[Long latency is characteristic for "imported" cases of malaria in children at a municipal hospital in Vienna]. / Lange Latenzzeit als Charakteristikum "importierter Malaria" bei Kindern in einem städtischen Krankenhaus in Wien.

BACKGROUND: Malaria is the most frequent tropical disease and the most important parasitic infectious disease in the world. Due to high mobility by travelling and migration also in Central Europe malaria has to be considered also in children and youths. METHODS: We report four cases of malaria being diagnosed and treated at the department of paediatrics, Vienna Danube Hospital, a municipal centre. RESULTS: In all cases the latency time or incubation period respectively was long with up to one year which made the diagnosis of malaria unlikely at first glance. CONCLUSIONS: Taking into account the long latency or incubation period and often fragmentary report of medical history malaria has to be considered in all children after a stay in a country at risk for malaria even if this stay dates back a long time in order to diagnose and treat this disease quickly.

[Life threatening secondary bacterial infection of varicella skin lesions]. / Lebensbedrohliche bakterielle Infektionen ausgehend von Varizellen Hautläsionen.

As immunization coverage of varicella vaccination is low, the disease is still very frequent in Austria. Albeit the prognosis in general is good, the incidence of varicella-related hospitalization is about 6 per 100,000 in all children between 0-15 years of age, affecting mainly previously healthy children. Especially young children under the age of 5 are at risk with highest rates among children younger than one year. The most common complications are secondary bacterial infections, neurological and respiratory complications. Two cases of life threatening secondary bacterial infection are presented. One child suffered from a Toxic Shock Syndrome caused by group A streptococcus along with large necrotizing skin lesions. The second child nearly lost her left eye due to a deep orbital abscess. Both children survived without severe sequelae but had to undergo several procedures of plastic surgery. Implementation of the varicella vaccination program in the USA has shown a near elimination of deaths due to severe varicella complications. The initiation of the varicella vaccination program for children until the age of 2 in Austria should be considered to prevent complications and deaths caused by varicella.

Neonatal diabetes mellitus due to pancreas agenesis: a new case report and review of the literature.

Neonatal diabetes mellitus (NDM) is a rare condition (1:400,000 neonates) defined as hyperglycemia occurring in the first months of life, lasting more than 2 wk and requiring insulin for management. We here report on a 33-month-old girl with pancreatic agenesis, an extremely rare cause of permanent neonatal diabetes mellitus (PNDM). Timely diagnosis and adequate treatment of both endocrine and exocrine insufficiency may permit survival and normal development.

Validity of the neurological examination in diagnosing diabetic peripheral neuropathy.

The aim of this study was to evaluate the prevalence of diabetic peripheral neuropathy in children and adolescents with type 1 diabetes mellitus and examine whether the neurological examination validly diagnoses diabetic peripheral neuropathy as compared with the gold standard of nerve conduction velocity in these patients. Nerve conduction velocity was measured in an unselected consecutive series of patients aged 8-18 years who had been suffering from type 1 diabetes mellitus for at least 1 year. For the neurological examination, neuropathy disability scores and neuropathy sign scores were used. Of the 39 patients, six (15%) had clinically evident diabetic peripheral neuropathy, whereas nerve conduction velocity testing revealed diabetic peripheral neuropathy in 15 (38%) patients. Sensitivity and specificity of the neurological examination for the diagnosis of diabetic peripheral neuropathy were 40% and 100%, respectively. The corresponding positive and negative predictive values were 100% and 72.7%, respectively. This conclusions from this study are that in children and adolescents with type 1 diabetes mellitus, diabetic peripheral neuropathy is highly prevalent, but in the majority of patients it is subclinical. Sensitivity and negative predictive values of the neurological examination are low. Therefore, routine nerve conduction velocity measurement for the assessment of diabetic peripheral neuropathy appears to be warranted in these patients.