Pediatric Infectious Disease Journal最新文献

{"title":"Are Management Practices for Pediatric Uncomplicated Acute Otitis Media Different on Weekends Versus Weekdays?","authors":"Eyal Schneider, Maor Pichadze, Shir Avraham, Sharon Ovnat Tamir, Yonatan Yeshayahu, Tal Marom","doi":"10.1097/INF.0000000000005286","DOIUrl":"10.1097/INF.0000000000005286","url":null,"abstract":"<p><strong>Background: </strong>Acute otitis media (AOM) is a leading cause of antibiotic prescriptions in children. The \"weekend effect\"-reduced care quality outside standard hours due to lower senior supervision-has been reported for various pediatric conditions, but its impact on AOM management remains unexplored.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of children 6 months to 10 years old diagnosed with uncomplicated AOM in a secondary academic pediatric emergency department (PED) between 2017 and 2024. Treatment appropriateness was assessed against the 2023 Israeli AOM guidelines. Care optimality was stratified by visit timing and physician seniority into 3 levels: level 0 (weekday, attending present), level 1 (after-hours, attending present) and level 2 (after-hours, no attending).</p><p><strong>Results: </strong>Of 288 children included, weekend and weekday visitors were clinically and demographically comparable. The presence of attending physicians was significantly higher on weekdays (82.8% vs. 55.6%, P < 0.001). Guideline-appropriate treatment was achieved in 72.9% of cases overall, with amoxicillin as the first-line chosen antibiotic therapy. No significant differences in treatment appropriateness were found between weekend and weekday visits, nor across care optimality levels ( P = 0.363), indicating that physician supervision level did not influence guideline adherence.</p><p><strong>Conclusions: </strong>AOM management was guideline-adherent regardless of visit timing or physician supervision level, with no weekend effect identified. These findings suggest effective standardization of clinical practice in our pediatric emergency department and support maintaining current protocols as a model for consistent AOM care in emergency settings.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e442-e445"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laryngeal Tuberculosis in the Modern Era: Diagnostic Challenges.","authors":"Inês Teles de Figueiredo, Ana Pereira Lemos, Lorena Stella, Mariana Cardoso de Oliveira, Inês Madureira, Catarina Gouveia","doi":"10.1097/INF.0000000000005258","DOIUrl":"10.1097/INF.0000000000005258","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e477-e478"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postnatal Care-associated Echovirus 11 Infection in Malaysia: Severe Disease With Variable Outcomes.","authors":"Soo Lin Chuah, Joanne Zhi Han Lau, Chin Seng Gan, Kee Seang Chew, Li Lyn Ooi, I-Ching Sam, Yoke Fun Chan","doi":"10.1097/INF.0000000000005303","DOIUrl":"10.1097/INF.0000000000005303","url":null,"abstract":"<p><strong>Background: </strong>Echovirus 11 (E11) is a common circulating enterovirus globally and in Malaysia. In recent years, severe neonatal E11 infections have been increasingly reported in Europe and Asia. An increase in severe E11 cases reported in Malaysia highlights significant potential for transmission in postnatal environments in hospitals and the community.</p><p><strong>Methods: </strong>We present clinical and laboratory findings for 5 neonates admitted with laboratory-confirmed E11 infection in Kuala Lumpur, Malaysia, between September 2023 and January 2024. E11 was diagnosed by virus culture or polymerase chain reaction. The E11 VP1 genes were sequenced and compared to other global E11 sequences.</p><p><strong>Results: </strong>Patients were between 2 and 9 days of age. Four cases presented with multiorgan failure with prominent liver dysfunction requiring intensive care, and 2 died. Two had the unusual complication of thrombotic microangiopathy. The fifth patient had uncomplicated meningitis. All cases had E11 viruses of D5 genotype, similar to recently reported global sequences. Two patients with identical virus sequences had been in the same neonatal unit of another hospital, implying a common source. The other 3 were community-acquired cases with related viral sequences. Three cases were admitted from different confinement centers, which are postnatal community care facilities for newborns and mothers.</p><p><strong>Conclusions: </strong>E11 genotype D5 is the main cause of the recent global upsurge of severe neonatal E11 infections. Severe multiorgan disease and hemorrhagic hepatitis syndrome are associated with poor prognosis. E11 transmission in postnatal settings shows the importance of stringent infection control practices, especially in community confinement centers, which are becoming increasingly widespread.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"998-1002"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Invasive Group A Streptococcal Infections in Children: The European Society for Pediatric Infectious Disease Guidelines.","authors":"Elena Chiappini, Roberta Pellegrino, Irene Dalpiaz, Marco Renni, Eleni Vergadi, Lauri Ivaska, Lorenza Romani, Gulhadiye Avcu, Gregorio Milani, Dana Danino","doi":"10.1097/INF.0000000000005336","DOIUrl":"10.1097/INF.0000000000005336","url":null,"abstract":"<p><strong>Background: </strong>Invasive group A streptococcal (iGAS) infections in children, although rare, are associated with significant morbidity and mortality, and their incidence has risen globally in recent years. Evidence for optimal management in children is limited. These guidelines aim to provide evidence-based recommendations for the management of pediatric iGAS, including antibiotic therapy, adjunctive nonantibiotic therapies and prophylaxis of close contacts.</p><p><strong>Methods: </strong>The ESPID Guidelines Committee convened a multidisciplinary working group. A systematic literature search of pediatric studies published from 2003 to 2023 in PubMed, Embase and the Cochrane Library was performed. Clinical questions with pediatric data were formulated as PICO and assessed using the GRADE approach, with consensus achieved through a modified Delphi process. For clinically important questions lacking sufficient evidence, narrative synthesis with nongraded expert consensus was used. Additional publications until August 2025 contributed qualitatively but were not formally GRADE-graded.</p><p><strong>Results: </strong>Penicillins remain the first-line therapy for iGAS. In severe or toxin-mediated infections (eg, necrotizing fasciitis or streptococcal toxic shock syndrome), adjunctive clindamycin is suggested, with linezolid as an alternative where clindamycin resistance is confirmed or in central nervous system disease. Intravenous immunoglobulin may be considered in life-threatening toxin-mediated disease, whereas evidence for corticosteroids is insufficient. Prophylaxis is recommended for high-risk household contacts (neonates, postpartum women, elderly, immunocompromised, and recent varicella infection) and considered for all contacts in outbreak settings.</p><p><strong>Conclusions: </strong>These ESPID guidelines provide evidence-based recommendations for the management of pediatric iGAS. Given the rarity and limited trial data, most recommendations are weak and supported by low-quality evidence, highlighting the need for high-quality pediatric studies.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e457-e470"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive Right Knee Pain in a Two-year-old Boy After Treatment for Lyme Arthritis.","authors":"Megan M Seefelt, Emily C Johnson, Rachel M Randall, Thomas G Boyce","doi":"10.1097/INF.0000000000005287","DOIUrl":"https://doi.org/10.1097/INF.0000000000005287","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":"45 11","pages":"e471-e473"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fulminant Neurotuberculosis With Early Atypical Findings and Rapid Fatal Outcome in an Adolescent: A Diagnostic Challenge.","authors":"Sofia Maria Brito Cal Muinhos, Victor Gabriel Costa Campos de Azevedo Nery, Camylla Aparecida Brito Dos Santos, Paula Sayhara Mendes Barbosa, Aline de Souza Araújo Fernandes Pinheiro, Álvaro Filipe Marques Gonçalves de Sales, Paulo César Trindade da Costa","doi":"10.1097/INF.0000000000005272","DOIUrl":"10.1097/INF.0000000000005272","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e478-e479"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Epidemiologic Characteristics With Molecular Confirmation of Cyclosporiasis in Pediatric Patients Presenting to the Emergency Department With Acute Diarrheal Disease in Quindio, Colombia.","authors":"Daniela Agudelo-Torres, Jessica Triviño-Valencia, Nancy Yhomara Cabeza, Fabiana Lora-Suarez, Jorge Enrique Gómez-Marín","doi":"10.1097/INF.0000000000005285","DOIUrl":"10.1097/INF.0000000000005285","url":null,"abstract":"<p><strong>Background: </strong>No analyses have explored the differential clinical characteristics of cyclosporiasis compared with other diarrheal etiologies.</p><p><strong>Methods: </strong>We conducted a prospective study of 118 children with diarrheal illnesses. Stool samples were analyzed using Ziehl-Neelsen (ZN) staining and polymerase chain reaction (PCR) targeting the ssu rRNA gene. Positive PCR samples were sequenced to identify phylogroups (A, B and C). Quantitative variables were compared using the Mann-Whitney U test. Qualitative associations were analyzed using odds ratios (ORs) and Fisher exact or χ 2 tests. A parsimonious multivariate logistic regression identified independent predictors while controlling for sample size effects.</p><p><strong>Results: </strong>Cyclosporiasis was identified in 18.6% (n = 22) by ZN and 19.5% (n = 23) by PCR. Diagnostic agreement was substantial (kappa = 0.81). Stool pH was significantly more alkaline in the ZN-positive group (median: 7.5, range: 4.0-9.0) than in the negative group (median: 6.0, range: 4.0-9.0; P = 0.0206). High-output diarrhea (OR = 3.58; 95% confidence interval: 1.29-9.94; P = 0.011) and abdominal pain (OR = 3.05; 95% confidence interval: 1.16-7.99; P = 0.020) were the primary clinical hallmarks of cyclosporiasis. Lineage B was the endemic strain, causing most acute, high-output secretory diarrhea cases. The parasite was found in domestic water and food (coriander) with 100% identity with lineage B.</p><p><strong>Conclusions: </strong>Pediatric Cyclospora infection presents with a distinct clinical triad: high-volume watery diarrhea, abdominal pain and alkaline stool Ph. Lineage B is the drive core of cases with waterborne transmission as a primary pathway.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"964-970"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Prognostic Models Fail to Reliably Distinguish Kawasaki Disease From Pediatric Multisystem Inflammatory Syndrome Temporally Associated With COVID-19.","authors":"Vivien Pols, Petros Strempas, Heidi Weberruss, Thomas Rupprecht","doi":"10.1097/INF.0000000000005277","DOIUrl":"10.1097/INF.0000000000005277","url":null,"abstract":"<p><strong>Background: </strong>Along with the emergence of coronavirus disease 2019 (COVID-19), a hyperinflammatory multisystemic syndrome in children called PIMS appeared. Despite its close similarity to the Kawasaki disease (KD), the conclusion of PIMS being a distinct disease entity was reached quickly. Since then, research projects have been implemented to find differences and reliable distinction parameters with conflicting results. Therefore, the aim of this study was to explore existing prognostic models on their ability to distinguish the diagnoses.</p><p><strong>Methods: </strong>Two externally developed prognostic models were applied to 2 distinct datasets: one consisting solely of 26 KD and PIMS cases from Bayreuth, the other comprising 632 cases of both diagnoses reported by pediatricians from all over Germany and Innsbruck, Austria. The potential of the models to distinguish the diagnoses on a phenotypic level was evaluated based on their sensitivities and specificities, κ-coefficients by Cohen and correlation analysis.</p><p><strong>Results: </strong>The sensitivity and specificity of both prognostic models did not display a reliable distinguishability between KD and PIMS. Moreover, correlation analysis cannot confirm the correlation of most parameters utilized in the models with the PIMS diagnosis. The only parameter showing a positive correlation in both datasets was the patients' older age.</p><p><strong>Conclusions: </strong>These findings are congruent with the general inconclusiveness in research concerning the distinction of KD and PIMS. We could not reproduce a distinguishability using the models or a correlation between the utilized parameters and PIMS except for one. Henceforth, research will need to focus on nonphenotypical properties for differentiation of KD and PIMS.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"942-946"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Integrase Strand Transfer Inhibitors Among Children Living With HIV in Latin America and the Caribbean.","authors":"Marco Tulio Luque, Liping Du, Vanessa Rouzier, Daisy M Machado, Jorge Pinto, Bryan E Shepherd, Jessica L Castilho","doi":"10.1097/INF.0000000000005281","DOIUrl":"10.1097/INF.0000000000005281","url":null,"abstract":"<p><strong>Background: </strong>Limited data exist on integrase strand transfer inhibitor (INSTI) use among children. We assessed dolutegravir (DTG) and raltegravir (RAL) use and outcomes among Latin American and Caribbean children with HIV.</p><p><strong>Methods: </strong>Cohorts from Brazil, Haiti and Honduras contributed data for children (age <18 years) receiving care since the widespread availability of DTG and RAL (approximately 2013-2022). Trends and factors associated with INSTI (DTG/RAL) initiation were examined using multivariable logistic and Cox regression models among antiretroviral therapy (ART)-naïve and -experienced children, respectively. We compared viral and treatment outcomes among ART-naïve children by INSTI use with log-rank tests.</p><p><strong>Results: </strong>Among ART-naïve children, 77/110 started DTG, 5/109 started RAL and 91 started other ART. The proportion of ART-naïve children initiating DTG increased from 0% in 2016 to 93% (13/14) in 2022. Starting DTG was more likely in older ART-naïve children and in more recent calendar years ( P ≤ 0.01). Among ART-experienced children, 122/273 switched to DTG, and 25/288 switched to RAL. More recent calendar year and a greater number of prior ART regimens were associated with a higher incidence of switch to DTG and RAL ( P < 0.01). There was no statistical difference in virologic suppression among ART-naïve children by use or non-use of DTG; however, children started on DTG had a longer duration of the first regimen than those started on other ART ( P < 0.01).</p><p><strong>Conclusions: </strong>INSTI use among children has increased in parts of Latin American And Caribbean. As more children start INSTI regimens, further research is needed on their clinical impact.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"979-985"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Infective Endocarditis in Pediatric Staphylococcal Bacteremia: A 20-Year Cohort Study.","authors":"Apisara Pakotiprapha, Paweena Chungsomprasong, Chodchanok Vijarnsorn, Prakul Chanthong, Thita Pacharapakornpong, Ploy Thammasate, Auttapol Srivichean, Kritvikrom Durongpisitkul, Jarupim Soongswang","doi":"10.1097/INF.0000000000005257","DOIUrl":"10.1097/INF.0000000000005257","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of Staphylococcus aureus endocarditis (SAE) in children with S. aureus bacteremia (SAB) varies widely and is generally lower than that in adults. This study aimed to determine the prevalence of SAE in pediatric patients with SAB and to identify the associated clinical risk factors.</p><p><strong>Methods: </strong>This retrospective study included all children 0-18 years old diagnosed with SAB at a university hospital in Thailand between 2003 and 2023, identified using International Statistical Classification of Diseases and Related Health Problems 10th Revision codes. Endocarditis was defined using the modified Duke criteria, in accordance with the 2023 European Society of Cardiology guidelines for the management of endocarditis.</p><p><strong>Results: </strong>Among the 171 children with SAB, 15 (8.8%) met the criteria for definite infective endocarditis. Methicillin-sensitive S. aureus was the predominant pathogen in both uncomplicated SAB and SAB complicated by endocarditis. Congenital heart disease was significantly associated with SAE ( P = 0.02). Additional risk factors included protein-energy malnutrition (PEM) ( P = 0.04) and more than 2 positive blood cultures ( P = 0.001), whereas immunocompromised status was associated with a reduced risk ( P < 0.001). Both SAB and SAE were associated with prolonged hospitalization and increased mortality.</p><p><strong>Conclusions: </strong>SAE occurred in 8.8% of pediatric SAB cases. Congenital heart disease, protein-energy malnutrition and persistent bacteremia were key predictors of SAE. In settings where echocardiography is not immediately accessible, these clinical risk factors can guide the early identification of high-risk patients and support decisions regarding monitoring intensity and timely referral. Larger prospective studies are needed to validate these associations and to facilitate the development of practical prediction tools for pediatric SAE.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"925-928"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}