RESUMEN
We conducted an observational study from January 2016 through January 2017 of patients admitted to a reference pediatric hospital in Madrid, Spain, for neurologic symptoms and enterovirus infection. Among the 30 patients, the most common signs and symptoms were fever, lethargy, myoclonic jerks, and ataxia. Real-time PCR detected enterovirus in the cerebrospinal fluid of 8 patients, nasopharyngeal aspirate in 17, and anal swab samples of 5. The enterovirus was genotyped for 25 of 30 patients; enterovirus A71 was the most common serotype (21/25) and the only serotype detected in patients with brainstem encephalitis or encephalomyelitis. Treatment was intravenous immunoglobulins for 21 patients and corticosteroids for 17. Admission to the pediatric intensive care unit was required for 14 patients. All patients survived. At admission, among patients with the most severe disease, leukocytes were elevated. For children with brainstem encephalitis or encephalomyelitis, clinicians should look for enterovirus and not limit testing to cerebrospinal fluid.
Asunto(s)
Encefalitis Viral/virología , Encefalomielitis/virología , Enterovirus Humano A/aislamiento & purificación , Infecciones por Enterovirus/virología , Epidemias , Enfermedades del Sistema Nervioso/virología , Niño , Preescolar , Encefalitis Viral/epidemiología , Encefalomielitis/epidemiología , Infecciones por Enterovirus/epidemiología , Femenino , Humanos , Lactante , Masculino , Enfermedades del Sistema Nervioso/epidemiología , Estudios Prospectivos , España/epidemiologíaRESUMEN
When pertussis is associated with hyperleukocytosis, mortality approaches to 80%. Immature leukocytes have been identified in pulmonary arterioles, small arteries and venules. Techniques aimed at reducing leukocyte mass might improve the prognosis of these patients. We report our experience with 3 patients in whom a leukoreduction was performed in the context of severe pertussis and hyperleukocytosis.
Asunto(s)
Leucocitosis/sangre , Leucocitosis/terapia , Tos Ferina/sangre , Tos Ferina/terapia , Recambio Total de Sangre , Resultado Fatal , Femenino , Humanos , Hipoxia/sangre , Lactante , Unidades de Cuidado Intensivo Pediátrico , Leucaféresis , MasculinoRESUMEN
BACKGROUND: Pleuropulmonary blastoma (PPB) is the most common lung neoplasms in childhood. Usually presents as recurrent respiratory infections and in some cases as pneumothorax. CASE REPORT: We report the case of a 2-year-old patient that was diagnosed with PPB, that first manifested as recurrent pneumothorax. Three chest computed tomography were necessary for the diagnosis. The first 2 tomographies showed no abnormalities suggestive of malignancy. The patient had a family history of both PPB and leukemia. Three years and a half after completion of treatment, the patient is in complete remission. CONCLUSIONS: PPB is an uncommon disease but is the most common pulmonary neoplasms in childhood. We must suspect it in patients with a suggestive family history and recurrent pneumothorax in the same location.