RESUMO
This article highlights the changing profile of the pediatric patient with central nervous system infection as countries develop and the roles of different imaging modalities such as cranial ultrasound, MR imaging, and computed tomography. It discusses the commonly encountered congenital toxoplasmosis, rubella, cytomegalovirus, herpes simplex (TORCH) infections, Group B Streptococcal and Escherichia coli infections in the neonatal period, and disease outbreaks affecting children. Iatrogenic, opportunistic, and immune-mediated changes as well as long-term effects of infection and mimics of infection are also discussed. Variety of images is provided to show the range of neuroimaging findings encountered, particularly on cranial ultrasound and MR imaging.
Assuntos
Infecções do Sistema Nervoso Central , Herpes Simples , Recém-Nascido , Humanos , Criança , Infecções do Sistema Nervoso Central/diagnóstico por imagem , Herpes Simples/congênito , Imageamento por Ressonância Magnética , Neuroimagem , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Our retrospective study examined community-acquired invasive pneumococcal disease (IPD) in children admitted to KK Women's and Children's Hospital, Singapore. METHODS: All pneumococcal isolates from sterile sites from 1997 to 2004 were surveyed. RESULTS: There were 147 positive pneumococcal isolates with a mean age of 45 months. The estimated incidence of IPD was 13.6 per 10(5) children under 5 years old. Diagnoses at presentation were: Pneumonia 63.3% (included 14.3% empyema), bacteremia 17%, meningitis 15.6% (included 2.8% meningitis and pneumonia), 4.1% others. The morbidity rate was 25.2%, mortality rate was 6.1%. Antibiotic resistance was: Penicillin 44%, ceftriaxone 15%, erythromycin 62%, trimethoprim-sulfamethoxazole 67%. A separate serotype analysis (n=93, 63%) showed that the current 7valent pneumococcal conjugate vaccine (PCV7) would cover 78.1% of vaccine serotypes and 89% of vaccine-related serotypes for children under 5 years old.