The Pediatric infectious disease journal
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Human caliciviruses (HCVs) are little known, recently recognized viruses associated with gastroenteritis. We identified HCV infection in an outbreak of gastroenteritis which occurred in one room of a day care center (DCC) participating in a longitudinal study of diarrhea. Utilizing an enzyme-linked immunoassay and immunosorbent electron microscopy to detect HCV, we tested specimens from all children in attendance during the period of the illness outbreak and during prior and subsequent weeks. ⋯ Forty percent of children less than 1 year of age were infected with HCV during the period of investigation. Few documented HCV infections have been reported. This may be related to a high attack rate of predominantly asymptomatic infections in early life, resulting in a high prevalence of antibody to HCV by 4 years of age.
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Pediatr. Infect. Dis. J. · Mar 1990
Correlating reported fever in young infants with subsequent temperature patterns and rate of serious bacterial infections.
A retrospective study was performed of 292 infants younger than 2 months of age with a history of fever who received a standardized evaluation and were admitted to the hospital for possible sepsis. The purpose was to correlate the presence of this symptom with subsequent temperature patterns and the rate of serious bacterial infections (SBI). Caretakers reported fever per rectum via thermometer in 244 infants and tactile fever in 48 infants. ⋯ Of 26 infants with tactile fever who were afebrile on presentation, none had subsequent fever during hospitalization and only 1 (3.8%) had SBI (urinary tract infection); of 40 infants with reported fever per rectum who were afebrile on presentation, 8 (20%) had subsequent fever during hospitalization and 4 (10%) had SBI (meningitis, bacteremia, osteomyelitis and urinary tract infection). There were a total of 19 infants (6.5%) with SBI; although 5 (27%) were afebrile on presentation (4 with reported fever per rectum, 1 with tactile fever), all 19 exhibited abnormal clinical and/or laboratory features on evaluation which were suggestive of underlying serious infection. Management decisions for young infants with reported fever should be based on both clinical findings and temperature-pattern profiles.
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Pediatr. Infect. Dis. J. · Mar 1990
Septic shock in children: bacterial etiologies and temporal relationships.
In a retrospective analysis of 2110 admissions to the pediatric intensive care unit, 564 cases of septic shock were identified (26.7% of the total admissions). Septic shock was defined in patients with: (1) clinical evidence of sepsis; (2) fever (greater than 38.3 degrees C) or hypothermia (less than 35.6 degrees C); (3) tachycardia; (4) tachypnea; and (5) inadequate organ perfusion. Inadequate perfusion was defined as hypotension or evidence of peripheral hypoperfusion (poor capillary refill or cyanosis with hypoxemia, oliguria, acidosis or altered mentation). ⋯ Septic shock with confirmed bacterial infection occurred in 143 patients (143 of 564, 25.2%); these cases were caused by Haemophilus influenzae, type b (59 of 143, 41.3%), Neisseria meningitidis (26 of 143, 18.2%) and Streptococcus pneumoniae (16 of 143, 11.2%). Eight of 564 (1.4%) cases of septic shock were not clinically apparent on initial evaluation and were diagnosed within 24 hours after admission to the hospital. We conclude that septic shock occurs more frequently in children than previously appreciated and may develop after admission to the hospital.