{"title":"Concomitant Rifampicin-Sensitive Pulmonary Tuberculosis With Pre-extremely Drug-Resistant Neuro-Tuberculosis in Child With Steroid-Resistant Nephrotic Syndrome.","authors":"Vaidehi Mehta,Ramsha Ansari,Ira Shah","doi":"10.1097/inf.0000000000004555","DOIUrl":"https://doi.org/10.1097/inf.0000000000004555","url":null,"abstract":"Mixed tuberculosis occurs with multiple clonally distinct mycobacterium tuberculosis strains in an individual. We present a 12-year-old girl with steroid-resistant nephrotic syndrome and drug-sensitive pulmonary tuberculosis (Xpert MTB/Rif) and preextensively drug-resistant tuberculosis neuro-tuberculosis (Line Probe Assay). Mixed tuberculosis involving drug-susceptible and drug-resistant strains can hinder treatment. This case highlights the challenges in diagnosing mixed tuberculosis to ensure effective management.","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria D S Quintans,Renata A de O Vianna,Luis G C Velarde,Solange A de Oliveira,Alexandre R Fernandes,Arnaldo C Bueno,Claudete A A Cardoso
{"title":"Neurodevelopmental Outcomes in Children Vertically Exposed to Chikungunya Virus: A Two Years Follow-up Study.","authors":"Maria D S Quintans,Renata A de O Vianna,Luis G C Velarde,Solange A de Oliveira,Alexandre R Fernandes,Arnaldo C Bueno,Claudete A A Cardoso","doi":"10.1097/inf.0000000000004534","DOIUrl":"https://doi.org/10.1097/inf.0000000000004534","url":null,"abstract":"OBJECTIVESTo monitor by the first 24 months of life, children born to mothers with laboratory evidence of chikungunya virus (CHIKV) infection during pregnancy or up to 8 weeks before it, and to describe abnormalities in head circumference (HC), auditory and ophthalmological assessments and neuroimaging tests during the follow-up period.METHODThis is a observational, descriptive, longitudinal and prospective study of children born to mothers who had a rash and a positive test for CHIKV during pregnancy or up to 8 weeks before it. They were admitted between November 2015 and May 2019 in the outpatient multidisciplinary clinic to investigate acute exanthematous disease. The exposed children were followed up by a multidisciplinary team and underwent periodic measurements of the HC. The Denver II test was applied, in addition to transfontanellar ultrasound (TU) to evaluate neurodevelopmental outcomes during the study period. Ophthalmological and auditory examinations, echocardiography and laboratory tests were also included.RESULTSWe included in the study 27 children vertically exposed to CHIKV. All children had a negative polymerase chain reaction test for the virus collected at the first outpatient visit (mean age of 16.8 days and standard deviation of 8 days). No clinical condition compatible with congenital infection at birth was reported. A change in HC characterized by macrocephaly and mild global delay development was observed in a 1-year-old child whose mother was infected in the peripartum, but with normal TU. Changes in the TU were observed in 2 other children with nonspecific subependymal cystic malformation that was not evident by the cranial computed tomography. The other children monitored showed normal results in the Denver II test, in the HC and TU. No changes were identified on ocular ophthalmoscopy or auditory brainstem response test. Two children had an increase in serum ferritin levels during the first year of life, with the others' inflammatory disease markers normal.CONCLUSIONSOur study added knowledge about the neurodevelopment of children exposed to CHIKV during pregnancy by a longitudinal and prospective follow-up, throughout their first 24 months of life. We did not observe a negative impact of exposure to the virus on the neurological examination, global developmental test or measurements of the HC of these children.","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle L Harrison,Benjamin F R Dickson,Mike Sharland,Phoebe C M Williams
{"title":"Beyond Early- and Late-onset Neonatal Sepsis Definitions: What are the Current Causes of Neonatal Sepsis Globally? A Systematic Review and Meta-analysis of the Evidence.","authors":"Michelle L Harrison,Benjamin F R Dickson,Mike Sharland,Phoebe C M Williams","doi":"10.1097/inf.0000000000004485","DOIUrl":"https://doi.org/10.1097/inf.0000000000004485","url":null,"abstract":"Sepsis remains a leading cause of neonatal mortality, particularly in low- and lower-middle-income countries (LLMIC). In the context of rising antimicrobial resistance, the etiology of neonatal sepsis is evolving, potentially making currently-recommended empirical treatment guidelines less effective. We performed a systematic review and meta-analysis to evaluate the contemporary bacterial pathogens responsible for early-onset sepsis (EOS) and late-onset neonatal sepsis (LOS) to ascertain if historical classifications-that guide empirical therapy recommendations based on assumptions around causative pathogens-may be outdated. We analyzed 48 articles incorporating 757,427 blood and cerebrospinal fluid samples collected from 311,359 neonates across 25 countries, to evaluate 4347 significant bacteria in a random-effects meta-analysis. This revealed gram-negative bacteria were now the predominant cause of both EOS (53%, 2301/4347) and LOS (71%, 2765/3894) globally. In LLMICs, the predominant cause of EOS was Klebsiella spp. (31.7%, 95% CI: 24.1-39.7%) followed by Staphylococcus aureus (17.5%, 95% CI: 8.5 to 28.4%), in marked contrast to the Streptococcus agalactiae burden seen in high-income healthcare settings. Our results reveal clear evidence that the current definitions of EOS and LOS sepsis are outdated, particularly in LLMICs. These outdated definitions may be guiding inappropriate empirical antibiotic prescribing that inadequately covers the causative pathogens responsible for neonatal sepsis globally. Harmonizing sepsis definitions across neonates, children and adults will enable a more acurate comparison of the epidemiology of sepsis in each age group and will enhance knowledge regarding the true morbidity and mortality burden of neonatal sepsis.","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Planetary Health: What You Need to Know as a Pediatric Infectious Diseases Doctor.","authors":"Nina Schöbi,Maria Kourti,Lilly M Verhagen,","doi":"10.1097/inf.0000000000004517","DOIUrl":"https://doi.org/10.1097/inf.0000000000004517","url":null,"abstract":"","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Australian Single-Center Cohort of Pediatric Empyema: Incidence, Pathogens and Disease Severity, and the Interaction of the COVID-19 Pandemic.","authors":"Emily R Le Fevre,Hiran Selvadurai,Stuart Haggie","doi":"10.1097/inf.0000000000004544","DOIUrl":"https://doi.org/10.1097/inf.0000000000004544","url":null,"abstract":"BACKGROUNDEmpyema is the most common complication of pediatric community-acquired pneumonia, posing a significant morbidity to children. Clinicians have observed an increase in empyema rates and acuity in the years following the COVID-19 pandemic.METHODSThis retrospective analysis of children managed for empyema in a tertiary pediatric hospital, aimed to compare the incidence and describe the clinical characteristics prepandemic and postpandemic (2017-2023).RESULTSThere were 222 empyema cases, with a median age of 3 years (0.3-15 years). The majority (87.8%) of cases were managed with a chest drain and fibrinolytics. The remaining underwent minimally invasive video-assisted thoracoscopic surgery. Admissions postpandemic were associated with significantly longer lengths of stays (14 vs 12 days, P ≤ 0.001), higher rates of pediatric intensive care unit admissions (32% vs 26%, P = 0.045), and they required higher level of care (inotropes, noninvasive and invasive ventilation). There were also significantly higher rates of Streptococcus pyogenes (28% vs 7%, P ≤ 0.001), while rates of other organisms were not significantly different. We also noted a significant reduction in immunization rates post-pandemic (95.8% vs 83.1%, P < 0.01); however, there was no significant difference in S. pneumoniae serotypes between epochs.CONCLUSIONSThis study demonstrates an increased rate and severity of pediatric empyemas in the post-pandemic period. We propose that the increase was secondary to the increased rates of S. pyogenes seen in the postpandemic period. This rise in infection rates may be alleviated with nonpharmacologic measures aimed at reducing transmission; however, such measures are not sustainable and should be avoided.","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cameron Burton,Rachel Webb,Andrew Anglemyer,Alexander Humphrey,Amelie Tuato'o,Emma Best
{"title":"Severe Invasive Pneumococcal Disease Caused by Serotype 19A in Children Under Five Years in Tāmaki Makaurau Auckland, Aotearoa New Zealand.","authors":"Cameron Burton,Rachel Webb,Andrew Anglemyer,Alexander Humphrey,Amelie Tuato'o,Emma Best","doi":"10.1097/inf.0000000000004528","DOIUrl":"https://doi.org/10.1097/inf.0000000000004528","url":null,"abstract":"BACKGROUNDIncreases in childhood invasive pneumococcal disease (IPD) have been reported in several countries following the easing of COVID-19 pandemic mitigations. In Aotearoa New Zealand (AoNZ), a surge in IPD is occurring in young children concurrent with changes in pneumococcal vaccines and declining immunization coverage. We sought to examine epidemiologic and clinical features of IPD among children under 5 years in a large urban region of AoNZ in the 3 years post-COVID-19.METHODSDemographic, clinical and laboratory data were collated from children under 5 years with Streptococcus pneumoniae identified from normally sterile sites between January 1, 2021, and December 31, 2023, in Tāmaki Makaurau Auckland, AoNZ.RESULTSWe identified 93 episodes of IPD (annual incidence of 18-40 cases per 100,000 population per year). Serotype was identified in 68 episodes and 46 (68%) were serotype 19A. Incidence was higher in Pacific children compared with non-Māori, non-Pacific children (incidence rate ratio: 2.3; 95% confidence interval: 1.4-3.7). Bacteremia occurred in 65 (70%) episodes, empyema in 47 (51%), meningitis in 11 (12%) and hemolytic uremic syndrome in 7 (7.5%). All cases of hemolytic uremic syndrome and empyema were only among children with serotype 19A. Two children died, both had serotype 19A, and 13/91 survivors (14%) experienced serious sequelae.CONCLUSIONSThe use of the pneumococcal conjugate vaccine with lower valency and easing of COVID-19 containment measures each may have contributed to an increase in IPD in AoNZ. Serotype 19A is associated with empyema and causes severe disease in young children. Urgent efforts are required to improve PCV13 coverage in AoNZ.","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"No Increase in Severity of Mycoplasma pneumoniae: Insights From the Postpandemic Epidemic.","authors":"Inês Taborda,Rita Tomé,Carolina Santos Ferreira,Raquel Oliveira Inácio,João Vaz,Anália Carmo,Lia Gata,Fernanda Rodrigues","doi":"10.1097/inf.0000000000004545","DOIUrl":"https://doi.org/10.1097/inf.0000000000004545","url":null,"abstract":"Following near-absence during the COVID-19 pandemic, Mycoplasma pneumoniae infection has recently reemerged in children, much later than other respiratory pathogens. We describe the resurgence that we have observed starting in late 2023. Compared with prepandemic, disease severity and extrapulmonary manifestations did not change, while median age at presentation increased.","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"153 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Pain in the Neck Sixty Years On.","authors":"Nigel Curtis,Eric Levi","doi":"10.1097/inf.0000000000004546","DOIUrl":"https://doi.org/10.1097/inf.0000000000004546","url":null,"abstract":"This report describes the recurrence of an infected first branchial cleft cyst in an adult and highlights the importance of considering branchial cleft cysts in the differential diagnosis of cervical lymphadenitis or abscess in early childhood to enable definitive surgery.","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Early Congenital Cytomegalovirus Detection Pathways in Pediatric Audiology Services in England: Findings From a National Audit in England.","authors":"Vishnuga Raveendran,Hannah Garnett,Catherine Magee,Simone Walter,Heather Bailey","doi":"10.1097/inf.0000000000004496","DOIUrl":"https://doi.org/10.1097/inf.0000000000004496","url":null,"abstract":"","PeriodicalId":501652,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}