The Pediatric infectious disease journal
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Pediatr. Infect. Dis. J. · Dec 2011
Trimethoprim-sulfamethoxazole therapy for children with acute osteomyelitis.
The emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has complicated the conventional management of osteomyelitis. While oral clindamycin is commonly used to treat acute CA-MRSA osteomyelitis, the emergence of inducible clindamycin resistance among CA-MRSA isolates has made alternative therapy necessary. The excellent oral bioavailability, susceptibility profile, favorable palatability, and low cost of trimethoprim-sulfamethoxazole (TMP-SMX) make this drug an attractive option for treating osteomyelitis, yet its clinical efficacy for osteomyelitis has not been established. ⋯ Orally administered TMP-SMX appears to be a useful and well-tolerated therapy for treatment of acute osteomyelitis in children. Further prospective comparative studies will be needed to confirm this observation.
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Pediatr. Infect. Dis. J. · Dec 2011
Congenital cytomegalovirus infection as a cause of sensorineural hearing loss in a highly immune population.
The burden of congenital cytomegalovirus (CMV)-associated sensorineural hearing loss (SNHL) in populations with CMV seroprevalence approaching 100% is unknown. The purpose of this study was to assess the rate, associated factors, and predictors of SNHL in CMV-infected infants identified by newborn screening in a highly seropositive maternal population. ⋯ Even in populations with near universal immunity to CMV, congenital CMV infection is a significant cause of SNHL demonstrating the importance of CMV as a major cause of SNHL in children worldwide. As in other populations, SNHL is more frequently observed in symptomatic CMV infection.
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Cryptococcus gattii is a known, emerging infectious disease pathogen predominantly in the Pacific Northwest, the United States, and British Columbia, Canada. We report a case of an immunocompetent adolescent from New England who had severe pulmonary and central nervous system infection caused by the VGI genotype of C. gattii.
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Pediatr. Infect. Dis. J. · Dec 2011
Point-of-care capillary blood lactate measurements in human immunodeficiency virus-uninfected children with in utero exposure to human immunodeficiency virus and antiretroviral medications.
To estimate the prevalence of elevated point-of-care (POC) capillary blood lactate concentrations in human immunodeficiency virus (HIV)-exposed, uninfected children (HEU) and to determine if POC lactate varies with in utero antiretroviral (ARV) exposure. ⋯ POC lactate testing is a useful rapid laboratory screening assay for HEU children with ARV exposure. ARV use during pregnancy has resulted in a dramatic decrease in mother-to-child transmission of HIV, and the risk of elevated lactate in HEU children is low. However, as new ARVs and more complex regimens are used during pregnancy by HIV-infected women, continued monitoring for infant toxicities is essential.