egidio Barbi, Pierluigi Marzuillo, Elena Neri, Samuele Naviglio, Baruch S Krauss
Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. Furthermore, antipyretics are the most common medications administered to children. We review the epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin...
September 1, 2017: Children
https://www.readbyqxmd.com/read/28763426/epidemiology-of-sepsis-like-illness-in-young-infants-major-role-of-enterovirus-and-human-parechovirus
#12
Eveline P de Jong, Monique G A van den Beuken, Erika P M van Elzakker, Katja C Wolthers, Arwen J Sprij, Enrico Lopriore, Frans J Walther, Frank Brus
BACKGROUND: Sepsis-like illness is a main cause for hospital admission in young infants. Our aim was to investigate incidence, epidemiology and clinical characteristics of enterovirus (EV) and human parechovirus (HPeV) infections in young infants with sepsis-like illness. METHODS: This is a prospective observational cohort study in which infants younger than 90 days of age, presenting with sepsis-like symptoms in a secondary care children's hospital, underwent a full sepsis work-up...
February 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28711429/-appropriateness-of-antibiotic-prescribing-in-paediatric-patients-in-a-hospital-emergency-department
#13
Borja Croche Santander, Elena Campos Alonso, Adela Sánchez Carrión, Laura Marcos Fuentes, Isabel Diaz Flores, Juan Carlos Vargas, Bárbara Fernández Domínguez, Cristóbal Toro Ibañez
INTRODUCTION: Antibiotics represent one of the most widely prescribed therapeutic agents in children. It has been estimated that 30-50% of antibiotic prescriptions for this population are inappropriate. In this scenario, analysis of prescription data provides an invaluable source of information as a basis for implementing strategies for improvement in this field. OBJECTIVE: To assess the appropriateness of antibiotic prescriptions in a paediatric population at an emergency department...
July 12, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28437150/cost-of-cancer-related-neutropenia-or-fever-hospitalizations-united-states-2012
#14
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...
June 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
#15
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
#16
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
#17
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
#18
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...
December 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
#19
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
#20
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
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