Pediatric emergency care
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Pediatric emergency care · Aug 2014
Effectiveness of Intravenous Levetiracetam as an Adjunctive Treatment in Pediatric Refractory Status Epilepticus.
Intravenous levetiracetam (LEV) has been shown to be effective and safe in treating adults with refractory status epilepticus (SE). We sought to investigate the efficacy and safety of intravenous LEV for pediatric patients with refractory SE. ⋯ The current study demonstrated that the adjunctive use of intravenous LEV was effective and well tolerated in pediatric patients with refractory SE, even in patients younger than 2 years. Intravenous LEV should be considered as an effective and safe treatment option for refractory SE in pediatric patients.
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Pediatric emergency care · Aug 2014
Case ReportsPneumonia and Purulent Pericarditis Caused by Streptococcus pneumoniae: An Uncommon Association in the Antibiotic Era.
Bacterial pericarditis in children has become a rare entity in the modern antibiotic era. The most common pathogen is Staphylococcus aureus, being Streptococcus pneumoniae an exceptional cause. We present 2 children, who were diagnosed of pneumonia complicated with a pleural effusion that developed a purulent pericarditis with signs of cardiac tamponade. ⋯ Pneumococcal antigens were positive in pleural and pericardial fluids in both cases, and S. pneumoniae was isolated from pleural effusion in one of them. Both children fully recovered, and none of them developed constrictive pericarditis, although 1 case presented a transient secondary left ventricular dysfunction. Routine immunization with 10- and 13-valent vaccines including a wider range of serotypes should further decrease the already low incidence.
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Pediatric emergency care · Aug 2014
Case ReportsNeurologic deterioration in a child undergoing treatment for tuberculosis meningitis.
Clinical deterioration while receiving antituberculosis (anti-TB) therapy can be due to a number of etiologies, including drug resistance, disease progression despite effective therapy, or alternative diagnoses. We present the case of a 22-month-old girl diagnosed with TB meningitis 4 months prior to presentation. At time of her initial diagnosis, computed tomography showed hydrocephalus and basilar meningitis with some evidence of ischemic damage. ⋯ Differential diagnosis included shunt malfunction and/or shunt infection. Magnetic resonance imaging of the brain showed interval development of tuberculomas. Symptomatic and radiographic improvement was seen after initiation of corticosteroids for immune reconstitution inflammatory syndrome, which can be seen in immunocompetent children, with onset weeks to months after starting antituberculous therapy.
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Pediatric emergency care · Aug 2014
Rate of and Risk Factors for Early Recurrence in Patients With Febrile Seizures.
Patients with febrile seizures (FSs) are observed in emergency departments or admitted to hospitals because of the possibility of recurrence. There are no guidelines regarding the observation time for recurring FS. The aim of this study was to identify the rate, time, risk factors, and cumulative probability of early recurrence. ⋯ The majority of recurrent FSs occurred in the first 24 hours. The type and duration of seizures were significant risk factors for early recurrence.