The Pediatric infectious disease journal
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Fulminant bacterial meningitis is a rare host reaction to infection characterized by sudden onset, rapid deterioration, abrupt cerebral edema, and refractory intracranial hypertension associated with an extremely high mortality rate. ⋯ Fulminant bacterial meningitis is an example of an aberrant host response to infection that challenges available medical intervention.
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Pediatr. Infect. Dis. J. · Sep 2013
Prognostic Factors in Pediatric Sepsis Study, from the Spanish Society of Pediatric Intensive Care.
Sepsis and septic shock represent up to 30% of admitted patients in paediatric intensive care units (PICU), with a mortality that can exceed 10%. ⋯ Patients with sepsis and multiorgan failure, especially those with nosocomial infection or the presence of neutropenia or purpura, have a worse prognosis and should be monitored and treated early.
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Pediatr. Infect. Dis. J. · Sep 2013
Scientific rationale for study design of community-based simplified antibiotic therapy trials in newborns and young infants with clinically diagnosed severe infections or fast breathing in South Asia and sub-Saharan Africa.
Newborns and young infants suffer high rates of infections in South Asia and sub-Saharan Africa. Timely access to appropriate antibiotic therapy is essential for reducing mortality. In an effort to develop community case management guidelines for young infants, 0-59 days old, with clinically diagnosed severe infections, or with fast breathing, 4 trials of simplified antibiotic therapy delivered in primary care clinics (Pakistan, Democratic Republic of Congo, Kenya and Nigeria) or at home (Bangladesh and Nigeria) are being conducted. ⋯ The results of these trials will inform World Health Organization policy regarding community case management of young infants with clinical severe infections or with fast breathing.
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Pediatr. Infect. Dis. J. · Sep 2013
Ongoing trials of simplified antibiotic regimens for the treatment of serious infections in young infants in South Asia and sub-Saharan Africa: implications for policy.
The current World Health Organization (WHO) recommendation for treatment of severe infection in young infants is hospitalization and parenteral antibiotic therapy. Hospital care is generally not available outside large cities in low- and middle-income countries and even when available is not acceptable or affordable for many families. Previous research in Bangladesh and India demonstrated that treatment outside hospitals may be possible. ⋯ The studies are expected to result in information that would inform WHO guidelines on simple, safe and effective regimens for the treatment of clinical severe infection and pneumonia in newborns and young infants in settings where referral is not possible. The studies will also inform the inputs and process required to establish outpatient treatment of newborn and young infant infections at health facilities near the home. We expect that the information from research and the resulting WHO guidelines will form the basis of policy dialogue by a large number of stakeholders at the country level to implement outpatient treatment of neonatal infections and thereby reduce neonatal and infant mortality resulting from infection.
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Pediatr. Infect. Dis. J. · Sep 2013
The bacterial meningitis score to distinguish bacterial from aseptic meningitis in children from Sao Paulo, Brazil.
In a retrospective cohort of 494 children with meningitis in Sao Paulo, Brazil, the Bacterial Meningitis Score identified all the children with bacterial meningitis (sensitivity 100%, 95% confidence interval: 92-100% and negative predictive value 100%, 95% confidence interval: 98-100%). Addition of cerebrospinal fluid lactate to the score did not improve clinical prediction rule performance.