Toxocariasis in migrant children: A 6 years' experience in a reference pediatric unit in Spain.

BACKGROUND: Toxocariasis is a worldwide distributed zoonosis that affects characteristically children. Clinical presentation is highly variable, often asymptomatic, and treatment duration is controversial. METHODS: A retrospective descriptive study (January 2014-December 2019) was performed in a referral Unit for Pediatric Tropical Diseases. Patients younger than 18 years of age diagnosed with toxocariasis were included. RESULTS: Out of 931 children screened for toxocariasis, 49 (5.3%) were seropositive. The median age was 11.0 years, 55.1% male and 30.6% referred contact with puppies. Overall, 34.7% were Latin-American, 24.5% Asiatic, 20.4% European, and 20.4% African. Only 34.7% presented symptoms, gastrointestinal the most common (52.9%). The 57.1% of children presented eosinophilia and 50% elevated total IgE. Most cases (95.9%) corresponded to covert toxocariasis. All children were treated with albendazole for 5, 14 or 21 days, and 4 children required a second course. Follow-up data were available in 32 children (65.3%) for a median of 7 months, showing a progressive decline in eosinophils, IgE-titers and ELISA optical density. CONCLUSION: Toxocariasis is mostly asymptomatic in children and eosinophilia is not always present. Serological tests should be included in migrant health screening and in the diagnostic assessment of eosinophilia. Eosinophil count, IgE-titers and ELISA optical-density could be useful during follow-up.

Imported malaria in children in Madrid, Spain, 2007-2013 / Malaria importada en niños en la Comunidad de Madrid, 2007-2013

Background: The majority of malaria cases diagnosed in Europe in the last few years have occurred in people living in non-endemic areas travelling back to their home country to visit friends and relatives (VFRs). Children account for 15-20% of imported malaria, with known higher risk of severe disease. Material and methods: A retrospective multicentre study was conducted in 24 hospitals in Madrid (Spain) including patients under 16 years diagnosed with malaria (2007-2013). Results: A total of 149 episodes in 147 children were reported. Plasmodium falciparum was the species most commonly isolated. Twenty-five patients developed severe malaria and there was one death related to malaria. VFR accounted for 45.8% of our children. Only 17 VFRs had received prophylaxis, and 4 of them taken appropriately. They presented more frequently with fever (98% vs. 69%), a longer time with fever (55 vs. 26%), delay in diagnosis of more than three days (62 vs. 37%), and more thrombocytopenia (65 vs. 33%) than non-VFRs, and with significant differences (p < 0.05). Conclusions: VFRs represent a large proportion of imported malaria cases in our study. They seldom took adequate prophylaxis, and delayed the visit to the physician, increasing the length of fever and subsequent delaying in diagnosis. Appropriate preventive measures, such as education and pre-travel advices should be taken in this population (AU)

Antecedentes: En los últimos años la mayoría de los casos de malaria en Europa se han producido en personas asentadas en zonas no endémicas que viajan a su país de origen para visitar a amigos y familiares (VFR). Los niños representan el 15-20% de la malaria importada, con el conocido alto riesgo de enfermedad grave. Material y métodos: Estudio multicéntrico retrospectivo en 24 hospitales en Madrid, que incluyó pacientes menores de 16 años con diagnóstico de malaria (2007-2013). Resultados: Se registraron 149 episodios en 147 niños. Plasmodium falciparum fue la especie más frecuentemente aislada. Veinticinco niños padecieron paludismo grave y hubo una muerte relacionada con la malaria. Los pacientes VFR representaron el 45,8% de nuestros niños estudiados. Solo 17 de los VFR habían recibido profilaxis y en solo 4 casos la tomaron apropiadamente. Estos pacientes presentaron con más frecuencia fiebre (98% vs 69%), retraso en el diagnóstico más de 3 días (62 vs 37%) y trombocitopenia (65 vs 33%). Conclusiones: Los niños VFR representaron una gran proporción de casos de paludismo importado en nuestro estudio. Rara vez tomaron la profilaxis de forma adecuada. Además estos niños presentaron un mayor retraso en la consulta al médico tras la aparición de síntomas, con el subsiguiente retraso en el diagnóstico. Es necesario tomar las medidas preventivas adecuadas, como la educación o el consejo pre-viaje, en esta población (AU)

Por la protección de la salud de los niños refugiados / For the health protection of refugee children

No disponible

¿Es posible tener dengue autóctono en España? / Is it possible to have autochthonous dengue fever in Spain?

No disponible

Adopción internacional en España: situación actual / International adoption in Spain: Current situation

No disponible

Alerta de rabia terrestre en España en 2013. Actuación pediátrica / Terrestrial rabies alert in Spain in 2013. Paediatric update

No disponible

Dengue importado: arbovirosis emergente en Espa˜na / Imported dengue: An emerging arbovirosis in Spain

El dengue es causado por uno de 4 serotipos del virus dengue. En España, solo se han comunicado casos importados. Las manifestaciones clínicas más frecuentes son fiebre y exantema, aunque puede haber formas graves, especialmente en infecciones secundarias. Presentamos a 5 niños con dengue no grave, infección primaria, diagnosticados por sospecha clínica y antecedente epidemiológico mediante inmunocromatografía y ELISA. Evolución favorable en todos los casos. Es importante considerar este diagnóstico en todo viajero internacional que presenta fiebre dentro de los 14 días tras volver de un área endémica, para un diagnóstico precoz, un adecuado tratamiento y un buen pronóstico

Dengue is caused by one of 4 serotypes of dengue virus. Only imported cases have been reported in Spain. The main clinical findings are fever and exanthema, although there may be severe forms, particularly in secondary infections. Five children with a primary, non severe dengue infection are presented. The diagnosis was based on clinical suspicion and epidemiological history, and confirmed by immunochromatography and ELISA tests. The outcome was favourable in all cases. It is important to consider this diagnosis in international travellers that present with fever within the 14 days of returning from an endemic area, in order to get an early diagnosis, adequate treatment and a good prognosis

[Imported dengue: an emerging arbovirosis in Spain]. / Dengue importado: arbovirosis emergente en España.

Dengue is caused by one of 4 serotypes of dengue virus. Only imported cases have been reported in Spain. The main clinical findings are fever and exanthema, although there may be severe forms, particularly in secondary infections. Five children with a primary, non severe dengue infection are presented. The diagnosis was based on clinical suspicion and epidemiological history, and confirmed by immunochromatography and ELISA tests. The outcome was favourable in all cases. It is important to consider this diagnosis in international travellers that present with fever within the 14 days of returning from an endemic area, in order to get an early diagnosis, adequate treatment and a good prognosis.

Interpretación de la prueba de tuberculina en niños con alteración de la inmunidad celular mediada por linfocitos CD4 / Interpretation of the tuberculin test in children with CD4 lymphocyte cell mediated immunity changes

La inmunosupresión puede ser causa de un falso negativo en la interpretación de la prueba de tuberculina (PT). Se realiza un estudio transversal en una población de niños adoptados e inmigrantes para analizar si la alteración de la inmunidad celular mediada por linfocitos CD4 puede modificar el resultado de la PT. Se incluyó a 1.074 niños (enero de 2003-diciembre de 2008). El estudio de subpoblaciones linfocitarias se efectuó en 884 niños. Un 5,3% tuvo valores de linfocitos CD4 < 25%. No existieron diferencias en el resultado de la PT entre niños con valores normales y patológicos de linfocitos CD4. Varios estudios, incluyendo nuestra serie, han demostrado que no existe una correlación directa entre el valor porcentual de linfocitos CD4 y el resultado de la PT. No obstante, estos resultados deberían confirmarse con series más numerosas y con un mayor porcentaje de niños con valores porcentuales de linfocitos CD4 < 25%

Immunosuppression could be a cause of a false negative tuberculin skin test (TST) result. A cross-sectional study was performed on a population of immigrants and internationally adopted children to analyse whether CD4 cell counts could modify the TST results. A total of 1074 children were included between January 2003 and December 2008. CD4 cell counts were performed on 884 children, in whom 5.3% had CD4 values <25%. There were no differences in TST results among children with normal and pathological CD4 cell counts. Several studies, including this one, have shown that there is no direct association between the CD4 value and the TST results. These results should be confirmed with larger series and with a higher percentage of children with CD4 values <25%

[Interpretation of the tuberculin test in children with CD4 lymphocyte cell mediated immunity changes]. / Interpretación de la prueba de tuberculina en niños con alteración de la inmunidad celular mediada por linfocitos CD4.

Immunosuppression could be a cause of a false negative tuberculin skin test (TST) result. A cross-sectional study was performed on a population of immigrants and internationally adopted children to analyse whether CD4 cell counts could modify the TST results. A total of 1074 children were included between January 2003 and December 2008. CD4 cell counts were performed on 884 children, in whom 5.3% had CD4 values <25%. There were no differences in TST results among children with normal and pathological CD4 cell counts. Several studies, including this one, have shown that there is no direct association between the CD4 value and the TST results. These results should be confirmed with larger series and with a higher percentage of children with CD4 values <25%.

Actualización en el diagnóstico y tratamiento de la malaria / Update in the diagnosis and treatment of malaria

En los últimos años estamos asistiendo a un aumento de la inmigración, de los niños viajeros y de adopción internacional, lo cual ha favorecido el resurgimiento de la malaria. Dado que la mortalidad asociada no es despreciable, resultan esenciales tanto el diagnóstico como el tratamiento precoz. Por otra parte, se han producido cambios terapéuticos importantes (nuevos fármacos, desarrollo de resistencias…). En este artículo se realiza una puesta al día y se recogen las nuevas recomendaciones siguiendo las directrices de las principales guías disponibles (OMS, CDC)(AU)

An increase in the cases of malaria in our country has been observed due to immigration, and adopted children. Malaria management requires an integrate approach, including prompt diagnoses and treatment to avoid the associated morbidity and mortality. In the last years, new recommendations have been introduced due to the appearance of new resistant areas. In this article we aim to provide a summary of the key recommendations following the main malaria guidelines (WHO and CDC)(AU)

[Update in the diagnosis and treatment of malaria]. / Actualización en el diagnóstico y tratamiento de la malaria.

An increase in the cases of malaria in our country has been observed due to immigration, and adopted children. Malaria management requires an integrate approach, including prompt diagnoses and treatment to avoid the associated morbidity and mortality. In the last years, new recommendations have been introduced due to the appearance of new resistant areas. In this article we aim to provide a summary of the key recommendations following the main malaria guidelines (WHO and CDC).

Síndrome de Frey: una entidad de diferenciar de la alergia alimentaria / Frey´s syndrome: an entity to differentiate from food allergy

El síndrome de Frey es una entidad benigna y autolimitada poco frecuente en la edad pediátrica. Se caracteriza por episodios recurrentes de eritema facial en el territorio de inervación del nervio auriculotemporal tras el inicio de la masticación. Presentamos el caso de una lactante de 8 meses que presenta eritema facial unilateral tras la ingesta de frutas. Es importante conocer este síndrome para un diagnóstico correcto y precoz durante la infancia, evitando de este modo la realización de pruebas diagnosticadas no indicadas, la prescripción de dieta de exclusión innecesarias y asegurando la tranquilidad de los padres (AU)

Frey´s syndrome is a benign and self-limited entity, which is rare in children. It´s characterized by recurrent episodies of facial flushing after the mastication, over the distribution of the auriculotemporal nerve. We report a 8 months old girl with unilateral facial flushing after fruits intake. It´s important to know this syndrome for accurate and early diagnosis, avoiding additional test, innecessaries exclusion diet and reassuring parents (AU)

"Consenso en adopción internacional. Guía para pediatras y otros profesionales sanitarios". Resumen estructurado / No disponible

Se presenta un resumen estructurado del documento “Consenso en adopción internacional.Guía para pediatras y otros profesionales sanitarios” publicado en noviembre de 2005. Elresumen presentado trata de ser una muestra representativa del conjunto del documentooriginal y reflejar con fidelidad su contenido y propósitos.La adopción internacional ha aumentado en nuestro entorno de forma extraordinaria.En el período de tiempo de 1997 a 2004 han llegado a nuestro país 24.042 niños procedentesde 49 países. Los niños adoptados en el extranjero tienen mayor riesgo de presentar problemasde salud. El viaje y la estancia en el extranjero implican riesgos adicionales. Se describenel contenido de la consulta preadoptiva y las recomendaciones para llevar a cabo una evaluacióncompleta tras la llegada del niño desde su lugar de origen a su nueva familia. También sedestaca la necesidad de hacer un seguimiento longitudinal a largo plazo

We present a structured summary of the document “Consensus on international adoption.Guidelines for paediatricians and other health professionals” published on November2005. The summary presented tries to be a representative sample of the whole original documentand to reflect its contents and proposals with fidelity. International adoption hasincreased in an extraordinary way in our country. Between 1997 and 2004, 24042 childrenfrom 49 countries have arrived. Children adopted abroad have an increased risk of presentingwith health problems. The journey and stay abroad implies additional risks. We describethe contents of the preadoptive medical visit and recommendations for making acomplete evaluation after the arrival of the child from his/her country of origin to the newfamily. We also stress the need of undertaking a long follow up