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Sirs and pediatric and antibiotic

Franziska Gies, Eva Tschiedel, Ursula Felderhoff-Müser, Peter-Michael Rath, Joerg Steinmann, Christian Dohna-Schwake
BACKGROUND: Antimicrobially pre-treated children with systemic inflammation often pose a diagnostic challenge to the physician. We aimed to evaluate the additional use of SeptiFast multiplex polymerase chain reaction (PCR) to identify causative pathogens in children with suspected systemic bacterial or fungal infection. METHODS: Prospective observational study in 39 children with systemic inflammatory response syndrome (SIRS) under empiric antibiotic treatment. Primary outcome was the rate of positive blood cultures (BC), compared to the rate of positive SeptiFast (SF) results...
2016: BMC Infectious Diseases
Kevin J Downes, Scott L Weiss, Jeffrey S Gerber, Sarah B Klieger, Julie C Fitzgerald, Fran Balamuth, Sherri E Kubis, Pam Tolomeo, Warren B Bilker, Xiaoyan Han, Irving Nachamkin, Charles Garrigan, Jennifer H Han, Ebbing Lautenbach, Susan E Coffin
BACKGROUND: Biomarkers that identify critically ill children with systemic inflammatory response syndrome (SIRS) at low risk for bacterial infection may help clinicians reduce unnecessary antibiotic use. METHODS: We conducted a prospective cohort study of children with SIRS and suspected infection admitted to a pediatric intensive care unit from January 5, 2012 to March 7, 2014. We enrolled patients upon initiation of new antibiotics (Time 0) and measured a panel of 8 serum biomarkers daily over 72 hours...
May 4, 2016: Journal of the Pediatric Infectious Diseases Society
Michal Svarc, Vratislav Sedlak, Vladimir Koblizek, Frantisek Salajka, Jakub Novosad
SESSION TYPE: Infectious Disease Global Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Community acquired pneumonia is one of the leading cause of hospitalization worldwide. Parapneumonic pleural effusions are seen in approximately 35-40% of patients, and almost 10% require drainage. The number of all cases of pneumonia in the world rises as well as the rate of unusual etiological agents including opportunistic pathogens, such as Canida Albicans. Immune response is vital for surviving the pneumonia, which remains potentially fatal even in 21st century...
October 1, 2012: Chest
Halden F Scott, Aaron J Donoghue, David F Gaieski, Ronald F Marchese, Rakesh D Mistry
OBJECTIVES: Failure to recognize shock contributes to inadequate early resuscitation in many children with sepsis. Serum lactate levels are used to identify adult patients with septic shock, but physical examination diagnosis alone is recommended in pediatric sepsis. The authors sought to test the utility of lactate testing in pediatric emergency department (ED) patients with systemic inflammatory response syndrome (SIRS). The hypothesis was that early hyperlactatemia (serum lactate ≥ 4...
November 2012: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Babak Pourakbari, Setareh Mamishi, Javid Zafari, Hanieh Khairkhah, Mohammad H Ashtiani, Masomeh Abedini, Shahla Afsharpaiman, Soroush Seifi Rad
BACKGROUND: Fever as a common presenting complaint in pediatric patients can be due to various causes. Differentiating bacterial infection from other causes is important because the prompt use of antibiotics is critical in bacterial infection. Traditional markers of infection such as BT and WBC count may be unspecific and culture may be late or absent. CRP and Procalcitonin (PCT) have been considered to evaluate the evolution of infections and sepsis in patients presenting with SIRS. Neopterin has also been proposed to aid in the diagnosis of bacterial infection...
May 2010: Brazilian Journal of Infectious Diseases
Leticia Castillo, Joseph Carcillo
In an effort to attain earlier diagnoses in children with hemophagocytic lymphohistiocytosis (HLH), the International Histiocyte Society has now broadened their diagnostic criteria to no longer differentiate primary (HLH) and secondary hemophagocytic lymphohistiocytosis (SHLH). Five of the following eight diagnostic criteria needed to be met: 1) fever, 2) cytopenia of two lines, 3) hypertriglyceridemia and/or hypofibrinogenemia, 4) hyperferritinemia (>500 microg/L), 5) hemophagocytosis, 6) elevated soluble interleukin-2 receptor (CD25), 7) decreased natural killer-cell activity, and 8) splenomegaly can also commonly be found in patients with sepsis, systemic inflammatory response syndrome (SIRS), multiorgan dysfunction syndrome (MODS), and macrophage activation syndrome (MAS)...
May 2009: Pediatric Critical Care Medicine
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