Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo最新文献

{"title":"Jacobsen syndrome associated with Shone's complex: a case report.","authors":"Andressa Brum, Larissa Valéria Laskoski, Fabiana Gonçalves de Oliveira Azevedo Matos, Luciana Paula Grégio d'Arce","doi":"10.1590/1984-0462/2025/43/2024136","DOIUrl":"10.1590/1984-0462/2025/43/2024136","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to report the case of a child with Jacobsen syndrome in order to provide phenotypic information about this rare genetic disorder.</p><p><strong>Case description: </strong>A 5-year-old female preschooler was diagnosed with Jacobsen syndrome by karyotype testing. She presented with a variety of craniofacial anomalies and malformations, including cardiac impairment, characterized by a cluster of malformations in the left ventricle in line with the diagnosis of Shone's complex.</p><p><strong>Comments: </strong>Jacobsen syndrome occurs due to a deletion of contiguous genes on the long arm of chromosome 11 (11q). The main characteristics associated with this genetic disorder are short stature and delayed neuropsychomotor development, trigonocephaly and craniofacial dysmorphism, hematological alterations, and cardiac malformations, among others. Thus, the child is being monitored at a Craniofacial Anomalies Center with a multi-professional team in order to monitor her development and treat the associated comorbidities.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024136"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the combination of corporal adiposity and cardiorespiratory fitness with cardiometabolic risk factors in children - PREVOI Study.","authors":"Renata Chácara Pires, Haysla Xavier Martins, Míriam Barbosa, Maria Del Carmen Bisi Molina","doi":"10.1590/1984-0462/2025/43/2024105","DOIUrl":"10.1590/1984-0462/2025/43/2024105","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between the combination of corporal adiposity (CA) and cardiorespiratory physical fitness (CRF) with cardiometabolic risk factors in children aged 7-10 years.</p><p><strong>Methods: </strong>Cross-sectional observational study with a sample of 251 children registered in Family Health Units. Sociodemographic, lifestyle, anthropometric, biochemical, blood pressure, and CRF data were collected. Cardiometabolic risk factors assessed: total cholesterol, HDL-c, LDL-c, triglycerides (TG), fasting glucose and blood pressure. CRF was assessed by the 6-minute run/walk test and classified into: \"physically unfit\" and \"physically fit\". Nutritional status was assessed by body mass index (BMI)/age and categorized into CA groups: \"no excess weight [≤ z-score+1]\" and \"excess weight [> z-score+1]\". CRF and CA were combined, and the children were classified as \"no excess weight + physically fit\", \"no excess weight + physically unfit\", \"excess weight + physically fit\" and \"excess weight + physically unfit\". Bivariate analyses were performed, and Poisson regression models were tested. The Statistical Package for the Social Sciences (SPSS) version 21.0 software was used, adopting p<0.05.</p><p><strong>Results: </strong>Around 65% of the children had low CRF and 59% had excess weight (overweight+obesity). After adjustment, there was a greater occurrence of having altered HDL-c, TG and presence of ≥ 3 grouped cardiometabolic factors among those who had excess weight + physically unfit.</p><p><strong>Conclusions: </strong>The prevalence of altered HDL and TG and of ≥3 grouped cardiometabolic risk factors was significantly higher among children who had excess weight and were physically unfit.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024105"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet mass index, systemic immune-inflammation index, and neutrophil-lymphocyte ratio as practical markers in childhood brucellosis.","authors":"Hilal Koyuncu, Ayşe Tolunay Oflu, Ayşe Güngör, Ayşegül Bükülmez","doi":"10.1590/1984-0462/2025/43/2024123","DOIUrl":"10.1590/1984-0462/2025/43/2024123","url":null,"abstract":"<p><strong>Objective: </strong>Brucellosis is a multisystem infectious disease and may cause an increase in acute phase reactants. This study aimed to examine the platelet mass index (PMI), the neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in children with brucellosis and to determine their roles in focal involvement.</p><p><strong>Methods: </strong>This retrospective observational study included 69 patients with brucellosis and a control group of 69 healthy children. Inflammation markers, PMI, NLR, and SII were compared in brucellosis patients and the control group and in brucellosis patients with and without focal involvement.</p><p><strong>Results: </strong>Hemoglobin and platelet values were significantly lower in brucellosis cases compared to the control group (p<0.001), and C-reactive protein and ferritin were significantly higher (p<0.001). SII and PMI were significantly lower in the brucellosis patient group compared to the control group (p<0.001). In the comparing cases with and without focal involvement, no statistically significant difference was detected in hematological parameters and inflammation markers.</p><p><strong>Conclusions: </strong>This study showed that PMI, one of the new markers that can be calculated from complete blood count, may be useful in diagnosing childhood brucellosis. Similar results could not be reached for NLR and SII. New studies testing the diagnostic value of PMI, NLR, and SII in childhood brucellosis are needed.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024123"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life in patients with spinal muscular atrophy in Brazil: patient self-assessment and carer perception.","authors":"Maíra Coelho, Marise Bueno Zonta, Salmo Raskin, Silvia Valderramas","doi":"10.1590/1984-0462/2025/43/2024073","DOIUrl":"10.1590/1984-0462/2025/43/2024073","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to assess the perception of quality of life of patients with spinal muscular atrophy (SMA) and investigate whether there is a correlation between patients' perception and that of their carers.</p><p><strong>Methods: </strong>Cross-sectional analytical observational study. In the first part, socioeconomic, demographic, clinical, and treatment information were collected from patients diagnosed with SMA, regardless of type, sex, or age. SMA type 1 does not sit; SMA type 2 sits; SMA type 3 walks; and SMA type 4 begins in adulthood. In the second part of the study, patients aged between 2 and 25 years and their caregivers responded to the Pediatric Quality of Life Inventory 4.0 questionnaire.</p><p><strong>Results: </strong>Of the 235 families recruited, 167 were eligible to respond to the questionnaire, 115 caregivers and 49 patients were included. The results point to a different perception of quality of life between patients and caregivers. Patients with SMA type 2 perceive more impaired physical and emotional capacity compared to SMA type 3 and 1, respectively. As for caregivers, the perception of quality of life in relation to physical and social capacity and the total score are worse for patients with SMA type 1 compared to other types. Perceptions correlate with emotional capacity in SMA type 2 and the total aspect in SMA type 3.</p><p><strong>Conclusions: </strong>Patients with SMA type 2 had a worse perception of their quality of life than other patients. Perception differed between patients and their caregivers, with the former having a better perception than the latter.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024073"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypopigmented mycosis fungoides: an important differential diagnosis of hypochromias in childhood.","authors":"Maria Fernanda de Almeida Cavalcante Aranha, Maria Amélia Lopes Dos Santos, Carla Andréa Avelar Pires, Leônidas Braga Dias Júnior, Rafaela Garcia Pereira, Marina Lopes de Freitas Freire, Tamara Tavares da Cruz, Luiza Rennó Rocha de Oliveira","doi":"10.1590/1984-0462/2025/43/2024181","DOIUrl":"10.1590/1984-0462/2025/43/2024181","url":null,"abstract":"<p><strong>Objective: </strong>To highlight the importance of early recognition of hypopigmented mycosis fungoides (HMF) in cases of cutaneous hypochromia in children, with a view to an effective diagnostic and therapeutic approach.</p><p><strong>Case description: </strong>Two cases of HMF in children are reported. The first case involves an eight-year-old boy with hypochromic macules on the trunk and root of the upper and lower limbs, while the second case is a six-year-old boy with widespread hypochromic patches. Both patients presented with prolonged evolution of hypopigmentation, leading to the suspicion of HMF after excluding other differential diagnoses. Histopathological and immunohistochemical tests were fundamental in confirming the diagnosis of HMF.</p><p><strong>Comments: </strong>HMF is a less prevalent and less publicized form of mycosis fungoides and is more common in children and people with a high phototype. Its diagnosis is challenging and often requires multiple biopsies for confirmation. Treatment includes phototherapy and immunosuppressive therapy, depending on the patient's age and extent of lesions. Early recognition of HMF is crucial for proper management and to avoid complications associated with malignant evolution.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024181"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic dysfunction-associated liver disease and biliary lithiasis in children with Down Syndrome: a retrospective study.","authors":"Renato Nisihara, Nayane Hiba Fuga, Liete Maia, Marcelo Gasparin Mansur, Fernanda Liberatti, Maiana Rossasi, Nanci Oliveira","doi":"10.1590/1984-0462/2025/43/2024130","DOIUrl":"10.1590/1984-0462/2025/43/2024130","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the presence of metabolic dysfunction-associated fatty liver disease (MAFLD) and gallbladder abnormalities in a sample of people with Down syndrome in Brazil.</p><p><strong>Methods: </strong>This is a retrospective study using medical charts involving Down syndrome patients, diagnosed by karyotype, aged over 5 years, who underwent abdominal ultrasound and were monitored by the same professional in a clinic in Curitiba, Brazil. Data spanned January 1995 to September 2023; all cases with no use of alcohol or hepatotoxic medications.</p><p><strong>Results: </strong>A total of 124 patients were evaluated, 64 (51.6%) being females. Ages varied between 5 and 30 years (average of 13.2±5.7 years). Body mass index ranged from 14.08 to 44.98 kg/m2, with 27 (21.7%) patients being overweight and 42 (33.8%) obese. The frequency of increased total cholesterol and triglyceride concentrations was significantly higher in children. No age or sex differences were seen in low- and high-density lipoprotein cholesterol. Alanine transferase (ALT) and aspartate transferase (AST) levels were within normal ranges and showed no differences concerning sex or age. Four patients (3.2%) had diagnosis of MAFLD. The prevalence of gallstone varied widely in terms of the number and size of stones among patients, affecting 11 (8.9%) of them, with no significant difference in age or sex.</p><p><strong>Conclusions: </strong>MAFLD was found in 3.2% of the individuals, while gallstone disease was identified in 8.9% of the cases studied. Moreover, we noted a significant presence of risk factors associated with MAFLD, with dyslipidemia being the predominant factor.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024130"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital toxoplasmosis in infants from chronically infected mothers: report of two cases.","authors":"Roberta Rassi Almeida, Geovana Batista de Campos, Ana Maria Castro","doi":"10.1590/1984-0462/2025/43/2024120","DOIUrl":"10.1590/1984-0462/2025/43/2024120","url":null,"abstract":"<p><strong>Objective: </strong>To describe two severe cases of congenital toxoplasmosis in infants born to chronically infected mothers who did not receive education or information on the prevention of gestational toxoplasmosis during prenatal care.</p><p><strong>Case description: </strong>The mothers had a previous serological diagnosis of toxoplasmosis conducted during prenatal care, with non-reactive (<10 IU/mL) IgM and reactive IgG (>10 IU/mL), and were considered \"immune\" to the infection. Both infants were born with sequelae of the congenital infection, including neurological and ocular alterations.</p><p><strong>Comments: </strong>Managing gestational toxoplasmosis in susceptible pregnant women is a considerable challenge in several countries, especially in South America. It is necessary to diagnose and monitor chronic gestational toxoplasmosis, as it may result from reactivation or reinfection. Both forms can cause sequelae and irreparable damage to newborns. In addition, it is essential to guide all pregnant women on how to avoid contact with Toxoplasma gondii, regardless of their serological status.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024120"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaphylaxis management: knowledge of Brazilian pediatricians.","authors":"Maria Cecília Barata Dos Santos Figueira, Georgia Veras de Araújo Gueiros Lira, Giselia Alves Pontes da Silva, Emídio Cavalcanti de Albuquerque, Luciana Rodrigues Silva, Dirceu Solé, Emanuel Sávio Cavalcanti Sarinho","doi":"10.1590/1984-0462/2025/43/2024087","DOIUrl":"https://doi.org/10.1590/1984-0462/2025/43/2024087","url":null,"abstract":"<p><strong>Objective: </strong>To verify the level of knowledge of Brazilian pediatricians about anaphylaxis, identifying sociodemographic and educational characteristics of the professional which contribute to the adequate management of this clinical disorder.</p><p><strong>Methods: </strong>A survey was carried out on the management of anaphylaxis using a questionnaire prepared and distributed by email to pediatricians in different states in Brazil. The level of knowledge about anaphylaxis was classified as: satisfactory; unsatisfactory; more than satisfactory; ideal, according to evaluation criteria adopted for the statements of clinical cases that addressed the drug of choice, route of administration, positioning of the patient with anaphylaxis and recognition of the clinical case with differential diagnosis.</p><p><strong>Results: </strong>A total of 1,645 Brazilian pediatricians participated, of which 48.5% had satisfactory knowledge of the management of anaphylaxis. Approaches to choosing the preferred drug for anaphylaxis and the route of administration were the biggest obstacles to responses. The factors associated with satisfactory knowledge were shorter time since graduation, having a medical residency in pediatrics, having a qualification in allergy and immunology, having completed the Pediatric Advanced Life Support (PALS) in the last two years and having experience in anaphylaxis.</p><p><strong>Conclusions: </strong>The results regarding satisfactory knowledge of anaphylaxis are lower than those expected for the treatment of a potentially fatal condition. It is important to encourage the continuing education of pediatricians who work mainly in emergencies, wards, and intensive care units, in light of the use of the assumptions of andragogy and Ausubel's theory, with active methodologies, to promote significant and permanent learning of management of anaphylaxis.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024087"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of enteral insulin on enteral diet tolerance in premature infants: systematic review.","authors":"Letícia Baciuk-Souza, Laura Ferrer Del Pra, Luca Schiliró Tristão, Mayco José Reinaldi Serra, Vera Esteves Vagnozzi Rullo","doi":"10.1590/1984-0462/2025/43/2024115","DOIUrl":"10.1590/1984-0462/2025/43/2024115","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this systematic review was to evaluate the effect of enteral insulin supplementation provided to premature newborns on the time to achieve full enteral feeding. Secondary objectives included evaluating the effects on weight gain, the occurrence of adverse events, and mortality.</p><p><strong>Data source: </strong>A systematic review of randomized clinical trials was conducted using the databases PubMed, Scientific Electronic Library Online (SciELO), clinicaltrials.gov, Embase, and Latin American and Caribbean Health Sciences Literature (Lilacs). The review was registered in PROSPERO under CRD42024523021. Premature newborns receiving enteral and parenteral nutrition who were given either breast milk or formula milk supplemented with enteral insulin as intervention, compared with placebo, were included. After applying the eligibility criteria, two articles were selected for this study.</p><p><strong>Data synthesis: </strong>The two studies included in this review identified a reduced time to achieve full enteral feeding. Regarding secondary outcomes, there was a reduction in the number of days receiving parenteral nutrition and a reduction in adverse events and mortality. However, there was no agreement among the studies concerning weight gain.</p><p><strong>Conclusions: </strong>Enteral insulin appears to be an effective treatment for reducing the time to achieve full enteral feeding. However, more studies are necessary to recommend its use in clinical practice.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024115"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive infections by group A Streptococcus infections in Brazil: a pediatric case series.","authors":"Daniela Otoni Russo, Marina Melo Moreira, Aline Almeida Bentes, Bárbara Araujo Marques, Ericka Viana Machado Carellos, Flávia Duarte Nogueira, Roberta Maia de Castro Romanelli, Ana Luisa Lodi Jimenez, Carolina Campos Vieira de Souza, Luana Casilho Moreira, Milena Pereira Parreira, Renata Araujo Avendanha, Renata Campos Correa Dos Santos, Márcio Antônio Ferreira Arantes Junior, Lilian Martins Oliveira Diniz","doi":"10.1590/1984-0462/2025/43/2024100","DOIUrl":"10.1590/1984-0462/2025/43/2024100","url":null,"abstract":"<p><strong>Objective: </strong>Group A Streptococcus (GAS) are Gram-positive cocci that colonize the nasopharynx and/or skin and in rare cases may cause severe invasive infections. Although these infections decreased during the COVID-19 pandemic, some countries have observed an increased number of invasive GAS (iGAS) diseases in recent years. The objective of this study was to describe a series of iGAS diseases in a referral hospital for the treatment of pediatric infectious disease in Minas Gerais State, Brazil, between September 2022 and August 2023. The data were obtained from medical records, and GAS was isolated from blood, pleural, cerebrospinal, or joint fluid.</p><p><strong>Case description: </strong>A total of nine patients, four male and five female, between eight months and ten years of age, were admitted. Of the patients observed, three (33%) had pneumonia, three (33%) had toxic shock syndrome, three (33%) had septic arthritis, one (11%) had osteomyelitis, two (22%) had meningitis, and two (22%) cellulitis. The majority of patients (5) experienced complications, including pleural effusion, septic shock, cerebral vasculitis, and limb amputations. In total, seven (75%) patients were admitted to the intensive care unit, and one patient died.</p><p><strong>Comments: </strong>It is important to be aware of the possibility of S. pyogenes infection in children with pulmonary, neurological, osteoarticular, skin infections or in severe cases of septic shock. Given the absence of specific clinical signs, epidemiological data showing an increase in the local incidence of S. pyogenes infections is of great importance and should serve as an alert for the diagnosis of the disease.</p>","PeriodicalId":74721,"journal":{"name":"Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo","volume":"43 ","pages":"e2024100"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}