The Pediatric infectious disease journal
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Pediatr. Infect. Dis. J. · Aug 2004
Cerebrospinal latex agglutination fails to contribute to the microbiologic diagnosis of pretreated children with meningitis.
We conducted a 10-year retrospective study of all children who had cerebrospinal fluid latex agglutination testing for bacterial antigens performed at 1 tertiary care urban children's hospital. Of the 176 patients with culture-negative meningitis who were pretreated with antibiotics before lumbar puncture, none had a positive latex agglutination study (0 of 176; 95% confidence interval, 0-2%). Latex agglutination studies identified no additional cases of bacterial meningitis beyond those identified by culture in pretreated patients. Clinical decision-making algorithms for the management of pretreated patients at risk for bacterial meningitis should not include latex agglutination testing.
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Pediatr. Infect. Dis. J. · Aug 2004
Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features.
Acute disseminated encephalomyelitis (ADEM) is a central nervous system demyelinating disease that usually follows an apparently benign infection in otherwise healthy young persons. The epidemiology, infectious antecedents and pathogenesis of ADEM are poorly characterized, and some ADEM patients are subsequently diagnosed with multiple sclerosis (MS). ⋯ ADEM is a potentially severe demyelinating disorder likely to be increasingly diagnosed as more magnetic resonance imaging studies are performed on patients with acute encephalopathy. Further characterization of the central nervous system inflammatory response will be needed to understand ADEM pathogenesis, to improve diagnostic and treatment strategies and to distinguish ADEM from MS.
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Pediatr. Infect. Dis. J. · Jul 2004
Review Case ReportsCavitating tuberculosis in an infant: case report and literature review.
Primary cavitating tuberculosis is a rare complication of primary tuberculosis in young children. In the absence of a known adult source case, the diagnosis of tuberculosis in children can be difficult. We describe an 8-month-old baby with primary cavitating tuberculosis, in whom there was considerable delay in diagnosis, and review the literature.
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Pediatr. Infect. Dis. J. · Jul 2004
In situ diagnosis of central venous catheter-related bloodstream infection without peripheral blood culture.
Catheter-related bloodstream infections (CRBIs) are frequent complications of the use of long term central venous catheters (CVCs). Comparative quantitative culture of blood obtained via the CVC and a peripheral vein (PV) is a well-accepted method of diagnosing CRBI; however, an alternative definition for use when a PV culture is not available is desirable. ⋯ Our study suggests that comparison of colony counts from 2 lumens of a double lumen catheter is acceptable for diagnosis of CRBI when a PV culture is not available. Further validation is needed before discontinuing the recommendation to obtain a PV culture.
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Pediatr. Infect. Dis. J. · Jun 2004
Comparative StudyDifferentiating acute bacterial meningitis from acute viral meningitis among children with cerebrospinal fluid pleocytosis: a multivariable regression model.
Although accurate models for predicting acute bacterial meningitis exist, most have narrow application because of the specific variables selected for them. In this study, we estimate the accuracy of a simple new model with potentially broader applicability. ⋯ Among children with CSF pleocytosis, a prediction model based exclusively on age, CSF total protein and CSF neutrophils differentiates accurately between acute bacterial and viral meningitis.