ENTEROVIRAL MENINGITIS IN VERY YOUNG INFANTS

PEDIATRICS ◽  
1967 ◽  
Vol 40 (4) ◽  
pp. 617-626
Author(s):  
Alan G. Nogen ◽  
Martha L. Lepow
Keyword(s):  
General Hospital ◽  
Young Infant ◽  
Neurologic Examination ◽  
Young Infants ◽  
Normal Glucose ◽  
Enteroviral Meningitis ◽  
Csf Findings

Enteroviral meningitis was studied in five infants less than 6 weeks of age. Eight additional cases of suspected enteroviral meningitis from the Cleveland Metropolitan General Hospital were reviewed with regard to symptoms, CSF findings, neurologic examination, prognosis, and epidemiology. The entity of enteroviral meningitis should be considered in and viral cultures obtained from any young infant when examination of the CSF reveals a pleocytosis, normal glucose, and absence of organisms on Gram's stain and culture.

INTRAPERICARDIAL TERATOMA: A CAUSE OF ACUTE PERICARDIAL EFFUSION IN INFANCY

PEDIATRICS ◽  
1969 ◽  
Vol 43 (1) ◽  
pp. 71-78
Author(s):  
James L. Reynolds ◽  
John K. Donahue ◽  
Charles W. Pearce
Keyword(s):  
Pericardial Effusion ◽  
Clinical Features ◽  
Personal Experience ◽  
Young Infant ◽  
Early Infancy ◽  
Cardiac Tumors ◽  
Young Infants

On the basis of personal experience with two patients and a review of the 35 previously reported cases, we described the pathologic and clinical features of intrapericardial teratoma. This tumor is single, large, encapsulated, multicystic, and pedunculated. It is attached by a short fibrous stalk or pedicle to the adventitia of one or both great arteries. Only 2 of the 37 intrapericardial teratomas were malignant. The tumor is found predominantly in children, usually during early infancy, and among cardiac tumors of childhood it is second only to rhabdomyoma in frequency. Acute or chronic pericardial effusion commonly accompanies the teratoma. All young infants reported have had acute pericardial effusion with tamponade. Typically, the associated fluid is serous, sterile, copious, and recurrent; it usually obscures the presence of the tumor. Intrapericardial teratoma is a likely diagnosis in any young infant having such penicardial effusion; other cardiac tumors do not have these clinical features. Artificial pneumopericardium will demonstrate the teratoma, and operation is curative if the tumor is benign. Uncontrollable bleeding from the aorta on dissection of the tumor stalk has been an operative hazard; but, if anticipated, it can be avoided.

THE HISTIDINE REQUIREMENT OF THE INFANT

PEDIATRICS ◽  
1963 ◽  
Vol 31 (5) ◽  
pp. 786-801
Author(s):  
Selma E. Snyderman ◽  
Audrey Boyer ◽  
Ellen Roitman ◽  
L. Emmett Holt ◽  
Philip H. Prose
Keyword(s):  
Weight Gain ◽  
Amino Acid ◽  
Essential Amino Acid ◽  
Young Infant ◽  
Nitrogen Retention ◽  
Sebaceous Glands ◽  
Young Infants

Histidine appears to be an essential amino acid for the young infant. Its omission from the diets of young infants gives rise to a depression of weight gain and of nitrogen retention. It also resulted in a dermatitis clinically and pathologically similar to infantile eczema, except for the absence of pruritus and atrophic changes in the sebaceous glands. Under the conditions of this study, the histidine requirement was less than 35 mg/kg/day in all six infants tested with this intake. Five infants were given a trial of 22 mg/kg/day; in three this figure was satisfactory, but in the remaining two there was some evidence of inadequacy. An intake of 16.6 mg/kg/day appeared to be adequate for one infant.

scholarly journals Clinical characteristics of enteroviral meningitis without pleocytosis in children: a retrospective single center observational study in the Republic of Korea

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yura Ko ◽  
Woochan Jeon ◽  
Minjung Kathy Chae ◽  
Heewon Yang ◽  
Jisook Lee
Keyword(s):  
Lumbar Puncture ◽  
Age Groups ◽  
Rt Pcr ◽  
Young Infants ◽  
Younger Age ◽  
Confirmation Test ◽  
Csf Pleocytosis ◽  
The Republic ◽  
Enteroviral Meningitis ◽  
Wbc Count

Abstract Background We aimed to study the prevalence of enterovirus (EV) meningitis without the presence of cerebrospinal fluid (CSF) pleocytosis and identify patient factors and clinical features associated with it. Methods This was a retrospective analysis of patients aged < 18 years old who were diagnosed with EV meningitis by CSF reverse-transcriptase polymerase chain reaction (RT-PCR) testing between January 2015 and December 2016. Clinical variables were compared with regard to the presence of CSF pleocytosis. Results A total of 305 patients were enrolled in study; 169 (55.4%) had no pleocytosis. Patients without pleocytosis were younger (median age 2 months vs. 67.0 months, p < 0.01) and had lower white blood cell (WBC) count (median, 8600/mm3 vs. 10,300/mm3, p < 0.01). Also absolute neutrophil (ANC) count were lower than pleocytosis group (median, 4674/mm3 vs. 7600/mm3, p < 0.01). Comparing three age groups, CSF apleocytosis was present in 106 of 128 patients (82.8%) aged ≤3 months, 7 of 13 patients (53.8%) aged 3 months–3 years and 56 of 164 patients (34.1%) aged > 3 years. Younger age groups had higher prevalence of CSF apleocytosis (p < 0.01). In patients aged ≤3 months, 94.5% underwent lumbar puncture within 24 h of symptom onset. The frequency of not having pleocytosis was higher than the frequency of having pleocytosis during peak EV infection prevalent months (summer and fall) (p < 0.01). Conclusion This study shows that EV meningitis in young infants, with early lumbar puncture, or occurring during peak EV meningitis prevalent seasons cannot be solely excluded by pleocytosis. Also, a confirmation test for EV meningitis should be performed using RT-PCR.

scholarly journals Systems vaccinology: a promise for the young and the poor

2015 ◽  
Vol 370 (1671) ◽  
pp. 20140340 ◽  
Author(s):  
Nelly Amenyogbe ◽  
Ofer Levy ◽  
Tobias R. Kollmann
Keyword(s):  
Host Response ◽  
Young Infant ◽  
Vaccine Effectiveness ◽  
Small Sample ◽  
Vulnerable Population ◽  
Childhood Vaccination ◽  
Molecular Networks ◽  
Young Infants ◽  
The Poor ◽  
The World

As a child, the risk of suffering and dying from infection is higher the younger you are; and higher, the less developed a region you are born in. Childhood vaccination programmes have greatly reduced mortality around the world, but least so for the very young among the very poor of the world. This appears partly owing to suboptimal vaccine effectiveness. Unfortunately, although most vaccines are administered to the newborn and very young infant (less than or equal to two months), we know the least about their host response to vaccination. We thus currently lack the knowledge to guide efforts aimed at improving vaccine effectiveness in this vulnerable population. Systems vaccinology, the study of molecular networks activated by immunization, has begun to provide unprecedented insights into mechanisms leading to vaccine-induced protection from infection or disease. However, all published reports of systems vaccinology have focused on either adults or at most children and older infants, not those most in need, i.e. newborns and very young infants. Given that the tools of systems vaccinology work perfectly well with very small sample volumes, it is time we deliver the promise that systems vaccinology holds for those most in need of vaccine-mediated protection from infection.

Enteroviral meningitis without pleocytosis in children

2012 ◽  
Vol 97 (10) ◽  
pp. 874-878 ◽  
Author(s):  
Ki Wook Yun ◽  
Eun Hwa Choi ◽  
Doo Sung Cheon ◽  
Jina Lee ◽  
Chang Won Choi ◽  
...  
Keyword(s):  
Multiple Logistic Regression Analysis ◽  
Age Group ◽  
Clinical Factors ◽  
Blood Cell Count ◽  
Multivariate Models ◽  
Reverse Transcription Pcr ◽  
Young Infants ◽  
Younger Age ◽  
Csf Pleocytosis ◽  
Enteroviral Meningitis

ObjectivesThis study aims to describe the clinical characteristics of enteroviral meningitis in association with the absence of cerebrospinal fluid (CSF) pleocytosis.DesignThis was a retrospective analysis of databases of patients diagnosed with enteroviral meningitis by CSF reverse transcription-PCR testing. Presence of CSF non-pleocytosis at each age group was analysed by use of the two criteria. Clinical variables were compared with regard to the presence of CSF pleocytosis. Multiple logistic regression analysis was used to identify factors that were associated with CSF pleocytosis.SettingTwo hospitals in South Korea, between January 2008 and August 2011.Patients390 infants and children with enteroviral meningitis.InterventionsNone.Main outcome measuresProportion of enteroviral meningitis without CSF pleocytosis.ResultsAmong the 390 patients with enteroviral meningitis, 16–18% did not have CSF pleocytosis. In particular, CSF pleocytosis was not present in 68–77% of the neonates with enteroviral meningitis, demonstrating that the proportion of CSF pleocytosis decreased significantly with age (p<0.001). In multivariate models, younger age (adjusted OR 0.981; 95% CI 0.973 to 0.989), lower peripheral white blood cell count (adjusted OR 0.843; 95% CI 0.791 to 0.899), and shorter interval between onset and lumbar puncture (adjusted OR 0.527; 95% CI 0.315 to 0.882) were associated with the absence of CSF pleocytosis in enteroviral meningitis.ConclusionsThis study demonstrated high proportion of non-pleocytic enteroviral meningitis in young infants and identified several clinical factors that contributed to the absence of CSF pleocytosis. We suggest that CSF enterovirus PCR testing is likely to detect more cases of enteroviral meningitis, especially in young infants.

scholarly journals Spiral Fracture in Young Infant Causing a Diagnostic Dilemma: Nutritional Rickets versus Child Abuse

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Sonia Kaushal ◽  
Manish Raisingani ◽  
Raphael David ◽  
Bina Shah
Keyword(s):  
Vitamin D ◽  
Young Infant ◽  
Vitamin D Supplementation ◽  
Psychosocial Assessment ◽  
Diagnostic Dilemma ◽  
Elevated Alkaline Phosphatase ◽  
Spiral Fracture ◽  
Nutritional Rickets ◽  
Young Infants ◽  
Vitamin D Levels

Fractures are uncommon in young, nonambulatory infants. The differential diagnosis includes nonaccidental injury (NAI) and metabolic bone disease, including rickets. While rickets typically present after six months of age, multiple cases have been reported in younger infants. We report a case of an 11-week-old male infant who presented with a spiral fracture of the humerus and no radiologic evidence of rickets. A detailed psychosocial assessment failed to reveal any risk factors for NAI. The patient had elevated alkaline phosphatase and PTH with low 25 hydroxyvitamin D and 1,25 dihydroxyvitamin D levels. Additionally, the mother was noncompliant with prenatal vitamins, exclusively breastfeeding without vitamin D supplementation, and had markedly low vitamin D levels 15 weeks postpartum. The biochemical data and history were consistent with rickets. Given the diagnostic dilemma, the working diagnosis was rickets and the patient was started on ergocalciferol with subsequent normalization of his laboratory values and healing of the fracture. These findings are consistent with nutritional rickets largely due to maternal-fetal hypovitaminosis D. This case highlights that in young infants rickets should be considered even in the absence of positive radiologic findings. Additionally, it illustrates the importance of maintaining adequate vitamin D supplementation during pregnancy and early infancy.

scholarly journals Group B Streptococcus vaccine development: present status and future considerations, with emphasis on perspectives for low and middle income countries

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2355 ◽  
Author(s):  
Miwako Kobayashi ◽  
Johan Vekemans ◽  
Carol J. Baker ◽  
Adam J. Ratner ◽  
Kirsty Le Doare ◽  
...  
Keyword(s):  
At Risk ◽  
Disease Burden ◽  
Vaccine Development ◽  
Young Infant ◽  
Group B Streptococcus ◽  
Current Status ◽  
Middle Income ◽  
Young Infants ◽  
Group B ◽  
Low And Middle Income

Globally, group BStreptococcus(GBS) remains the leading cause of sepsis and meningitis in young infants, with its greatest burden in the first 90 days of life. Intrapartum antibiotic prophylaxis (IAP) for women at risk of transmitting GBS to their newborns has been effective in reducing, but not eliminating, the young infant GBS disease burden in many high income countries. However, identification of women at risk and administration of IAP is very difficult in many low and middle income country (LMIC) settings, and is not possible for home deliveries. Immunization of pregnant women with a GBS vaccine represents an alternate pathway to protecting newborns from GBS disease, through the transplacental antibody transfer to the fetus in utero. This approach to prevent GBS disease in young infants is currently under development, and is approaching late stage clinical evaluation.This manuscript includes a review of the natural history of the disease, global disease burden estimates, diagnosis and existing control options in different settings, the biological rationale for a vaccine including previous supportive studies, analysis of current candidates in development, possible correlates of protection and current status of immunogenicity assays. Future potential vaccine development pathways to licensure and use in LMICs, trial design and implementation options are discussed, with the objective to provide a basis for reflection, rather than recommendations.

Clinical and Analytical Characteristics and Short-Term Evolution of Enteroviral Meningitis in Young Infants Presenting With Fever Without Source

2012 ◽  
Vol 28 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Borja Gomez ◽  
Santiago Mintegi ◽  
Mari Cruz Rubio ◽  
Diego Garcia ◽  
Silvia Garcia ◽  
...  
Keyword(s):  
Short Term ◽  
Young Infants ◽  
Term Evolution ◽  
Enteroviral Meningitis

Double switch operation in a young infant

2004 ◽  
Vol 14 (6) ◽  
pp. 661-663 ◽  
Author(s):  
Nobuyuki Ishibashi ◽  
Mitsuru Aoki ◽  
Tadashi Fujiwara
Keyword(s):  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Arterial Switch Operation ◽  
Young Infant ◽  
Severe Tricuspid Regurgitation ◽  
Young Infants ◽  
Switch Operation ◽  
Double Switch ◽  
Congenitally Corrected Transposition ◽  
Corrected Transposition

We performed a combined Senning and arterial switch operation on a 2-month-old patient with congenitally corrected transposition, Ebstein's malformation producing severe tricuspid regurgitation, ventricular septal defect, pulmonary hypertension, and congestive heart failure. The tricuspid regurgitation was improved. The double switch operation has the advantage of improving the function of the systemic atrioventricular valve, especially in newborns or young infants in whom the outcome of the valvar repair is poor.

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