The Pediatric infectious disease journal
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Pediatr. Infect. Dis. J. · Jan 2004
Comparative StudyEffective ultrasonographic predictor for the diagnosis of acute lobar nephronia.
Correct identification of acute lobar nephronia (ALN) is necessary to prevent progression to renal abscess. The goal of this retrospective study was to determine whether the sonographic finding of severe nephromegaly (i.e. renal length greater than mean + 3 sd) is a preselection criterion for computed tomographic (CT) scanning in diagnosing pediatric ALN among children with an acute upper urinary tract infection. ⋯ Pediatric ALN was effectively predicted using sonographic findings of severe nephromegaly and/or focal mass before CT scanning.
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Pediatr. Infect. Dis. J. · Dec 2003
Review Case ReportsA ten-year-old boy with a pulmonary nodule secondary to Cryptococcus neoformans: case report and review of the literature.
Pulmonary cryptococcosis is an uncommonly recognized disease of childhood. Among immunocompetent and non-HIV-infected individuals, pulmonary cryptococcosis may be asymptomatic or present with chronic, nondescript symptomatology. In this report we describe a 10-year-old with malignant fibrous histiocytoma of bone and a pulmonary nodule secondary to Cryptococcus neoformans. We use this case as a background to review the pediatric literature regarding pulmonary cryptococcosis and to discuss the utility of immunohistochemistry for diagnosis of this clinical entity.
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Pediatr. Infect. Dis. J. · Dec 2003
ReviewCiprofloxacin in treatment of fever and neutropenia in pediatric cancer patients.
This article reviews clinical trials of outpatient management of fever and neutropenia in pediatric cancer patients. The syndrome of fever and neutropenia is discussed, and strategies of identifying patients at low risk for complex or fatal infections are described. A number of clinical trials in a wide range of clinical settings and countries have demonstrated that low risk pediatric cancer patients with fever and neutropenia can be prospectively identified and safely treated as outpatients. ⋯ In selected high risk patients, prophylactic use of limited spectrum fluoroquinolones such as ciprofloxacin may reduce the incidence of Gram-negative bacteremias. Use of fluoroquinolone therapy as prophylaxis, however, is controversial because of concerns about an emergence of resistant organisms. Prudent use of fluoroquinolones as therapy and prophylaxis is essential to prolonging the benefits of this class of compounds.
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Pediatr. Infect. Dis. J. · Dec 2003
Comparative StudyUtility of sepsis evaluation in infants 90 days of age or younger with fever and clinical bronchiolitis.
To identify the clinical utility of obtaining blood, urine and cerebrospinal fluid for bacterial culture among febrile infants <90 days of age with clinical bronchiolitis. ⋯ The risk of bacteremia or meningitis among infants <90 days with fever and bronchiolitis is low in this age group. The risk of urinary tract infection in this age group is also low, but not negligible, at 2%.
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Pediatr. Infect. Dis. J. · Dec 2003
Aseptic meningitis in infants younger than six months of age hospitalized with urinary tract infections.
Aseptic meningitis associated with urinary tract infection (UTI) in young infants has not been described in detail in the literature. We performed a retrospective study to determine the incidence and clinical features of aseptic meningitis accompanying UTI. ⋯ A cerebrospinal fluid pleocytosis is relatively common in hospitalized infants <6 months of age who have a UTI and usually does not reflect bacterial meningitis. Knowledge of this may prevent unnecessary courses of antibiotics for presumed bacterial meningitis and lead to evaluation for other possible causes of aseptic meningitis including viral or congenital infections.