The Pediatric infectious disease journal
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Pediatr. Infect. Dis. J. · Jan 2003
Case ReportsSimultaneous infection with Borrelia burgdorferi and human granulocytic ehrlichiosis.
A 5-year-old child with simultaneous early Lyme disease and human granulocytic ehrlichiosis (HGE) is described. Because of the shared vector, HGE and Lyme disease are increasingly identified as coinfections in tick-exposed patients. Early recognition of concurrent Lyme disease and HGE is important because amoxicillin, an antibiotic of choice for young children with early Lyme disease, is ineffective for HGE.
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Pediatr. Infect. Dis. J. · Dec 2002
Case ReportsRecurrent crepitant cellulitis caused by Clostridium perfringens.
A previously healthy 13-year-old boy developed extensive subcutaneous emphysema of the lower limb after a penetrating injury to the knee. Clostridium perfringens was isolated from the wound. Despite surgical debridement and appropriate antibiotics, the emphysema recurred, and prolonged antibiotic treatment was required. This case highlights the distinction between gas gangrene and the lesser known entity of clostridial crepitant cellulitis.
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Pediatr. Infect. Dis. J. · Dec 2002
Comparative StudyPopulation-based surveillance for hospitalized and ambulatory pediatric invasive pneumococcal disease in Santiago, Chile.
Nine- and 11-valent pneumococcal conjugate vaccines under development may control pediatric pneumococcal disease in nonindustrialized countries. Because these vaccines are expensive, population-based surveillance of pneumococcal disease in children <36 months of age was undertaken in Santiago, Chile to provide health authorities with reliable data on the burden of invasive pneumococcal disease and causative serotypes, including those in outpatients with high fever. ⋯ ER surveillance detected approximately one case of pneumococcal bacteremia among febrile ambulatory patients for each hospitalized invasive case. Because 71% of cases were caused by vaccine serotypes (and 87% by vaccine serogroups), 9- and 11-valent pneumococcal conjugate vaccines could prevent most invasive pediatric pneumococcal disease in Chile.
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Pediatr. Infect. Dis. J. · Dec 2002
Comparative StudyTympanostomy tube placements, sociodemographic factors and parental expectations for management of acute otitis media in Iceland.
Widespread antimicrobial use is a risk factor for development of antimicrobial resistance. Antimicrobial treatment of acute otitis media (AOM) may not always be necessary. Little is known about the influence of parental expectations on physicians' decision-making in relation to treatment of AOM. Evidence is insufficient as to whether tympanostomy tube placement reduces antibiotic consumption. ⋯ Parental expectations to antimicrobial treatment and awareness about resistance development appear to influence treatment strategies for AOM. The high rate of tympanostomy tube placement in preschool children does not result in reduced antimicrobial consumption.
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Pediatr. Infect. Dis. J. · Nov 2002
Randomized Controlled Trial Clinical TrialEfficacy of subcutaneous tunneling for prevention of bacterial colonization of femoral central venous catheters in critically ill children.
Blood stream infections are a common and serious complication of central venous catheters (CVCs). To decrease catheter colonization, some authors advocate tunneling the catheter in the subcutaneous tissue during insertion. This technique has proved effective in adults, but there are no data on its safety and efficacy in critically ill children. Our objective was to evaluate the efficacy and safety of subcutaneous tunneling of short term, noncuffed CVCs for the prevention of CVC-related infections in critically ill children. ⋯ Subcutaneous tunneling of CVCs in the femoral site is a safe procedure and decreases significantly the rate of CVC colonization in critically ill children.