The Pediatric infectious disease journal
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We assessed neutrophil CD64 as a diagnostic marker for neonatal sepsis. For early-onset sepsis, the CD64 index with a cut-point value of 2.38 had sensitivity, specificity and negative predictive values of 100%, 68% and 100%, respectively. For late-onset sepsis, the respective values were 3.62, 75%, 77% and 96%. Neutrophil CD64 index can be incorporated as a valuable marker for excluding neonatal sepsis.
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Pediatr. Infect. Dis. J. · Jul 2012
Retropharyngeal abscess in children: the rising incidence of methicillin-resistant Staphylococcus aureus.
Because of a recent upsurge in retropharyngeal abscess (RPA) cases due to community-associated methicillin-resistant Staphylococcus aureus (MRSA), we reevaluated the microbiology, clinical manifestations and treatment outcome of RPA over the past 6 years (2004 to 2010). Findings were compared with those of a previous 11-year study (1993 to 2003) period. ⋯ RPA has increased in frequency in our pediatric population with an associated increase of Staphylococcus aureus, mainly community-associated MRSA. This is likely due to the overall increase in community-associated MRSA infections in our pediatric patients. Treatment with ceftriaxone and clindamycin in addition to surgical drainage was effective.
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Pediatr. Infect. Dis. J. · Jun 2012
Procalcitonin to detect invasive bacterial infection in non-toxic-appearing infants with fever without apparent source in the emergency department.
The reliability of procalcitonin as a predictor of invasive infection in infants <36 months of age with fever and nontoxic appearance was assessed in 868 patients, 15 (1.7%) of whom had invasive infection. The area under the receiver operating characteristic curve for procalcitonin was 0.87 (optimum cutoff 0.9 ng/mL, sensitivity 86.7%, specificity 90.5%), whereas for C-reactive protein it was 0.79 (optimum cutoff 91 mg/L, sensitivity 33.3%, specificity 95.9%). In infants with fever of <8 hours duration, the area under the receiver operating characteristic curve was 0.97 for procalcitonin and 0.76 for C-reactive protein. Procalcitonin was a useful biomarker to predict invasive infection in non-toxic-appearing infants with fever without apparent focus, particularly in febrile episodes of <8 hours duration.
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Pediatr. Infect. Dis. J. · Jun 2012
Case ReportsApophysomyces trapeziformis infection associated with a tornado-related injury.
This report defines the role of Apophysomyces as an aggressive fungal pathogen seen after a tornado injury. Clinical and laboratory manifestations of infections after environmentally contaminated wounds incurred during a tornado are outlined, emphasizing mechanism of injury, comorbidities, and diagnostic and treatment challenges. Therapy with systemic antifungal therapy and aggressive serial tissue debridement was successful in achieving cure.
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Vitamin D deficiency and tuberculosis (TB) are associated in adults, but data in children are scarce. We screened refugee children routinely for vitamin D status and TB. Vitamin D values were significantly lower in latent TB (n = 81) and TB infection (n = 11) than in children without TB (n = 236). We conclude that refugee children with TB have reduced vitamin D levels.