Pediatric Infectious Disease Journal最新文献

{"title":"After 2 Nirsevimab Seasons, the Decline in RSV Deepens While Human Metapneumovirus Remains an Unaddressed Cause of Severe Bronchiolitis in Young Italian Children.","authors":"Alessandra Chiara Ferrari, Andrea Enzo Scaramuzza, Giulia Chiopris, Lorenzo Zanola, Elena Benedettucci, Enrico Antodaro, Domenico Sestito, Gloria Fumagalli, Antonella Scarda, Valentina Todescato, Christian Steuber, Claudio Cavalli","doi":"10.1097/INF.0000000000005447","DOIUrl":"https://doi.org/10.1097/INF.0000000000005447","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239179","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":"Toxic Megacolon and Secondary Acinetobacter lwoffii Bacteremia: An Unusual Presentation of Serogroup B Meningococcemia in a Toddler.","authors":"Aslihan Arslan Maden, İrem Ceren Erbaş, Tuğçe Aybek, Fatih Durak, Dilek Yilmaz","doi":"10.1097/INF.0000000000005440","DOIUrl":"https://doi.org/10.1097/INF.0000000000005440","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220224","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":"Diagnostic Challenges in Pediatric Infectious Encephalitis: Applicability of the International Encephalitis Consortium Criteria and Prognostic Factors in a Multicenter Study.","authors":"Celia García Bailo, José Antonio Alonso-Cadenas, Verónica Cantarín, Klaudia Irati Bidaurrazaga García, Roberto Velasco, Alicia Calvo Cillán, Ana María Borrull Senra, Cristina López Fernández, Izaskun Olaciregui Echenique, Alejandra Méndez Sánchez, Nathalie Campo Fernández, Iris Collazo Vallduriola, María José González Abad, Celia García Blanco, Ana de la Iglesia Rivaya, Laura Escolà Morales, Sara Figueroa Jiménez, Inés Valle T-Figueras, Borja Gómez","doi":"10.1097/INF.0000000000005444","DOIUrl":"https://doi.org/10.1097/INF.0000000000005444","url":null,"abstract":"<p><strong>Background: </strong>The International Encephalitis Consortium (IEC) criteria are widely used to diagnose pediatric encephalitis, although their performance has not been evaluated.</p><p><strong>Objective: </strong>To evaluate IEC criteria in children with suspected encephalitis and identify prognostic factors associated with adverse outcomes.</p><p><strong>Methods: </strong>Secondary analysis of a retrospective multicenter study including children aged <18 years undergoing cerebrospinal fluid polymerase chain reaction testing for suspected encephalitis in 10 Spanish Pediatric Emergency Departments between 2017 and 2023. Patients were classified according to the IEC criteria. Children fulfilling the major criterion and 1 minor criterion plus pathogen confirmation were classified as subthreshold encephalitis. Multivariable logistic regression was used to identify prognostic factors for adverse outcomes.</p><p><strong>Results: </strong>Of 446 children, 118 met IEC criteria (60 confirmed, 15 probable, 43 possible encephalitis). Twenty additional cases were classified as subthreshold encephalitis. Rates of adverse outcomes were similar in both groups (31.4% vs. 30.0%). Independent predictors of adverse outcomes were abnormal neuroimaging (adjusted odds ratio [aOR], 3.2; 95% confidence interval [CI], 1.6-6.4; P < 0.001), focal neurologic deficits (aOR, 2.6; 95% CI, 1.3-5.2; P = 0.01), bacterial etiology (aOR, 2.7; 95% CI, 1.05-6.8; P = 0.03), seizures (aOR, 2.1; 95% CI, 1.0-4.5; P = 0.04) and microbiologic confirmation (aOR, 1.9; 95% CI, 1.0-3.6; P = 0.048).</p><p><strong>Conclusions: </strong>Children with altered mental status and an encephalitis-associated pathogen but only 1 minor IEC criterion may represent missed encephalitis cases. Microbiologic confirmation, particularly bacterial etiology, and 3 minor IEC criteria were independently associated with worse outcomes, with abnormal neuroimaging being the strongest predictor.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220292","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":"First Do No Harm: When Can and Should We Withhold Antibiotics in Neonates?","authors":"Liesanne E J van Veen, Niek B Achten, Gerdien A Tramper-Stranders","doi":"10.1097/INF.0000000000005446","DOIUrl":"https://doi.org/10.1097/INF.0000000000005446","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220274","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":"Gallbladder Involvement in Pediatric Hepatitis A: Findings From an Italian Outbreak Cohort.","authors":"Pietro Aliberti, Marco Poeta, Francesco Maria Rosanio, Francesco Cirillo, Marta Giovengo, Marco Sarno, Luigi Martemucci, Francesco Nunziata, Maia De Luca, Stefania Mercadante, Andrea Lo Vecchio, Eugenia Bruzzese, Raffaello Rabuano, Claudia Mandato, Alfredo Guarino","doi":"10.1097/INF.0000000000005445","DOIUrl":"https://doi.org/10.1097/INF.0000000000005445","url":null,"abstract":"<p><strong>Background: </strong>Gallbladder involvement during acute hepatitis A virus (HAV) infection is generally considered an uncommon extrahepatic manifestation, although recent reports suggest it may be underrecognized. We evaluated the prevalence, clinical characteristics and outcomes of gallbladder abnormalities in a multicenter cohort of children hospitalized with acute HAV infection during an Italian outbreak.</p><p><strong>Methods: </strong>We conducted a multicenter observational study, including consecutive children with laboratory-confirmed acute HAV infection admitted to 4 tertiary pediatric hospitals between January and May 2026. Clinical, laboratory and ultrasonographic findings were collected. All patients underwent abdominal ultrasonography during the acute phase of illness.</p><p><strong>Results: </strong>Thirty-three children were included. Gallbladder abnormalities compatible with acute acalculous cholecystitis were identified in 18 patients (54.5%), including marked gallbladder wall thickening (>7 mm) in 8. Children with gallbladder involvement did not exhibit more severe clinical manifestations or greater biochemical impairment than those without ultrasonographic abnormalities. Serum bile acids were markedly elevated in most tested patients but were not associated with gallbladder abnormalities. All patients were managed conservatively, and none developed gallbladder perforation, empyema, gangrene or required surgical intervention. Complete clinical recovery with progressive normalization of laboratory and ultrasonographic findings was observed in all cases.</p><p><strong>Conclusions: </strong>Systematic ultrasonography identified gallbladder involvement in more than half of children hospitalized with acute HAV infection, suggesting that this manifestation may be substantially underrecognized rather than truly rare. Despite frequent ultrasonographic abnormalities, the clinical course was uniformly benign, supporting conservative management in the absence of complications.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207361","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":"First Documented Pediatric Hantavirus Infection in Athens Metropolitan Area, Greece.","authors":"Katerina Vlachodimitropoulou, Filippos Filippatos, Elissavet Georgiadou, Anna Papa, Athanasios Michos, Evangelia Lykopoulou, Vasiliki Karava","doi":"10.1097/INF.0000000000005448","DOIUrl":"https://doi.org/10.1097/INF.0000000000005448","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183688","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":"The Role of Vaccination in Antimicrobial Resistance Prevention in Children.","authors":"Tobias Tenenbaum, Luise Martin","doi":"10.1097/INF.0000000000005438","DOIUrl":"https://doi.org/10.1097/INF.0000000000005438","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183619","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":"Chronic Hepatitis B, Recurrent Cytopenias and HLH-like Episodes in a Child With DEGCAGS Syndrome.","authors":"Van Lam Nguyen, Thien Hai Do, Khanh Minh Le, Thi Huyen Trang Ngo, Sy Duc Nguyen","doi":"10.1097/INF.0000000000005443","DOIUrl":"https://doi.org/10.1097/INF.0000000000005443","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183531","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":"Pediatric Infectious Encephalitis in Spain: Etiology, Outcomes and Acyclovir Use in Emergency Departments.","authors":"Celia García Bailo, José Antonio Alonso-Cadenas, Verónica Cantarín, Klaudia Irati Bidaurrazaga García, Roberto Velasco, Alicia Calvo Cillán, Ana María Borrull Senra, Cristina López Fernández, Izaskun Olaciregui Echenique, Alejandra Méndez Sánchez, Nathalie Campo Fernández, Iris Collazo Vallduriola, María José González Abad, Celia García Blanco, Ana de la Iglesia Rivaya, Laura Escolà Morales, Sara Figueroa Jiménez, Inés Valle T-Figueras, Borja Gómez","doi":"10.1097/INF.0000000000005439","DOIUrl":"https://doi.org/10.1097/INF.0000000000005439","url":null,"abstract":"<p><strong>Background: </strong>Pediatric infectious encephalitis remains a significant cause of neurologic morbidity. Prompt antiviral treatment is recommended in patients with suspected herpes simplex virus (HSV) encephalitis. This study aimed to describe the epidemiology and outcomes of infectious encephalitis and to evaluate acyclovir use in children with suspected encephalitis presenting to the pediatric emergency department (PED).</p><p><strong>Methods: </strong>We conducted a multicenter, retrospective, cross-sectional study involving 10 Spanish PEDs (2017-2023), including children ≤18 years who underwent cerebrospinal fluid polymerase chain reaction testing as part of the evaluation of a possible central nervous system infection. Patients meeting the International Encephalitis Consortium (IEC) criteria for infectious encephalitis were analyzed, and acyclovir prescription rates were assessed.</p><p><strong>Results: </strong>We registered 446 episodes; 118 patients (26.5%) met the IEC criteria, and 88 (74.6%) had microbiologic confirmation. The most common pathogens were enterovirus (43.2%), influenza virus (18.2%) and HSV (9.0%). Thirty-seven patients (31.4%) had an adverse outcome, including 75% of those with HSV infection. Acyclovir was administered to 56.9% and 53.1% of patients with and without an altered mental status, respectively. All patients meeting IEC criteria presented with altered mental status and ≥1 minor criterion at evaluation in the PED.</p><p><strong>Conclusions: </strong>Enteroviruses were the leading cause of pediatric infectious encephalitis, whereas HSV infection was associated with the highest risk of adverse outcomes. Acyclovir use in the PED was suboptimal and poorly aligned with clinical criteria. Our findings suggest that empirical acyclovir should be considered in patients with altered mental status and at least one minor criterion, whereas it may be unnecessary in the absence of these features.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183635","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":"Chorioretinal Scars in Congenital Cytomegalovirus Infection Following Prenatal Valacyclovir Therapy.","authors":"Nemer Sayed Ahmad, Yaniv Zipori, Ido Solt, Dinah Zur, Anat Bachar Zipori","doi":"10.1097/INF.0000000000005433","DOIUrl":"https://doi.org/10.1097/INF.0000000000005433","url":null,"abstract":"<p><strong>Background: </strong>Congenital cytomegalovirus infection is the most common congenital infection. Ocular abnormalities affect approximately 14% of symptomatic children, but fewer than 1% of asymptomatic children. Prenatal valacyclovir reduces vertical transmission, but ophthalmic outcomes in exposed infants are poorly described.</p><p><strong>Methods: </strong>We describe 2 neonates with congenital cytomegalovirus confirmed by amniotic fluid and urine polymerase chain reaction following first-trimester maternal primary infection. Both mothers received high-dose valacyclovir (8 g daily) from 13 weeks' gestation. Infants underwent neonatal evaluation, including dilated fundus examination and multimodal retinal imaging.</p><p><strong>Results: </strong>Maternal treatment continued to 36 weeks in 1 pregnancy and was discontinued at 22 weeks in the other, after amniocentesis. Both infants had macular chorioretinal scarring. Optical coherence tomography demonstrated focal ellipsoid zone disruption in a clinically normal fellow eye in 1 infant. Cranial ultrasonography demonstrated caudothalamic and temporal lobe cysts with lenticulostriate vasculopathy in 1 infant and isolated lenticulostriate vasculopathy in the other. Physical and neurologic examinations, head circumference, full blood count, liver function and auditory brainstem responses were normal in both. Both were classified as symptomatic with central nervous system involvement on the basis of ocular findings and therefore received valganciclovir for a planned 6 months. Retinal findings were stable at 3 months.</p><p><strong>Conclusions: </strong>Macular chorioretinal scarring was present in both infants despite otherwise limited clinical findings, and the extent of cranial imaging abnormality did not correspond to ocular involvement. Ophthalmologic examination determined disease classification and management. These observations do not permit conclusions regarding the effect of prenatal valacyclovir on ocular outcome.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183587","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}