ABSTRACT
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Subject(s)
Humans , Male , Child, Preschool , Mucocutaneous Lymph Node Syndrome/diagnosis , Aneurysm/diagnosis , Platelet Aggregation Inhibitors/therapeutic use , Risk Factors , Delayed DiagnosisABSTRACT
Objetivos. El kala azar o leishmaniasis viscera (LV) es una de las enfermedades más olvidadas del mundo. En los países en desarrollo, 350 millones de personas están en riesgo de contraer LV, habiendo 2 millones de casos nuevos al año, En España, a partir de 1982, se hizo enfermedad de declaración obligatoria, notificándose unos 90 casos/año. A partir de 1995 pasó a ser enfermedad de declaración obligatoria en zonas endémicas, considerándose Aragón una de ellas. Pacientes y métodos. Estudio descriptivo retrospectivo de 14 casos de LV confirmados en edad pediátrica (0 a 14 años) ingresados en la Unidad de Infecciosos del Hospital Infantil Miguel Servet, de Zaragoza, entre enero de 1980 a diciembre de 2010. Resultados. Fueron ingresados 16 niños con el diagnóstico de LV. El estudio se lleva a cabo con datos de 14 pacientes. La edad media de presentación fue 3 años (rango 9 meses-12 años, mediana 19 meses). El 64% de los pacientes procedían del medio rural. Al ingreso presentaban una media de 3.700 leucocitos, con neurtropenia en el 71% de los pacientes. Existían trombopenia (<150.000 plaquetas/mm3) en un 77% de los casos. Presentaban anemia el 100% de los pacientes con una media de hemoglobina de 7,7 mg/dl. Un 64 % de los niños debutaron con pancitopenia. La VSG se elevó por encima de 20 mm/h en el 100% de los casos. En todos los pacientes se realizó aspirado de médula ósea, visualizándose el parásito en todas las muestras, confirmando el diagnóstico de LV. Todos los casos fueron tratados con meglumina antimoniato, excepto el último registrado en 2010 que recibió anfotericina B liposomal, todos con buena respuesta clínica (...) (AU)
Objectives. Kala azar o viscera leishmaniasis (LV) is one of the most neglected disease in the world. In developing countries, 350 million people are at risk of having LV and 2 million cases are reported every year. In Spain, since 1982 LV has become a compulsory notifiable disease with around 90 cases reported every year. In 1995, it was declared notifiable disease in endemic areas and one of them was Aragón. Patients and Methods. Retrospective study of 14 VL cases. All of them in patients between 0-14 years old admitted into the Infectious Diseases Unit at Children´s Hospital Miguel Servet in Zaragoza between January 1980 to December 2010. Results. A total of 16 children were admitted with the diagnosis of I. V. The study was carried out with data of 14 of these patients. The mean age at diagnosis was 3 years (range 9 months-12 years, median 19 months). The 64% of them came from rural areas. At admission, they had 3700 leukocyte average with neutropenia in 71% of those cases. All of them (100%9 were anemic with a 7.7 mg/ld hemoglobin/dl range but only nearly 77% has thrombocytopenia (<150,000 platelets/mm3). The 64% of the children debuted with pancytopenia. ESR rose were more than 20 mm/h in all cases (...) (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Leishmania/pathogenicity , Leishmaniasis, Visceral/epidemiology , Retrospective Studies , Thrombocytopenia/epidemiology , Meglumine/therapeutic use , Amphotericin B/analysis , Leukocyte Count , Neutropenia/epidemiologyABSTRACT
INTRODUCTION: Influenza is frequent during childhood, affecting approximately 30-40 % of children. OBJECTIVES: To identify the most frequent causes of hospitalization in children admitted to hospital for influenza, as well as the main symptoms and clinical diagnoses at discharge, and to relate these factors with the type of influenza virus and patients' age. A further aim was to evaluate the use of the diagnostic and therapeutic methods. MATERIAL AND METHODS: We performed a retrospective descriptive study through a review of the medical records of children admitted to the Miguel Servet Children's Hospital in Zaragoza (Spain) for influenza in four epidemic seasons (2002-2006). RESULTS: A total of 178 influenza cases were found, 132 due to influenza A and 46 due to influenza B. Hospital admission was mainly due to fever without focus, especially in infants aged less than 6 months, followed by convulsions and shortness of breath. The main symptoms were fever, cough, rhinitis, and vomiting. The latter was especially frequent in children older than 3 years and in patients with influenza B virus. The main discharge diagnoses were upper respiratory tract infection, pharyngitis-tonsillitis, and otitis. Diagnosis of bronchitis was more frequent in children aged less than 2 years old. Chest X-ray was performed in 80% of the patients and lung consolidation was found in 10.5%. Antibiotic therapy was administered in 59% of the patients, mainly amoxicillin-clavulanic acid. CONCLUSIONS: The causes of admission for influenza and clinical presentation of this infection vary widely, sometimes depending on age and the type of influenza virus.
Subject(s)
Hospitalization , Influenza, Human/diagnosis , Adolescent , Child , Child, Preschool , Disease Outbreaks , Female , Humans , Infant , Influenza, Human/epidemiology , Male , Retrospective Studies , SeasonsABSTRACT
La gripe es un proceso muy frecuente en la infancia que afecta al 30-40 % de los niños. Objetivos Entre los niños ingresados por virus de la gripe, determinar las causas más frecuentes de hospitalización, los síntomas principales y el diagnóstico clínico al alta relacionados con la edad y el tipo de virus de la gripe, así como valorar el uso de métodos diagnósticos y terapéuticos. Material y métodos Estudio descriptivo retrospectivo obtenido mediante la revisión de historias clínicas de niños hospitalizados con diagnóstico de gripe en el Hospital Infantil Miguel Servet de Zaragoza durante cuatro períodos epidémicos anuales (2002-2006). Resultados Se observaron 178 casos de gripe, de los que 132 correspondieron al virus de la gripe A y 46 al B. El principal motivo de ingreso en el hospital fue fiebre sin foco, sobre todo en menores de 6 meses, seguido por convulsión febril y dificultad respiratoria. La sintomatología predominante fue fiebre, tos y rinitis, y vómitos en mayores de 3 años, especialmente en los casos de gripe B. Los diagnósticos principales al alta fueron infección respiratoria de vías altas, faringoamigdalitis y otitis. El diagnóstico de bronquitis/bronquiolitis fue más frecuente en los pacientes menores de 2 años. Se realizó radiografía de tórax en el 80 %, con condensación neumónica en el 10,5 % y se administró antibioterapia en el 59 % de los pacientes, principalmente amoxicilina- ácido clavulánico. Conclusiones Existe una gran variación en las causas de ingreso y presentación clínica de la gripe, en algunos casos determinado por la edad y el tipo de virus gripal
Introduction Influenza is frequent during childhood, affecting approximately 30-40 % of children. Objectives To identify the most frequent causes of hospitalization in children admitted to hospital for influenza, as well as the main symptoms and clinical diagnoses at discharge, and to relate these factors with the type of influenza virus and patients age. A further aim was to evaluate the use of the diagnostic and therapeutic methods. Material and methods We performed a retrospective descriptive study through a review of the medical records of children admitted to the Miguel Servet Childrens Hospital in Zaragoza (Spain) for influenza in four epidemic seasons (2002-2006). Results A total of 178 influenza cases were found, 132 due to influenza A and 46 due to influenza B. Hospital admission was mainly due to fever without focus, especially in infants aged less than 6 months, followed by convulsions and shortness of breath. The main symptoms were fever, cough, rhinitis, and vomiting. The latter was especially frequent in children older than 3 years and in patients with influenza B virus. The main discharge diagnoses were upper respiratory tract infection, pharyngitis-tonsillitis, and otitis. Diagnosis of bronchitis was more frequent in children aged less than 2 years old. Chest X-ray was performed in 80 % of the patients and lung consolidation was found in 10.5 %. Antibiotic therapy was administered in 59 % of the patients, mainly amoxicillin- clavulanic acid. Conclusions The causes of admission for influenza and clinical presentation of this infection vary widely, sometimes depending on age and the type of influenza virus
Subject(s)
Male , Female , Infant , Child, Preschool , Child , Humans , Influenza, Human/epidemiology , Disease Outbreaks/statistics & numerical data , Communicable Disease Control/methods , Hospitalization/statistics & numerical data , Retrospective Studies , Radiography, Thoracic , Respiratory Tract Infections/epidemiology , Otitis/epidemiology , Anti-Bacterial Agents/therapeutic use , Influenza A virus/isolation & purification , Influenza B virus/isolation & purification , Influenza, Human/diagnosis , Influenza, Human/drug therapyABSTRACT
OBJECTIVE: To describe the clinical and radiological features, diagnosis, and treatment of an epidemic outbreak of tuberculosis in a daycare centre in Zaragoza. MATERIAL AND METHODS: The index case was a teaching assistant with a late diagnosis of bacilliferous tuberculosis. Mantoux testing was carried out in all children. In those with a positive Mantoux test, a chest X-ray was performed. Children with an abnormal chest X-ray underwent microbiological investigations. RESULTS: Among all the children in the daycare center, the Mantoux test was positive in 11 children. Chest X-ray was abnormal in 10 children. Of these, seven (70 %) were symptomatic. Chest X-ray showed dense opacification in nine children (90 %) and mediastinal lymph adenopathy in five (50 %). Three children (30 %) had lobar atelectasis requiring bronchoscopy and subsequent steroid therapy. Bacilloscopy was positive in only one child. Gastric juice culture was positive in seven children and the amplified Mycobacterium tuberculosis direct test was positive in a further seven. All microbiological investigations were negative in only one child. CONCLUSIONS: Establishing a definitive diagnosis of tuberculosis in children remains difficult and frequently relies on a constellation of clinical findings, radiology and epidemiology in children with a positive Mantoux test. The amplified Mycobacterium tuberculosis direct test has high sensitivity and provides fast results. Epidemic outbreaks continue to be frequent in Spain. Study of contacts shows high efficiency in controlling outbreaks.
Subject(s)
Disease Outbreaks , Tuberculosis, Pulmonary/epidemiology , Child Day Care Centers , Child, Preschool , Humans , Infant , Spain/epidemiology , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapyABSTRACT
Objetivo Describir la clínica, radiología, diagnóstico y tratamiento en los niños afectados por un brote de tuberculosis en una guardería de Zaragoza. Material y métodos El caso índice fue una cuidadora que fue diagnosticada tardíamente de tuberculosis activa. Se realizó Mantoux a todos los niños, a los positivos se hizo radiografía de tórax. En aquéllos con radiografía patológica se procedió al diagnóstico microbiológico. Resultados De todos los niños de la guardería, 11 presentaron un Mantoux positivo. La radiografía fue patológica en 10. De ellos, 7 (70 %) estaban sintomáticos. Las imágenes radiológicas mostraban en 9 (90 %) casos una condensación parenquimatosa y en 5 (50 %) una adenopatía parahiliar. Tres niños (30 %) presentaron atelectasia lobular y precisaron broncoscopia y administración posterior de corticoides. La baciloscopia fue positiva solamente en un niño, el cultivo en siete y la detección de muestra directa para el complejo tuberculosis en otros siete. Únicamente en un niño toda la investigación fue negativa. Conclusiones El diagnóstico de tuberculosis en la infancia es difícil, y a veces debe hacerse en base a unos criterios clínicos, radiológicos y epidemiológicos en niños con Mantoux positivo. Los test de detección de muestra directa para el complejo tuberculosis tienen una sensibilidad muy alta y proporcionan resultados muy rápidos. La aparición de brotes epidémicos continúa siendo un hecho frecuente en nuestro medio. El estudio de contactos en los mismos presenta un elevado rendimiento en el control de los brotes
Objective To describe the clinical and radiological features, diagnosis, and treatment of an epidemic outbreak of tuberculosis in a daycare centre in Zaragoza. Material and methods The index case was a teaching assistant with a late diagnosis of bacilliferous tuberculosis. Mantoux testing was carried out in all children. In those with a positive Mantoux test, a chest X-ray was performed. Children with an abnormal chest X-ray underwent microbiological investigations. Results Among all the children in the daycare center, the Mantoux test was positive in 11 children. Chest X-ray was abnormal in 10 children. Of these, seven (70 %) were symptomatic. Chest X-ray showed dense opacification in nine children (90 %) and mediastinal lymph adenopathy in five (50 %). Three children (30 %) had lobar atelectasis requiring bronchoscopy and subsequent steroid therapy. Bacilloscopy was positive in only one child. Gastric juice culture was positive in seven children and the amplified Mycobacterium tuberculosis direct test was positive in a further seven. All microbiological investigations were negative in only one child. Conclusions Establishing a definitive diagnosis of tuberculosis in children remains difficult and frequently relies on a constellation of clinical findings, radiology and epidemiology in children with a positive Mantoux test. The amplified Mycobacterium tuberculosis direct test has high sensitivity and provides fast results. Epidemic outbreaks continue to be frequent in Spain. Study of contacts shows high efficiency in controlling outbreaks
Subject(s)
Infant , Humans , Disease Outbreaks , Tuberculosis, Pulmonary/epidemiology , Child Day Care Centers , Spain/epidemiology , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapyABSTRACT
La varicela es una enfermedad frecuente en la infancia de evolución general mente benigna pero, en ocasiones, es motivo de ingreso hospitalario. En este trabajo se evalúan las causas que motivaron el ingreso hospitalario en un estudio retrospectivo, mediante la revisión de las historias clínicas codificadas como varicela desde el 1 de enero de 1999 al 31 de diciembre de 2004 de todos los niños de O a 13 años ingresados en el Hospital Infantil Universitario «Miguel Servet» de Zaragoza. Las complicaciones observadas con más frecuencia son las sobreinfecciones bacterianas de las lesiones y las neumonías. La vacunación sistemática disminuiría su incidencia. así como el número de complicaciones, la cantidad de los ingresos hospitalarios y el uso indiscriminado de fármacos
Measles is a common childhood disease that generally has a favorable outcome, but sometimes requires hospital admission. In this report, we evaluate the causes for admission by means of an observational, retrospective study of hospital stays due to complications of measles. We reviewed all the medical records corresponding to patients under fourteen years of age admitted to our hospital for measles between January 1, 1999, and Oecember 31, 2004. The most frequent complications were bacterial superinfection of the lesions and pneumonia. Systematic vaccination would decrease the incidence of this disease, as well as the rate of complications and admissions, and the indiscriminate use of antibiotic
Subject(s)
Male , Female , Child, Preschool , Child , Humans , Chickenpox/epidemiology , Hospitalization/statistics & numerical data , Child, Hospitalized/statistics & numerical data , Retrospective Studies , Chickenpox/complications , Drug Utilization/statistics & numerical dataABSTRACT
Nontuberculous or environmental mycobacterial disease in children has been increasingly recognized over the last decade. We present four patients who were diagnosed in the year 2000. The children were aged between 2 and 8 years. Three patients presented involvement of the cervical lymph nodes and one presented involvement of the inguinal nodes. Three of the children were treated with a combination of surgery and chemotherapy and one was treated with chemotherapy alone. We describe the clinical characteristics, laboratory findings, therapeutic management and complications of nontuberculous mycobacterial lymphadenitis in children.
Subject(s)
Mycobacterium Infections, Nontuberculous , Mycobacterium kansasii , Mycobacterium scrofulaceum , Age Factors , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Lymphadenitis/diagnosis , Lymphadenitis/etiology , Male , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/therapy , Mycobacterium avium-intracellulare Infection/diagnosis , Mycobacterium avium-intracellulare Infection/therapy , Time FactorsSubject(s)
Immunoglobulins, Intravenous/therapeutic use , Stevens-Johnson Syndrome/drug therapy , Anticonvulsants/adverse effects , Child , Epilepsy/drug therapy , Female , Follow-Up Studies , Humans , Immunoglobulins, Intravenous/administration & dosage , Lamotrigine , Stevens-Johnson Syndrome/diagnosis , Stevens-Johnson Syndrome/etiology , Time Factors , Triazines/adverse effectsABSTRACT
Las enfermedades ocasionadas por micobacterias no tuberculosas o ambientales han aumentado en la última década. Se presentan 4 casos diagnosticados durante el año 2000. Todos los niños tenían entre 2 y 8 años de edad. Tres casos presentaban afectación de los ganglios linfáticos cervicales y un caso de los inguinales. El tratamiento en 3 pacientes fue una combinación de cirugía y quimioterapia y un caso con quimioterapia solamente. En este trabajo se comentan las principales características clínicas, hallazgos de laboratorio, indicaciones terapéuticas y complicaciones de las linfoadenopatías producidas por micobacterias no tuberculosas (AU)
