[Clinical characteristics of children hospitalized for influenza virus infection]. / Características clínicas de los niños hospitalizados por infección por virus Influenza.

BACKGROUND: The clinical manifestations of influenza virus are fairly nonspecific and are similar to those of other viral infections, respiratory processes due to other causes and even septic disease in neonates. Few studies have been performed of the clinical characteristics of influenza virus infection in hospitalized children. OBJECTIVE: To evaluate the clinical characteristics of children hospitalized for influenza virus infection in four consecutive epidemic waves (2000-2004). MATERIAL AND METHODS: We retrospectively reviewed the medical records of children hospitalized for influenza A and B virus infection confirmed by cell culture and polymerase chain reaction. Age, sex, symptoms on admission, complementary investigations, diagnosis and outcome were evaluated. RESULTS: Eighty-four children were hospitalized, of which 74 had influenza virus type AH3, five had influenza virus type AH1 and five had influenza B virus. A total of 42.8 % were aged less than 6 months. The main symptoms were fever (75 patients), cough (56 patients) and ENT involvement (53 patients). The most frequent causes of admission were febrile syndrome (75 patients), bronchiolitis (19 patients), pneumonia (13 patients) and bronchitis (8 patients). In 21 patients viral or bacterial coinfection was found, the most frequent of which was respiratory syncytial virus (10 patients). Few differences were found among age groups except for pneumonia and prolonged fever (more frequent in children older than 6 months) and lymphocytosis (in children younger than 6 months). The greatest number of complementary investigations in younger children was performed for acute febrile syndrome in neonates aged less than 6 months. Risk factors for hospitalization were found in only three children, all of whom were older than 6 months. Outcome was favorable in all children. CONCLUSIONS: Influenza virus infection in hospitalized children is most frequent in previously healthy neonates with fever and nonspecific signs and symptoms that are similar to those of other infectious processes. Specific microbiological diagnostic techniques are required for an early diagnosis. Healthy infants aged less than 24 months are most at risk for hospitalization for influenza virus infection.

Características clínicas de los niños hospitalizados por infección por virus Influenza / Clinical characteristics of children hospitalized for influenza virus infection

Antecedentes: Las manifestaciones clínicas de la gripe son bastante inespecíficas y similares a otras infecciones virales, a procesos respiratorios de otra etiología e incluso a cuadros sépticos en lactantes. Existen pocos estudios sobre las características clínicas de la infección por virus Influenza en niños hospitalizados. Objetivo: Evaluar las características clínicas de los niños hospitalizados por infección por virus Influenza en cuatro ondas epidémicas consecutivas (2000-2004). Material y métodos: Estudio retrospectivo por revisión de historias clínicas de los niños hospitalizados por infección confirmada por virus Influenza A y B, mediante cultivo celular y reacción en cadena de la polimerasa. Se registraron las variables: sexo, edad, clínica al ingreso, exploraciones complementarias, diagnóstico y evolución posterior. Resultados Fueron hospitalizados 84 niños, 74 casos debidos a infección por virus Influenza AH3, 5 casos por virus Influenza AH1 y cinco por Influenza B. El 42,8 % fueron menores de 6 meses. El cuadro clínico principal fue fiebre (75 casos), tos (56 casos), afectación otorrinolaringológica (53 casos). Los diagnósticos más frecuentes que motivaron el ingreso fueron síndrome febril (75 casos), bronquiolitis (19 casos), neumonía (13 casos) y bronquitis (8 casos). En 21 casos se objetivó coinfección viral o bacteriana, siendo la asociación con virus respiratorio sincitial la coinfección más frecuente (10 casos). Se han observado pocas diferencias entre los diferentes grupos de edad, excepto para neumonía y fiebre prolongada (más frecuentes en mayores de 6 meses) y linfocitosis (en menores de 6 meses). El cuadro febril agudo en menores de 6 meses ha originado mayor número de exploraciones complementarias en los de menor edad. Sólo en tres niños se encontraron factores de riesgo para hospitalización, todos ellos mayores de 6 meses. Todos los casos evolucionaron favorablemente. Conclusiones: La infección por virus Influenza en los niños que están hospitalizados predomina en lactantes sanos, con fiebre y signos y síntomas respiratorios poco específicos, similares a otros cuadros infecciosos. Es necesario aplicar técnicas diagnósticas microbiológicas específicas para el diagnóstico precoz. Los lactantes sanos y menores de 24 meses constituyen el grupo de mayor riesgo para la hospitalización por infección por virus Influenza

Background: The clinical manifestations of influenza virus are fairly nonspecific and are similar to those of other viral infections, respiratory processes due to other causes and even septic disease in neonates. Few studies have been performed of the clinical characteristics of influenza virus infection in hospitalized children. Objective: To evaluate the clinical characteristics of children hospitalized for influenza virus infection in four consecutive epidemic waves (2000-2004). Material and methods: We retrospectively reviewed the medical records of children hospitalized for influenza A and B virus infection confirmed by cell culture and polymerase chain reaction. Age, sex, symptoms on admission, complementary investigations, diagnosis and outcome were evaluated. Results: Eighty-four children were hospitalized, of which 74 had influenza virus type AH3, five had influenza virus type AH1 and five had influenza B virus. A total of 42.8% were aged less than 6 months. The main symptoms were fever (75 patients), cough (56 patients) and ENT involvement (53 patients). The most frequent causes of admission were febrile syndrome (75 patients), bronchiolitis (19 patients), pneumonia (13 patients) and bronchitis (8 patients). In 21 patients viral or bacterial coinfection was found, the most frequent of which was respiratory syncytial virus (10 patients). Few differences were found among age groups except for pneumonia and prolonged fever (more frequent in children older than 6 months) and lymphocytosis (in children younger than 6 months). The greatest number of complementary investigations in younger children was performed for acute febrile syndrome in neonates aged less than 6 months. Risk factors for hospitalization were found in only three children, all of whom were older than 6 months. Outcome was favorable in all children. Conclusions: Influenza virus infection in hospitalized children is most frequent in previously healthy neonates with fever and nonspecific signs and symptoms that are similar to those of other infectious processes. Specific microbiological diagnostic techniques are required for an early diagnosis. Healthy infants aged less than 24 months are most at risk for hospitalization for influenza virus infection

Estenosis hipertrófica de píloro en gemelos / Hypertrophic pyloric stenosis in twins

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[Cystic adenomatoid malformation: late diagnosis of a congenital anomaly]. / Malformación adenomatoide quística. Diagnóstico diferido de una anomalía congénita.

Cystic adenomatoid malformation (CAM) is a congenital lung malformation characterized by adenomatoid proliferation of alveoli and terminal bronchioli. It is usually diagnosed perinatally, but some silent cases are discovered during childhood or adulthood. We present the case of a 9-year-old girl who presented with chest pain. Chest X-ray showed a cystic image in the upper lobe of the left lung, which was confirmed by computed tomography and magnetic resonance angiography. Lobectomy of the affected segment was performed and histological examination confirmed the diagnosis of CAM type I.

Malformación adenomatoide quística. Diagnóstico diferido de una anomalía congénita / Cystic adenomatoid malformation: late onset of a congenital anomaly

La malformación adenomatoide quística es una lesión pulmonar congénita que resulta de la proliferación adenomatosa de bronquiolos y alvéolos terminales, con formación de quistes. El diagnóstico se realiza habitualmente durante el período perinatal, pero existen casos asintomáticos que se descubren durante la infancia o en la edad adulta. Se presenta el caso de una niña de 9 años en estudio por dolor torácico. La radiología de tórax demostró una imagen quística en el lóbulo superior izquierdo que se confirmó mediante tomografía computarizada torácica y angiorresonancia. Se realizó resección quirúrgica del lóbulo afectado confirmándose mediante anatomía patológica el diagnóstico de malformación adenomatoide quística tipo 1 (AU)