The Pediatric infectious disease journal
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We reviewed cases of mastitis in infants treated at Children's Healthcare of Atlanta from 2005 to 2011. Among infants with breast cultures, Staphylococcus aureus was the most common cause. No infant with a positive breast culture had a concordant positive culture elsewhere. Our findings argue that urine, blood and spinal fluid cultures are unnecessary in well-appearing afebrile infants with mastitis.
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Pediatr. Infect. Dis. J. · Oct 2013
Randomized Controlled Trial Multicenter StudySafety and immunogenicity of a recombinant tetravalent dengue vaccine in 9-16 year olds: a randomized, controlled, phase II trial in Latin America.
The dengue virus is a member of the Flavivirus (FV) genus, which also includes the yellow fever virus. Dengue disease is caused by any 1 of 4 dengue virus serotypes and is a serious public health concern in Latin America. This study evaluated the safety and immunogenicity of a candidate recombinant, live-attenuated, tetravalent dengue vaccine (CYD-TDV) in 9-16 year olds in Latin America. ⋯ CYD-TDV had a favorable safety profile and elicited antibody responses against all 4 dengue virus serotypes in 9-16 year olds in Latin America. These findings support the continued development of CYD-TDV.
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Pediatr. Infect. Dis. J. · Oct 2013
Clinical characteristics of Kawasaki syndrome and the risk factors for coronary artery lesions in China.
Kawasaki syndrome (KS) is the leading cause of acquired heart disease in childhood in developed countries. This study was designed to identify the clinical characteristics of a large cohort of KS in China and explore the risk factors for coronary artery lesions. ⋯ KS occurs more frequently in children younger than 5 years, in boys and during the summer months. Redness at a Bacille Calmette-Guèrin inoculation site signals the diagnosis of incomplete KS in infants and young children. Male gender, younger age, intravenous immunoglobulin dose, delayed administration (>10 days), high platelet level and elevated erythrocyte sedimentation rate are predictive for coronary artery lesions, and total fever duration (>10 days) is predictive for coronary artery aneurysms in patients with coronary artery lesions.
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Pediatr. Infect. Dis. J. · Oct 2013
Desired vancomycin trough serum concentration for treating invasive methicillin-resistant Staphylococcal infections.
Vancomycin area under the curve/minimal inhibitory concentration (AUC/MIC) >400 best predicts the outcome when treating invasive methicillin-resistant Staphylococcus aureus infection; however, trough serum concentrations are used clinically to assess the appropriateness of dosing. We used pharmacokinetic modeling and simulation to examine the relationship between vancomycin trough values and AUC/MIC in children receiving vancomycin 15 mg/kg every 6 hours and methicillin-resistant Staphylococcus aureus MIC of 1 μg/mL. A trough of 7-10 μg/mL predicted achievement of AUC/MIC >400 in >90% of children.
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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.