American journal of diseases of children (1911)
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We examined 11 children with infective endocarditis initially and serially by two-dimensional echocardiography. Nine (82%) of the 11 patients had echocardiographic findings at initial examination compatible with infective endocarditis. These results provided strong evidence in support of the diagnosis before bacteriologic confirmation was available. ⋯ Echocardiographic evidence of vegetations persisted during antibiotic therapy and resolved slowly during many months. Serial echocardiograms were useful in cases in which obvious valve destruction or marked increase in vegetation size imaged echocardiographically could be combined with clinical evidence of progressive heart failure to support a decision for early surgical intervention. Two-dimensional echocardiography can make important contributions to the diagnosis and management of children with infective endocarditis.
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Herpetic whitlow is a herpes simplex virus infection of a distal phalanx. It is characterized by pain, swelling, erythema, and nonpurulent vesicle formation. Herpetic whitlow follows direct inoculation (exogenous or autogenous) or reactivation of latent virus. ⋯ The diagnosis of herpetic whitlow is readily confirmed by Tzanck test and culture. It is important to distinguish herpetic whitlow from bacterial felon or paronychia, as herpetic whitlow is a self-limited infection for which surgical incision is not indicated. We described herpetic whitlow in five children, one adolescent, and two pediatric residents.