RESUMEN
Three healthy boys, 3.5, 5 and 1.5 years of age, were admitted to hospital with a severe bacterial skin infection, cerebellar ataxia, and pneumonia, respectively, one week after the onset of varicella. They recovered completely after treatment. Studies in Europe report complications from varicella in 2.5% of healthy children. Most of these are neurological complications and secondary bacterial infections of skin and soft tissue. Last year, a European consensus was published that recommended that all healthy children be vaccinated against chickenpox. In The Netherlands, routine varicella zoster virus (VZV) vaccination has not (yet) been implemented. We propose a new discussion on the possible inclusion of VZV vaccination in the national vaccination programme.
Asunto(s)
Ataxia Cerebelosa/etiología , Vacuna contra la Varicela , Varicela/complicaciones , Herpesvirus Humano 3/inmunología , Pleuroneumonía/etiología , Enfermedades Cutáneas Bacterianas/etiología , Ataxia Cerebelosa/epidemiología , Varicela/prevención & control , Preescolar , Política de Salud , Humanos , Programas de Inmunización , Lactante , Masculino , Países Bajos/epidemiología , Pleuroneumonía/epidemiología , Enfermedades Cutáneas Bacterianas/epidemiologíaRESUMEN
A 14-year-old girl with Graves' disease developed a fever, sore throat and a severe systemic infection after being treated with antithyroid drugs for 1 year. Agranulocytosis was diagnosed. After long-term antibiotic treatment and supportive therapy she recovered. Agranulocytosis is a known side-effect of antithyroid drugs and is seen in 0.2 to 0.5% of the patients. It usually occurs within the first 3 months of treatment. Patients above the age of 40 seem to be more susceptible. Since the onset of agranulocytosis is relatively acute, routine blood monitoring is not very useful. It is more important to instruct patients who use a thyreostatic to contact their physician in case of unexplained fever or a sore throat.
Asunto(s)
Agranulocitosis/inducido químicamente , Antibacterianos/uso terapéutico , Antitiroideos/efectos adversos , Adolescente , Agranulocitosis/tratamiento farmacológico , Femenino , Fiebre/inducido químicamente , Enfermedad de Graves/tratamiento farmacológico , Humanos , Faringitis/inducido químicamente , Resultado del TratamientoRESUMEN
This paper describes a patient with a de novo inverted duplication of chromosome 8(q13-q21.2). He was born with a ventricular septum defect, glandular hypospadias and protruding ears. At the age of 5 1/2 years he had normal psychomotor development. Review of the literature on partial duplications of 8q reveals that the associated phenotype may be mild. Normal psychomotor development, as in our patient, however appears to be uncommon.
Asunto(s)
Anomalías Múltiples/genética , Inversión Cromosómica , Cromosomas Humanos Par 8 , Defectos del Tabique Interventricular/genética , Hipospadias/genética , Preescolar , Humanos , Hibridación Fluorescente in Situ , Cariotipificación , MasculinoRESUMEN
In 2 boys aged 8 years and 10 months, respectively, uncommon manifestations of cat scratch disease were seen. The first patient had acute encephalopathy: coma and generalized tonic-clinic convulsions. The second patient was presented with fever and peripheral lymphadenopathy in combination with hypodense lesions in the liver on ultrasound. Diagnosis was established on the clinical picture and the positive results of serological testing of antibody titres for Bartonella henselae. Both patients recovered completely within 2 months.
Asunto(s)
Bartonella henselae , Enfermedad por Rasguño de Gato/complicaciones , Encefalitis/etiología , Anticuerpos Antibacterianos/aislamiento & purificación , Bartonella henselae/inmunología , Enfermedad por Rasguño de Gato/microbiología , Niño , Coma/etiología , Encefalitis/microbiología , Hepatitis/etiología , Hepatitis/microbiología , Humanos , Lactante , Linfadenitis/etiología , Linfadenitis/microbiología , MasculinoRESUMEN
The Netherlands Centre for Monitoring of Adverse Reactions to Drugs received two reports of adrenal suppression, attributed to inhaled budesonide. In the first patient, a 7-year-old girl, there were growth retardation, centripetal weight gain and a Cushingoid moonface with unmeasurable serum levels of cortisol after long-term treatment with 600, and later 1000 micrograms daily. In the second patient, an 8-year-old boy, there was malaise with onset a few months after start of treatment with 400 micrograms budesonide daily. There was a lowered serum level of cortisol which returned to normal after discontinuation of budesonide. Although inhaled corticosteroids cause systemic adverse effects less frequently than orally administered corticosteroids, such effects may occur occasionally.