Clinical manifestations associated with acute viral gastroenteritis pathogens among pediatric patients in Qatar

Background: Acute viral gastroenteritis is a disorder that affects children globally but mostly in developing countries. Adenoviruses, rotaviruses, and noroviruses are the leading viral causes of childhood gastroenteritis. Objectives: This study is the first to investigate the frequency of these viruses in diarrheal samples from pediatric patients living in central Iran. Methods: A total of 173 samples of pediatric diarrhea, from May 2015 to May 2016, were included in this descriptive cross-sectional study. The samples were analyzed using in-house developed PCR and reverse transcription (RT)-PCR methods to investigate the frequency of adenoviruses, rotaviruses, and noroviruses. Results: Out of 173 samples of pediatric diarrhea, eight were shown to contain enteric viruses (4.6%): (1) four with adenoviruses (2.3%); (2) three with rotaviruses (1.7%); and (3) one with a genogroup II norovirus (0.6%). Most of the positive samples were obtained from children under the age of seven. The most common additional clinical symptoms in pediatric patients with viral agents were fever, vomiting, and abdominal pain. Conclusions: In central Iran, adenoviruses and rotaviruses were rarely found as agents responsible for gastroenteritis. Although viral gastroenteritis in this area had less frequency than bacterial gastroenteritis, we need to monitor all enteropathogenic agents for longer periods to understand better real endemicity and the possibility of unexpected viral enteritis outbreaks.

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Low Endemic Frequency of Adenovirus, Rotavirus and Norovirus in Pediatric Diarrhea Samples from Central Iran

10.21203/rs.3.rs-17963/v1 ◽

2020 ◽

Author(s):

Elnaz Abbasi ◽

Mahdieh Mondanizadeh ◽

Alex van Belkum ◽

Ehsanollah Ghaznavi-Rad

Keyword(s):

Pediatric Patients ◽

Clinical Symptoms ◽

Cross Sectional Study ◽

Central Iran ◽

Viral Gastroenteritis ◽

Cross Sectional ◽

Bacterial Gastroenteritis ◽

Viral Enteritis ◽

Acute Viral Gastroenteritis ◽

Term Monitoring

Abstract Background: Acute viral gastroenteritis is a disorder that affects children on a worldwide scale but mostly in developing countries. Adenoviruses, rotaviruses, and noroviruses are the major viral cause of childhood gastroenteritis. This study is the first to investigate the prevalence of these viruses in diarrhea samples from pediatric patients living in central Iran.Methods: A total of 173 samples of pediatric diarrhea, from May 2015 to May 2016, was included in this descriptive cross-sectional study. The samples were analyzed using in-house developed PCR and reverse transcription (RT) -PCR methods to investigate the prevalence of adeno-, rota- and noroviruses. Results: Out of 173 samples of pediatric diarrhea, eight were shown to contain enteric viruses (4.6%): four of these were adenovirus (2.3%), three were rotavirus (1.7%), and one represented a genogroup II norovirus (0.6%). Most of the positive samples were obtained from children under the age of seven. The most common additional clinical symptoms in pediatric patients with viral agents were fever, vomiting, and abdominal pain. Conclusions: Adenovirus and rotavirus were rarely found as agents responsible for gastroenteritis in central Iran. Although we show that the frequency of viral gastroenteritis is low in this area compared to bacterial gastroenteritis, still longer-term monitoring of all enteropathogenic agents should provide a deeper understanding of the real endemicity and the possible occurrence of unexpected outbreaks of viral enteritis.

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766. Everything Old is New Again-A Case Series of New World Leishmaniasis in African Children in Portland, Maine

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.956 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S428-S428

Author(s):

Jennifer Jubulis ◽

Amanda Goddard ◽

Elizabeth Seiverling ◽

Marc Kimball ◽

Carol A McCarthy

Keyword(s):

Latin America ◽

Cutaneous Leishmaniasis ◽

New World ◽

Pediatric Patients ◽

Data Extraction ◽

Clinical Manifestations ◽

Case Series ◽

Surgical Excision ◽

Skin Lesions ◽

Travel History

Abstract Background Leishmaniasis has many clinical manifestations and treatment regimens, dependent on species and host. Old world leishmaniasis is found primarily in Africa and Asia, and is associated with visceral disease, while new world disease, seen primarily in Latin America, is more commonly mucocutaneous. We present a case series of pediatric African patients with New World cutaneous leishmaniasis (NWCL). Methods Data extraction was performed via chart review, analyzing travel history, clinical presentation, diagnosis, and management in children with cutaneous leishmaniasis presenting to the pediatric infectious diseases clinic in Portland, ME. Biopsy specimens were sent to the federal CDC for identification by PCR and culture. Results Five cases of NWCL were diagnosed in pediatric patients in Maine from November 2018 through February 2020. Median age of patients was 10 years (range 1.5-15 years). Four cases (80%) occurred in children from Angola or Democratic Republic of Congo, arriving in Maine via Central/South America, with one case in a child from Rwanda who arrived in Maine via Texas. Three patients had multiple skin lesions and two had isolated facial lesions. Leishmaniasis was not initially suspected resulting in median time to diagnosis of 5 months (range 1-7 months). Four patients were initially treated with antibacterials for cellulitis and one was treated with griseofulvin. After no improvement, patients underwent biopsy with 2 patients diagnosed with L panamensis, 1 with L braziliensis, 1 with mixed infection (L panamensis and L mexicana), and 1 with Leishmania species only. One patient was managed with surgical excision, 3 with ketoconazole, and 1 was observed off therapy. Four patients were referred to otolaryngology. All continue to be followed in infectious disease clinic. Conclusion We present five cases of new world cutaneous leishmaniasis in African pediatric patients arriving to Maine through Latin America or Texas. Patients were diagnosed with cellulitis, tinea corporis or atopic dermatitis initially, underscoring importance of high index of suspicion in migrant patients. Detailed travel history and epidemiologic knowledge is essential to diagnosis, as patients may present with illness not congruent with country of origin. Optimal therapy remains unclear. Disclosures All Authors: No reported disclosures

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Hypophosphatasia: A Unique Disorder of Bone Mineralization

International Journal of Molecular Sciences ◽

10.3390/ijms22094303 ◽

2021 ◽

Vol 22 (9) ◽

pp. 4303

Author(s):

Juan Miguel Villa-Suárez ◽

Cristina García-Fontana ◽

Francisco Andújar-Vera ◽

Sheila González-Salvatierra ◽

Tomás de Haro-Muñoz ◽

...

Keyword(s):

Alkaline Phosphatase ◽

Genetic Disease ◽

Therapeutic Strategy ◽

Pediatric Patients ◽

Bone Mineralization ◽

Clinical Manifestations ◽

Allelic Heterogeneity ◽

Specific Enzyme ◽

Inorganic Pyrophosphate ◽

Enzyme Replacement

Hypophosphatasia (HPP) is a rare genetic disease characterized by a decrease in the activity of tissue non-specific alkaline phosphatase (TNSALP). TNSALP is encoded by the ALPL gene, which is abundantly expressed in the skeleton, liver, kidney, and developing teeth. HPP exhibits high clinical variability largely due to the high allelic heterogeneity of the ALPL gene. HPP is characterized by multisystemic complications, although the most common clinical manifestations are those that occur in the skeleton, muscles, and teeth. These complications are mainly due to the accumulation of inorganic pyrophosphate (PPi) and pyridoxal-5′-phosphate (PLP). It has been observed that the prevalence of mild forms of the disease is more than 40 times the prevalence of severe forms. Patients with HPP present at least one mutation in the ALPL gene. However, it is known that there are other causes that lead to decreased alkaline phosphatase (ALP) levels without mutations in the ALPL gene. Although the phenotype can be correlated with the genotype in HPP, the prediction of the phenotype from the genotype cannot be made with complete certainty. The availability of a specific enzyme replacement therapy for HPP undoubtedly represents an advance in therapeutic strategy, especially in severe forms of the disease in pediatric patients.

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The Specific Characteristics in Children with Obstructive Sleep Apnea and Cor Pulmonale

The Scientific World JOURNAL ◽

10.1100/2012/757283 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Pi-Chang Lee ◽

Betau Hwang ◽

Wen-Jue Soong ◽

C. C. Laura Meng

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pediatric Patients ◽

Pediatric Population ◽

Clinical Manifestations ◽

Cor Pulmonale ◽

Arousal Index ◽

Obstructive Sleep ◽

Hemodynamic Characteristics ◽

Pulmonary Arterial

Background.The prevalence of obstructive sleep apnea (OSA) in the pediatric population is currently estimated at 1-2% of all children. The purpose of this study was to investigate the clinical and hemodynamic characteristics in pediatric patients with cor pulmonale and OSA.Methods.Thirty children with the diagnosis of OSA were included. These patients consisted of 26 male and 4 female children with a mean age of 7 ± 4 years old. Five of those children were found to be associated with cor pulmonale, and 25 had OSA but without cor pulmonale.Results.The arousal index was much higher in children with OSA and cor pulmonale. The children with OSA and cor pulmonale had much lower mean and minimal oxygen saturation and a higher incidence of bradycardia events. All 5 patients with OSA and cor pulmonale underwent an adenotonsillectomy, and the pulmonary arterial pressure dropped significantly after the surgery.Conclusion.This study demonstrated that the OSA pediatric patients with cor pulmonale had the different clinical manifestations and hemodynamic characteristics from those without cor pulmonale. The adenotonsillectomy had excellent results in both the OSA pediatric patients with and without cor pulmonale.

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A Clinico-Epidemiological Comparison Study of Pediatric Acute Viral Gastroenteritis at a Tertiary Care Hospital

Annals of Clinical Microbiology ◽

10.5145/acm.2016.19.2.33 ◽

2016 ◽

Vol 19 (2) ◽

pp. 33

Author(s):

Bo Hyun Kim ◽

Tae-Hyoung Kim ◽

Mi-Kyung Lee

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Viral Gastroenteritis ◽

Care Hospital ◽

Comparison Study ◽

Acute Viral Gastroenteritis

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Acute Megakaryocytic Leukemia with or Without Acquired Trisomy 21 in 15 Pediatric Patients

10.21203/rs.3.rs-107199/v1 ◽

2020 ◽

Author(s):

Wenzhi ZHANG ◽

Hui LI ◽

Jingzhen LIU ◽

Jiawei XU ◽

Jinjin HAO ◽

...

Keyword(s):

Trisomy 21 ◽

Poor Prognosis ◽

Clinical Characteristics ◽

Pediatric Patients ◽

Laboratory Data ◽

Clinical Manifestations ◽

The Other ◽

Hematopoietic Stem ◽

Acute Megakaryocytic Leukemia

Abstract The knowledge of clinical characteristics and prognosis of pediatric acute megakaryocytic leukemia (AMKL) with or without acquired +21 was limited. We reported 15 AMKL pediatric patients without Down Syndrome (four cases with acquired +21 and 11 cases without acquired +21) with the clinical manifestations, laboratory data, and prognosis. The clinical features and laboratory data between patients with acquired +21 and patients without acquired +21 are similar. As for prognosis, three of the 11 cases without acquired +21 obtained complete remission (CR) after 1st induction. The median follow-up time of the 11 cases was 9 months. Among four cases with acquired +21, one case gave up treatment during 1st induction, one obtained CR after 1st induction and was still alive after 49 months of follow-up. One case obtained CR after 2nd induction and was still alive for 15 months of follow-up after bone marrow transplantation, the other patient was planning for allogeneic hematopoietic stem cell transplantation (HSCT) without CR. The median follow-up time of the four cases was 12 months. None relapsed in our study. In conclusion, acquired trisomy 21 may not be an indicator for poor prognosis. Cytogenetics analysis can help us for diagnosis stratification, prognostic judgment and individualized treatment of AMKL.

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Alveolar Echinococcosis in Children

Case Reports in Pediatrics ◽

10.1155/2020/5101234 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Emilija Jonaitytė ◽

Martynas Judickas ◽

Eglė Tamulevičienė ◽

Milda Šeškutė

Keyword(s):

Surgical Treatment ◽

Current Literature ◽

Echinococcus Multilocularis ◽

Cystic Echinococcosis ◽

Alveolar Echinococcosis ◽

Pediatric Patients ◽

Treatment Options ◽

Clinical Manifestations ◽

Diagnostic Methods

Alveolar echinococcosis (AE) is an infectious zoonotic disease that is caused by Echinococcus multilocularis. The disease is generally identified accidentally because of the long asymptomatic period, has a malignant behaviour, and mainly occurs in the liver. Usually it is diagnosed in adults and is very rare in pediatric patients. We report two cases of AE and 1 differential case between AE and cystic echinococcosis (CE) in children: two of them had lesions in the liver and one had rare extrahepatic presentation of a cyst in the spleen. All our patients received chemotherapy with albendazole because surgical treatment was not recommended. The children were followed-up from 10 to 30 months and no significant improvement was seen. In this report we discuss the difficulties we faced in the treatment and follow-up of these patients. We also review the main clinical manifestations, general diagnostic methods, and treatment options of AE according to the current literature.

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