Asunto(s)
Abandono Escolar/psicología , Adolescente , Ansiedad de Separación/diagnóstico , Ansiedad de Separación/psicología , Niño , Protección a la Infancia , Conducta Cooperativa , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Conflicto Familiar/psicología , Femenino , Humanos , Comunicación Interdisciplinaria , Masculino , Grupo Paritario , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/psicología , Psicoterapia , Derivación y Consulta , Conducta Sexual , Familia Monoparental , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/psicología , Ajuste Social , Aislamiento Social , Negativa del Paciente al TratamientoRESUMEN
Five cases of meningitis due to Haemophilus influenzae type b are reported. In four, the same pathogen was recovered from blood. In every case, meningitis developed despite administration of macrolides for ENT infections (4 cases) or pneumonia (1 case). These five observations are conclusive evidence that macrolides failed to prevent meningeal diffusion of Haemophilus influenzae presumptively responsible for the initial focal infection. In vitro activity of macrolides against Haemophilus influenzae is poor. For the treatment of ENT infections in pediatric patients aged 2 months to 5 years, the age group most susceptible to infection by Haemophilus influenzae, we recommend amoxicillin which is more active and bactericidal. An adequate dosage should be used (50 to 100 mg/kg/24 h) divided into four oral doses given at six hour intervals. This therapeutic attitude may need to be revised if the prevalence of beta-lactamase-producing H. influenzae strains (5 to 10% as of now) were to increase. In this case, use of an amoxicillin-clavulanic acid combination under the same conditions as outlined above may prove satisfactory. Correct administration of judiciously chosen antibiotics in ENT infections in infants and children is the most effective means of preventing meningitis due to H. influenzae.
Asunto(s)
Eritromicina/uso terapéutico , Leucomicinas/uso terapéutico , Meningitis por Haemophilus/tratamiento farmacológico , Troleandomicina/uso terapéutico , Amoxicilina/administración & dosificación , Amoxicilina/uso terapéutico , Preescolar , Eritromicina/administración & dosificación , Haemophilus influenzae , Humanos , Lactante , Leucomicinas/administración & dosificación , Meningitis por Haemophilus/etiología , Infecciones del Sistema Respiratorio/complicaciones , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Troleandomicina/administración & dosificaciónRESUMEN
We report the prenatal diagnosis in a 20 week male fetus at risk of chronic granulomatous disease (CGD). A previous affected brother was known in the family and the mother was detected as heterozygote. Three different assays were performed on fetal blood obtained under fetoscopy: cytochemical reduction of nitroblue tetrazolium (NBT), chemiluminescence after activation by opsonized zymosan or phorbol myristate acetate (PMA) and production of superoxide anion (O2-.). Results were comparable to those obtained in 6 fetuses investigated for other inherited diseases. Absence of functional polymorphonuclear defects was confirmed at birth. The use of 3 different techniques performed on whole blood for prenatal diagnosis of CGD has to be recommended instead of an isolated technique adapted to whole blood tests.
Asunto(s)
Enfermedad Granulomatosa Crónica/genética , Diagnóstico Prenatal/métodos , Femenino , Enfermedad Granulomatosa Crónica/diagnóstico , Humanos , EmbarazoRESUMEN
The authors report on an exceptional complication of BCG vaccination: a case of facial lupus vulgaris, which appeared one year after vaccination in a girl with normal cellular and humoral immunity.