• Pauline Abraham, Gregory Marin, Anne Filleron, Anne-Laure Michon, Hélène Marchandin, Sylvain Godreuil, Michel Rodière, Guillaume Sarrabay, Isabelle Touitou, Pauline Meslin, Carine Tournier, Philippe Van de Perre, Nicolas Nagot, and Eric Jeziorski.
• Service de pédiatrie, CH de Sète, Sète, France.
• Medicine (Baltimore). 2022 Sep 23; 101 (38): e30506.

AbstractInfectious diseases can result in unanticipated post-infectious inflammatory reactions (PIIR). Our aim was to explore PIIR in 3 frequent pediatric bacterial invasive infections in France by a retrospective monocentric study. We included children hospitalized between 2003 and 2012 for Streptococcus pneumoniae (SP), Neisseria meningitidis (NM), or Streptococcus pyogenes invasive infections. The PIIR had to have occurred between 3 and 15 days without fever despite an individually tailored antibiotic therapy. A descriptive analysis was carried out to determine PIIR risk factors. We included 189 patients, of whom 72, 79, and 38 exhibited invasive infections caused by S pyogenes, SP, and NM, respectively. The mean age was 44 months. PIIR were observed in 39 cases, occurring after a median of 8 days (5-12), with a median duration of 3 days (2-6). Fever, arthritis, and pleural effusion were observed in 87%, 28.2%, and 25.6%, respectively. In multivariate analysis, PIIR were associated with pleuropneumonia, hospitalization in an intensive care unit (ICU), and elevated C-reactive protein (CRP). PIIR were observed in 20% of children after SP, NM, or S pyogenes invasives infections. Their occurrence was associated with the initial severity but not the etiological microorganism. Further studies are warranted to confirm these findings.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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