Pediatric Infectious Disease Journal最新文献

{"title":"The Severity and Characteristics of Pediatric Group A Streptococcal Meningitis in the Netherlands (2015-June 2024): Results From a Nationwide Multicenter Cohort Study.","authors":"Mirte L Jansen, Evelien B van Kempen, Adam J Tulling, Emilie P Buddingh', Nina M van Sorge, Merijn W Bijlsma, Mirjam van Veen","doi":"10.1097/INF.0000000000005247","DOIUrl":"10.1097/INF.0000000000005247","url":null,"abstract":"<p><strong>Background: </strong>From 2022 onwards, several countries, including the Netherlands, reported a marked increase in invasive group A streptococcal (iGAS) infections. Therefore, we aimed to describe the clinical presentation, disease course, treatment and outcomes of group A streptococcus (GAS) meningitis, a rare but severe manifestation of GAS infection in pediatric patients.</p><p><strong>Methods: </strong>Children with GAS meningitis were selected from the COPP-iGAS study, a national observational cohort study in children 0-17 years of age with in-hospital diagnosis of iGAS between 2015 and June 2024, conducted across 20 hospitals in the Netherlands, including all 7 academic centers with a pediatric intensive care unit.</p><p><strong>Results: </strong>Twenty-seven children were included, of whom 41% (11/27) were younger than 5 years of age. Most patients presented during the first quarter of the year (n = 13/27, 48%). Admission to an intensive care unit occurred in 15/27 (56%) patients and 4/27 (15%) patients died. Detailed clinical data were available for 13/27 patients. Clinical course data could be evaluated for 12 of these patients. Among those 12 patients, almost two-thirds had a complicated disease course, mainly involving cardiorespiratory failure (4/12, 33%). All 12 patients received prolonged antibiotic therapy [median 43 days (IQR 14-61)], predominantly intravenously [median 42 days (IQR 14-50)]. Adjunctive therapy included corticosteroids (6/12, 50%), antiviral agents (3/12, 25%) and anticoagulants (3/12, 25%).</p><p><strong>Conclusion: </strong>Our findings highlight that pediatric GAS meningitis is a severe condition characterized by high intensive care admission rates and substantial mortality. In the subgroup with detailed clinical data, complications were frequent and prolonged antibiotic treatment was common. Increased clinical awareness is warranted.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"859-864"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690676","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":"In Reply: When to Suspect and How to Diagnose Kingella kingae Osteoarthritis.","authors":"Szofia Hajósi-Kalcakosz, Bálint Gergely Szabó","doi":"10.1097/INF.0000000000005235","DOIUrl":"10.1097/INF.0000000000005235","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e432"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623444","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":"A Retrospective Analysis of Dengue-associated Hemophagocytic Lymphohistiocytosis in a Dengue-endemic Country.","authors":"Daniel De Zubiría Posada, Vanessa Cabrera Guarín, Jacobo Triviño Arias, Oriana Arias Valderrama, Diego Medina Valencia, Mario Alejandro Bustos-Paz, Sofía Martínez Betancur, Alexis Antonio Franco Moreno, Pamela Andrea Rodríguez Riveros, Luz Ángela Urcuqui Bustamante, María Ximena Castro García, Jaime Alberto Patiño Niño, Paola Marsela Pérez Camacho, Viviana Lotero Díaz, Harry Mauricio Pachajoa Londoño, Manuela Olaya Hernández","doi":"10.1097/INF.0000000000005232","DOIUrl":"10.1097/INF.0000000000005232","url":null,"abstract":"<p><strong>Background: </strong>Dengue-associated hemophagocytic lymphohistiocytosis (DA-HLH) is a rare but severe hyperinflammatory complication of dengue. Its clinical overlap with severe dengue often delays recognition. We describe the clinical, laboratory and therapeutic characteristics of pediatric patients with DA-HLH in a dengue-endemic region of Latin America.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of pediatric patients diagnosed with DA-HLH at a tertiary-care center in Cali, Colombia, between 2013 and 2024. HLH was diagnosed using HLH-2004 criteria and supported by the HScore. Clinical features, laboratory parameters, treatment regimens and outcomes were analyzed. Associations between extreme biomarker values (below Q1 or above Q3) and mortality were assessed using Fisher exact test.</p><p><strong>Results: </strong>Nineteen patients were included, with a median age of 7 years. Fever and cytopenias were present in all cases, and hepatomegaly was frequently observed. Hyperferritinemia occurred in nearly all patients. Viral coinfections-most commonly Epstein-Barr virus and cytomegalovirus-were identified in over one-third of cases. Overall mortality was 21.1% and occurred exclusively among patients with significant underlying comorbidities. In this exploratory analysis, elevated total bilirubin was the only laboratory parameter associated with mortality.</p><p><strong>Conclusions: </strong>DA-HLH should be considered in pediatric patients with dengue who present with persistent fever, cytopenias, hepatic dysfunction and marked hyperferritinemia. In this exploratory analysis, elevated bilirubin appeared to reflect severe systemic and hepatic involvement rather than an independent prognostic factor, while viral coinfections may contribute to disease severity. Early recognition and individualized immunomodulatory management are essential, and larger multicenter studies are needed to validate these findings.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"888-893"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504607","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":"Outbreak of Shiga Toxin-producing Escherichia coli O157:H7 at a Child Care Center in Izumo, Japan.","authors":"Tomohiro Hirade, Miho Wakuri, Daisuke Koike, Ryoji Nomura, Hidemasa Izumiya, Jun Kawase","doi":"10.1097/INF.0000000000005425","DOIUrl":"https://doi.org/10.1097/INF.0000000000005425","url":null,"abstract":"<p><strong>Background: </strong>Shiga toxin-producing Escherichia coli (STEC) is a clinically significant pathogen that causes hemorrhagic colitis and hemolytic uremic syndrome. In June 2023, an outbreak of STEC O157:H7 occurred at a child care center in Izumo, Japan. This study aimed to identify the mode of transmission of STEC O157:H7 and contributing factors to prevent future outbreaks.</p><p><strong>Methods: </strong>The child care center comprised 138 individuals (111 children and 27 staff members). Stool samples were collected from all individuals. Data regarding clinical symptoms, antimicrobial treatment, duration of bacterial shedding and possible routes of transmission were collected.</p><p><strong>Results: </strong>During the outbreak, 45 of 111 children (41%) and 1 of 27 staff members (4%) were infected with STEC O157:H7. Secondary household transmission occurred in 21 of 152 family members (14%) across 9 families. Among the 45 infected children, 7 (16%) required hospitalization, and 3 (7%) developed hemolytic uremic syndrome. No fatalities occurred. Antibiotics were administered to 30 children (67%). The median duration of bacterial shedding was 12 days (interquartile range, 8-23 days). Person-to-person transmission was identified as the most likely route of transmission within the facility. Contributing factors included inadequate hygiene practices, close contact among children during classroom activities, delayed exclusion of symptomatic individuals and delayed closure of the center.</p><p><strong>Conclusions: </strong>Person-to-person transmission played a critical role in the STEC outbreak at the child care center and within households. Early identification and prompt exclusion of infected individuals are essential to prevent further transmission in child care settings.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113414","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 Intracranial Abscesses in a Tertiary Care Center: Antimicrobial Management, Diagnostic Yield of Molecular Testing and Radiologic Follow-up.","authors":"Roberto Privato, Federica Attaianese, Carlotta Montagnani, Agnese Tamborino, Elena Chiappini, Francesco Nieddu, Maria Moriondo, Angelo Galano, Flavio Giordano, Federico Mussa, Giuseppe Indolfi, Sandra Trapani, Luisa Galli, Elisabetta Venturini","doi":"10.1097/INF.0000000000005240","DOIUrl":"10.1097/INF.0000000000005240","url":null,"abstract":"<p><strong>Background: </strong>Brain abscesses and intracranial empyemas are rare but serious infections associated with substantial morbidity and long-term neurologic sequelae. Microbiologic confirmation is often limited by prior empirical therapy, and the diagnostic yield of real-time polymerase chain reaction in real-world settings remains uncertain. Evidence guiding antimicrobial duration, microbiologic work-up and radiologic follow-up in children is limited. We aimed to describe a pediatric cohort, focusing on management strategies, molecular diagnostics and radiologic follow-up.</p><p><strong>Methods: </strong>In this single-center study, we reviewed the clinical charts of a tertiary care pediatric hospital in Italy from 2017 to 2025. Children younger than 18 years diagnosed with brain abscess or subdural/epidural empyema were included. Clinical, radiologic, microbiologic, and immunologic treatment and outcome data were collected. Comparisons were performed using the Mann-Whitney U test and Fisher exact test.</p><p><strong>Results: </strong>The study cohort included 26 children (17 brain abscesses, 7 subdural empyemas and 2 epidural empyemas). Pathogens were identified in 21 patients (81%), with 23 isolates. Real-time polymerase chain reaction exclusively detected 43% of isolates (10/23). Half of patients received <6 weeks of intravenous therapy without recurrence, including 35% of brain abscesses. Children undergoing drainage/craniotomy had larger lesions ( P = 0.04) and required longer intravenous treatments than those managed conservatively (42 vs. 20 days, P = 0.022). Radiologic follow-up showed residual findings in most cases (60%). One child died; neurologic sequelae occurred in 15% of cases.</p><p><strong>Conclusions: </strong>Pediatric intracranial abscesses require intensive multidisciplinary care, with marked heterogeneity in current treatment strategies. Molecular testing substantially enhances diagnostic yield and pathogen identification. Radiologic structural sequelae are common, but their prognostic significance remains unclear. Standardized pediatric protocols and well-designed prospective studies are needed to optimize antimicrobial stewardship, define which candidates may safely receive shorter intravenous courses, and harmonize follow-up imaging.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"865-871"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623408","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":"Molecular Epidemiology of Non-Polio Enterovirus: Insights From L20B Cell Line Adaptation From Children With Acute Flaccid Paralysis in Pakistan.","authors":"Muhammad Naveed Adil, Muhammad Athar Abbas, Muhammad Masroor Alam, Muhammad Suleman Rana, Muhammad Salman, Salman Sharif, Muhammad Usman, Madiha Mahboob, Sajid Iqbal, Massab Umair, Adnan Khurshid, Ghulam Mujtaba, Muhammad Qaisar Ali, Johar Ali, Nasir Abbas","doi":"10.1097/INF.0000000000005245","DOIUrl":"10.1097/INF.0000000000005245","url":null,"abstract":"<p><strong>Background: </strong>Non-polio enteroviruses (NPEVs) are increasingly implicated in acute flaccid paralysis (AFP), often resembling poliomyelitis and complicating eradication efforts. In Pakistan, limited molecular surveillance has hindered comprehensive characterization. The L20B cell line, designed for poliovirus detection, occasionally supports NPEV replication, challenging AFP case interpretation.</p><p><strong>Methods: </strong>Between January 2021 and December 2022, 4615 stool samples from AFP cases in children ≤15 years were analyzed. Of these, 435 were identified as NPEVs via L20B cytopathic effects and intertypic differentiation reverse transcription-polymerase chain reaction. VP1 sequencing was performed on 218 representative isolates, yielding 153 high-quality sequences (70.2%). The 224/222 primer set showed superior amplification. Phylogenetic analysis used MUSCLE alignment and the Neighbor-Joining method in MEGA X, with statistical evaluation of epidemiological data.</p><p><strong>Results: </strong>NPEVs were frequently found in L20B-positive AFP cases, highlighting the cell line's limited specificity. Most cases involved children under 5, with a slight male bias. Enterovirus B was predominant (98.0%), especially Echovirus 7 (20.3%) and Echovirus 11 (10.5%), followed by Coxsackievirus B1 and Echovirus 33 (5.9% each). Geographic clustering was noted in Punjab (45.1%), Khyber Pakhtunkhwa (30.7%) and Sindh (20.3%), with seasonal peaks in late summer and early autumn. Phylogenetic data revealed localized Enterovirus B circulation with minimal genetic variation.</p><p><strong>Conclusions: </strong>The detection of diverse NPEVs in L20B-positive AFP cases emphasizes their relevance in post-polio surveillance. Incorporating routine VP1 sequencing, optimized primer use, and targeted seasonal and regional monitoring is vital to reduce diagnostic uncertainty and inform public health strategies.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"835-845"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778210","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":"Smartphone-based Detection of Group A Streptococcal Pharyngitis in Ugandan Children: A Pilot Study.","authors":"Joselyn Rwebembera, Emma Ndagire, Gloria Kaudha, Jafesi Pulle, Juliet Alepere, Jane-Liz Nambogo, Henry Kajumbula, Rachel Sarnacki, Miriam Nakitto, Raymond T Ng, Udit Gupta, Steve Rebiffe, David Talan, Peter Whitehead, Emmy Okello, Ndate Fall, David Bell, Andrea Beaton","doi":"10.1097/INF.0000000000005306","DOIUrl":"10.1097/INF.0000000000005306","url":null,"abstract":"<p><p>Prompt diagnosis of group A streptococcal pharyngitis is essential for primary prevention of acute rheumatic fever and rheumatic heart disease, yet affordable point-of-care diagnostics remain limited in low-resource settings. We conducted a prospective study among Ugandan children 5-15 years of age presenting with sore throat, comparing smartphone-acquired oropharyngeal videos analyzed using an artificial intelligence-based image recognition model-trained and validated using combined data from Ugandan and US-based cohorts-with microbiologic culture as the reference standard. Among 82 children evaluated with the optimized model, 12 (15%) had culture-confirmed group A streptococcal pharyngitis. The smartphone-based approach demonstrated 100% sensitivity (95% confidence interval [CI]: 73.5%-100%), 95.7% specificity (95% CI: 88.0%-99.1%) and an overall accuracy of 96.6% (95% CI: 90.0%-99.3%), with an area under the receiver operating curve of 0.93 (95% CI 0.83-1.00). These findings support the potential of smartphone-based artificial intelligence as a rapid, noninvasive diagnostic tool for primary prevention in rheumatic heart disease-endemic settings.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e412-e415"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150912","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":"A Rare Case of Neonatal Rib Osteomyelitis: Diagnostic Challenges and Successful Conservative Management.","authors":"Kevin Valentino, Daniele Donà, Marica De Pieri, Lilian Romina Brandolisio, Paolo Manzoni, Marco Binotti","doi":"10.1097/INF.0000000000005242","DOIUrl":"10.1097/INF.0000000000005242","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e429-e430"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623421","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":"CSF Glucose Reduction Before Pleocytosis Documented by Serial Lumbar Punctures in Neonatal Group B Streptococcal Meningitis.","authors":"Ryotaro Ninomiya, Yosuke Baba, Hisato Aihara, Marika Sugiyama, Hiroaki Tanaka, Kaho Nakamura, Sayaka Tomita, Kenji Oishi, Shun Toriumi, Hiromichi Shoji","doi":"10.1097/INF.0000000000005237","DOIUrl":"10.1097/INF.0000000000005237","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e428-e429"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623378","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 Tuberculosis Surveillance in Nuevo Leon, Mexico: A GIS-based Approach to Identify High-burden Areas.","authors":"Lindsay A Concha-Mora, Aracely Guzmán-Guajardo, José E Mares-Gil, Oscar Tamez-Rivera","doi":"10.1097/INF.0000000000005229","DOIUrl":"10.1097/INF.0000000000005229","url":null,"abstract":"<p><strong>Background: </strong>Pediatric tuberculosis (TB) remains underdiagnosed and underreported in Mexico, with limited data on its spatial distribution. This study used geographic information systems (GIS) to map pediatric TB cases diagnosed at a tertiary referral hospital in Nuevo Leon, Mexico, to identify spatial patterns and socioeconomic inequities.</p><p><strong>Methods: </strong>We conducted a retrospective study of 145 pediatric TB cases (<15 years) diagnosed between 2010 and 2023 at Hospital Regional Materno Infantil, the main public tertiary referral center for children in Nuevo León. GIS analyses included kernel density estimation, kernel relative risk nearest neighbor index, distance to hospital and overlay with marginalization indices.</p><p><strong>Results: </strong>Pulmonary TB was most common (55.2%; n = 80), followed by lymph node (15.8%; n = 23) and meningeal TB (13.1%; n = 19). Kernel density estimation identified hotspots in urban municipalities (Monterrey, Guadalupe, San Nicolás de los Garza). Nearest neighbor index confirmed significant clustering for pulmonary, lymph node and meningeal TB ( P < 0.05). Over 65% of cases resided >10 km from Hospital Regional Materno Infantil, and 85% lived in medium- to high-marginalization areas. Mortality (4.1%; n = 6) and treatment abandonment (11.0%; n = 16) were noted, with most occurring among cases from distant or marginalized areas.</p><p><strong>Conclusion: </strong>GIS surveillance at a single tertiary center revealed nonrandom spatial clustering of pediatric TB in urban hotspots and areas of socioeconomic deprivation in Nuevo Leon. Integrating geocoded case data with population denominators could enhance routine TB surveillance to prioritize local investigations and interventions.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"853-858"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634246","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}