Infección respiratoria por Chlamydia trachomatis, a propósito de 4 casos / Respiratory infection due to Chlamydia trachomatis, four cases report

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"Induced sputum versus gastric lavage for the diagnosis of pulmonary tuberculosis in children".

BACKGROUND: Diagnosis of pulmonary tuberculosis (PTB) is difficult in infants and young children. For microbiological confirmation of PTB children, sequential gastric lavage (GL) is recommended. Induced sputum (IS) may be an alternative or complementary tool, but the information is limited in children in developed countries. The aim of this study is to assess the safety and diagnostic yield from IS combined with GL for PTB diagnosis in non-HIV infected children. METHODS: The study involved 22 children with suspected PTB admitted to the Getafe Hospital from January 2007 to May 2011. IS and GL were performed on three consecutive days, according to a standardized protocol. In all samples, BK staining, culture and PCR were carried out, including Genotype MTBDR plus for resistance to INH-RIF (Isoniazid-Rifampin) since 2008. A preliminary analysis of an ongoing prospective study is presented. RESULTS: Median age was 72 months (range 1 month to 14 years of age). Seven (33%) were ≤ 5 years of age. Seventeen were clinically diagnosed of PTB based on positive PPD and radiological criteria. Microbiological confirmation was achieved in 10 (58.8%) by either GL or IS. M. tuberculosis was identified by GL in 8 children (47.1%) and by IS in 7 (41.2%). One infant (2 IS samples) had transient oxygen desaturation recovered spontaneously. CONCLUSIONS: IS appears to be safe and well tolerated by children for diagnosis of PTB and is more convenient. Increasing the diagnostic yield of PTB in children with PTB may be a complementary technique. Largest studies are necessary to define the role of IS in paediatric PTB.

Síndrome PFAPA: Estudio de 10 casos / PFAPA syndrome: Study of 10 cases

Fundamento y objetivo: El síndrome de PFAPA es una entidad autoinflamatoria que incluye fiebre periódica, estomatitis aftosa, faringitis y adenitis cervical. Su etiología es desconocida, pero una desregulación en el control de la respuesta inflamatoria parece tener un papel importante en la fisiopatología. Aunque se sospecha la existencia de un origen genético, no se ha determinado ninguna mutación hasta la fecha. Los corticoides son la base del tratamiento agudo, mientras que el papel de la amigdalectomía en el seguimiento a largo plazo es controvertido. Pacientes y método:Se realizó un estudio retrospectivo de los casos pediátricos diagnosticados de síndrome de PFAPA en nuestro centro en los últimos 4 años. Resultados: Se encontró un total de 10 pacientes diagnosticados de este síndrome que recibieron corticoides como único tratamiento eficaz con adecuada respuesta y pronóstico favorable. Conclusiones: El síndrome PFAPA constituye el tipo de fiebre periódica más frecuente en la edad pediátrica, cuyo origen genético no ha sido elucidado todavía. Nuestra contribución con 10 pacientes afectos resalta la frecuencia común de esta entidad y la necesidad de tenerla presente ante toda fiebre recurrente (AU)

Background and objectives: «PFAPA syndrome» is an autoinflammatory entity consisting of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis. Its etiology is unknown although a dysregulation in the control of the autoinflammatory response seems to play a role. Although a genetic origin is suspected, no specific mutation has been determined yet. Corticosteroids are the mainstay of the treatment during the acute attacks. However, in long-term follow-up the role of tonsillectomy is controversial. Patients and methods: A retrospective study of the pediatric cases diagnosed with the PFAPA syndrome was performed in our center during the last 4 years.Results: Ten patients were diagnosed with the syndrome who received corticosteroids as the only treatment with improvement and favourable prognosis. Conclusion: PFAPA syndrome is the most common periodic fever disorder described in childhood whose genetic background has not been yet clarified. Our contribution with 10 patients further supports the common existence of this entity and the need to keep it in mind when having recurrent fevers (AU)

[PFAPA syndrome: study of 10 cases]. / Síndrome PFAPA: Estudio de 10 casos.

BACKGROUND AND OBJECTIVES: «PFAPA syndrome¼ is an autoinflammatory entity consisting of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis. Its etiology is unknown although a dysregulation in the control of the autoinflammatory response seems to play a role. Although a genetic origin is suspected, no specific mutation has been determined yet. Corticosteroids are the mainstay of the treatment during the acute attacks. However, in long-term follow-up the role of tonsillectomy is controversial. PATIENTS AND METHODS: A retrospective study of the pediatric cases diagnosed with the PFAPA syndrome was performed in our center during the last 4 years. RESULTS: Ten patients were diagnosed with the syndrome who received corticosteroids as the only treatment with improvement and favourable prognosis. CONCLUSION: PFAPA syndrome is the most common periodic fever disorder described in childhood whose genetic background has not been yet clarified. Our contribution with 10 patients further supports the common existence of this entity and the need to keep it in mind when having recurrent fevers.