Pyogenic Arthritis of the Sacroiliac Joint in Pediatric Patients

PEDIATRICS ◽  
1980 ◽  
Vol 66 (3) ◽  
pp. 375-379
Author(s):  
Urs B. Schaad ◽  
George H. McCracken ◽  
John D. Nelson
Keyword(s):  
Pediatric Patients ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Etiologic Agent ◽  
Cast Immobilization ◽  
Radiographic Findings ◽  
Pyogenic Sacroiliitis ◽  
Bone Scans ◽  
Adequate Management

Clinical manifestations, diagnostic studies, and management of pyogenic sacroiliitis were reviewed in 77 pediatric patients. This infection occurs primarily in late childhood, is more common in boys, and has a subacute onset in about two thirds of cases. Recognition of the characteristic signs and symptoms of sacroiliac involvement coupled with radioisotope bone scanning substantially reduces the delay in correct diagnosis that averaged 3.9 weeks in all patients (4.8 weeks in those without and 1.7 weeks in those with bone scans performed). Joint aspiration under biplane fluoroscopic control and culture of the aspirated material is indicated in establishing the specific etiologic agent which is Staphylococcus aureus in most cases. Adequate management of pyogenic sacroiliitis consists of appropriately monitored antibiotic treatment and, if present, evacuation of pus. The use of spica cast immobilization offers no apparent beneficial effect. Indications for surgery include drainage of pus and removal of sequestered bone. With adequate management the prognosis of suppurative sacroiliitis in pediatric patients is excellent, despite persistent abnormal radiographic findings in most patients.

Clinical Characteristics of Pediatric Patients with Ocular Toxocariasis in China

2016 ◽  
Vol 235 (2) ◽  
pp. 97-105 ◽  
Author(s):  
Yalu Liu ◽  
Qi Zhang ◽  
Jing Li ◽  
Xunda Ji ◽  
Yu Xu ◽  
...  
Keyword(s):  
Rural Areas ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Age Of Onset ◽  
Age Groups ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Enzyme Linked Immunosorbent Assay ◽  
Ocular Toxocariasis

Objective: The aim of the study was to analyze the clinical characteristics of pediatric patients with ocular toxocariasis. Methods: Ocular toxocariasis was diagnosed and treated in 46 children from Shanghai and surrounding provinces. The diagnosis of ocular toxocariasis was confirmed immunologically by performing an enzyme-linked immunosorbent assay on serum and/or intraocular fluid. All pediatric patients and their guardians completed a questionnaire concerning their cases and living habits. Results: The mean age of onset was 6 ± 3 years. Most children (85%) resided in rural areas, and 91% of the children had contact with adult dogs or puppies. At the first visit, visual acuity (VA) was <20/200 in 36 cases, and we detected peripheral granuloma in 36 patients. In our study, the most common signs were vitritis, vitreous strands, and tractional retinal detachment. The Optomap 200Tx device detected granuloma with an 85% sensitivity, which is much higher than that of other techniques. We treated 40 cases (87%) with topical corticosteroids, while 28 patients (61%) were treated with systemic corticosteroids. Only 18 children (39%) required surgical intervention. All patients were examined and treated by the same ophthalmologists. Conclusions: Preschool children in China are more often affected by toxocariasis compared with other age groups. The most common signs included unilateral granuloma and ocular inflammation. In our study, clinical manifestations were severe and complicated. At the first visit, VA was <20/200 in most patients. Ocular toxocariasis was diagnosed on the basis of clinical signs and symptoms; the diagnosis was confirmed by immunological testing. Techniques using the Optomap 200Tx device can facilitate the early detection and lead to better visual prognosis.

scholarly journals Multisystem inflammatory syndrome in children associated with COVID-19: nursing care

2021 ◽  
Vol 11 (2) ◽  
pp. 10-17
Author(s):  
Sofia Panato Ribeiro ◽  
Simone Boettcher
Keyword(s):  
Nursing Care ◽  
Pediatric Patients ◽  
Quality Care ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Viral Disease ◽  
Provide Quality Care ◽  
Generalized Lymphadenopathy ◽  
Inflammatory Syndrome

In 2019, a new viral disease, known as SARS-Cov-2 infection, was identified. Scientists believed that it was a disease with low morbidity for pediatric patients; however, a small percentage of children infected with the new coronavirus developed a multisystem inflammatory response, which aroused the interest of many researchers and health professionals. The objective of the study is to describe the main characteristics related to the Pediatric Multisystemic Inflammatory Syndrome Associated with Covid-19 (MIS-C), its complications and nursing care. The main clinical manifestations of MIS-C are hyperthermia, gastrointestinal symptoms, skin manifestations, generalized lymphadenopathy, cardiac and neurological disorders. The main nursing care was listed according to the signs and symptoms, such as monitoring of neurological and hydroelectrolytic changes. The nurse professional must add knowledge about MIS-C so that he is able to qualify his care and improve his skills to provide quality care to pediatric patients.

scholarly journals New coronavirus infection in children in the Moscow region: clinical, epidemiological and treatment aspects

2020 ◽  
Vol 49 ◽  
Author(s):  
E. R. Meskina ◽  
M. K. Khadisova ◽  
T. V. Stashko ◽  
A. V. Bitsueva
Keyword(s):  
Pediatric Patients ◽  
Respiratory Infections ◽  
Severe Disease ◽  
Age Distribution ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Generation Cephalosporin ◽  
Moscow Region ◽  
Epidemiological Characteristics

Aim: To assess clinical and epidemiological characteristics, as well as treatment results in COVID-19 pediatric patients hospitalized to the Department of infectious disease in the Moscow region.Materials and methods: We retrospectively analyzed medical records of 124 pediatric patients aged from 1 month to 17 years with confirmed (63.7%) and highly probable (proven epidemiological association with the infection source) COVID-19 infection. The children were hospitalized from March 25, 2020 to August 11, 2020. Among patients that were hospitalized during this time period, 43% had pneumonia and 30% had acute respiratory disorders. All cases of pneumonia were confirmed by computed tomography. The children were treated according to the standard Russian guidelines.Results: The children had been infected with SARS-CoV-2 mostly from family members (75%; 95% confidence interval (CI) 66.4–82.3). In the families of the children with pneumonia, the number of pneumonia cases in their relatives was higher than in the families of the children with acute respiratory infections (1.7±1.0 vs. 1.1±0.5 respectively; р<0.001). The mean age of the hospitalized children was 8 years (7.4–9.6), with an even age distribution. The main COVID-19 signs and symptoms were as follows: fever (75.8%; 95% CI 67.3–83.0), cough (66.1%; 95% CI 57.1–74.4]), fatigues (38.7%; 95% CI 30.1–47.9), and hyposmia (33.9%; 95% CI 25.6–42.9). The severe disease course was rare (2.4%; 95% CI 0.5–6.9). The rates of positive reverse transcriptase polymerase chain reaction tests for SARS-CoV-2 were rapidly decreased at repeated tests: at day 3, 63.7% of the tests were positive, at day 7, 21.8% and at day 14, 5.6% (р<0.001). The prevalence of pneumonia was 56.4% without any age differences, with mostly minimal areas of lung abnormalities (78.6%). The severity of pneumonia and duration of clinical manifestations in the patients treated with a III generation cephalosporin or its combination with a macrolide were similar. Cough duration in those, who were treated with ipratropium bromide /fenoterol inhalations including their combination with budesonide, was higher than in those who did not use inhalation treatment. Pyrexia of>5 days duration can be a predictor of pneumonia in a  pediatric patient with COVID-19 (odds ratio 4.55 (2.1–9.9), sensitivity 61.4%, specificity 74.1%).Conclusion: The results obtained are important to develop further treatment strategies for children with COVID-19.

scholarly journals Right Testicular Artery Occlusion and Acute Appendicitis by Angiostrongylus costaricensis

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Luis Enrique Sánchez-Sierra ◽  
Roberto Antonio Martínez-Quiroz ◽  
Héctor S. Antúnez ◽  
Humberto Cabrera-Interiano ◽  
Fernando Josué Barrientos-Melara
Keyword(s):  
Acute Abdomen ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Artery Occlusion ◽  
Histopathological Study ◽  
Testicular Artery ◽  
Case Presentation ◽  
First Case

Introduction. Angiostrongylus costaricensis is a nematode from the superfamily Metastrongyloidea, whose etymology is “roundworm that lives in blood vessels”. This parasite can be found from the southern United States to northern Argentina and southern Brazil. In 1983, Morera and Ruiz published the first case of a testicular artery occlusion by A. costaricensis. Case Presentation. A five year old boy presented with eight days of pain, denying trauma backgrounds and followed with an increase of volume. The treatment was a right simply orchiectomy, finding necrosis of the testicle, the biopsy showed reddish-purple aspect and soft consistency. Histologic studies reveled the presence of a worm inside the testicular artery. Conclusion. The diagnosis of A. costaricensis infection should be considered in all pediatric patients, with signs and symptoms of orchitis or acute abdomen, from endemic areas, may cause occlusion of the testicular artery and appendicular artery causing testicular and cecal appendix necrosis, respectively, even putting the patient’s life at risk. The diagnosis is complex, because the clinical manifestations are similar to an orchitis or acute abdomen, therefore, the definitive diagnosis is made during the surgical intervention and histopathological study.

scholarly journals A case of recurrent acute aortic syndrome: Beyond emergency diagnosis and treatment

2018 ◽  
Vol 5 (3) ◽  
pp. 18
Author(s):  
Maria Domenica Amaradio ◽  
Elisabetta Mascheroni ◽  
Laura De Luca ◽  
Rodolfo Sbrojavacca
Keyword(s):  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Rapid Diagnosis ◽  
Congenital Disease ◽  
Common Pathway ◽  
Acute Aortic Syndromes ◽  
Complicated Process ◽  
Young Black Woman

Introduction: Acute aortic syndromes (AAS) are emergency conditions with a common pathway but various clinical manifestations. In order to reduce the extremely poor prognosis, these syndromes require a rapid diagnosis and decision making.Case report: We report the case of a young black woman with recurrent aortic dissection (RAD), presenting to the Emergency Department (ED) with an atypical symptom: ankle soreness. After the surgical treatment, several exams were performed in order to investigate underlying conditions for recurrence: after a first suspicion of tuberculous aortitis, the final diagnosis was Takayasu’s arteritis.Discussion: The aim of this article is to underline the extremely heterogeneous presentation of AAS that worsens the already complicated process in diagnosing the syndromes. Despite uncommon signs and symptoms, identifying patients with a high pre-test likelihood for the disease is crucial to promptly get a correct diagnosis. Once the diagnosis has been confirmed, since AAS may be a spy for important systemic diseases, conditions such as congenital disease, autoimmune and infectious aortitis need to be excluded and treated to prevent any recurrence or systemic implications.

scholarly journals The Close Relationship between Large Bowel and Heart: When a Colonic Perforation Mimics an Acute Myocardial Infarction

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Maria Francesca Secchi ◽  
Carlo Torre ◽  
Giovanni Dui ◽  
Francesco Virdis ◽  
Mauro Podda
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Conservative Treatment ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Diagnostic Procedures ◽  
Screening Colonoscopy ◽  
X Rays ◽  
Colonoscopic Perforation

Colonoscopic perforation is a serious and potentially life-threatening complication of colonoscopy. Its incidence varies in frequency from 0.016% to 0.21% for diagnostic procedures, but may be seen in up to 5% of therapeutic colonoscopies. In case of extraperitoneal perforation, atypical signs and symptoms may develop. The aim of this report is to raise the awareness on the likelihood of rare clinical features of colonoscopic perforation. A 72-year-old male patient with a past medical history of myocardial infarction presented to the emergency department four hours after a screening colonoscopy with polypectomy, complaining of neck pain, retrosternal oppressive chest pain, dyspnea, and rhinolalia. Right chest wall and cervical subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and bilateral subdiaphragmatic free air were reported on the chest and abdominal X-rays. The patient was treated conservatively, with absolute bowel rest, total parental nutrition, and broad-spectrum intravenous antibiotics. Awareness of the potentially unusual clinical manifestations of retroperitoneal perforation following colonoscopy is crucial for the correct diagnosis and prompt management of colonoscopic perforation. Conservative treatment may be appropriate in patients with a properly prepared bowel, hemodynamic stability, and no evidence of peritonitis. Surgical treatment should be considered when abdominal or chest pain worsens, and when a systemic inflammatory response arises during the conservative treatment period.

scholarly journals A study on the clinical features of dengue virus infected pediatric patients

2018 ◽  
Vol 5 (2) ◽  
pp. 368 ◽  
Author(s):  
Abhra Banerjee ◽  
Kanai Lal Barik ◽  
Arup Bandyopadhyay ◽  
Uttam Kumar Paul
Keyword(s):  
Dengue Fever ◽  
Clinical Features ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Viral Disease ◽  
Teaching Hospitals ◽  
Eastern India ◽  
Gastrointestinal Infections

Background: Dengue fever is currently the most important arthropod borne viral disease. During recent outbreaks in India, the clinical manifestations which were shown by the patients were slightly different from those in previous years. The present study was done to analyze the clinical features of all pediatric cases admitted for dengue to three tertiary care teaching hospitals in eastern India, to facilitate early treatment and better outcome.Methods: A direct history and clinical examination-record based descriptive study was conducted on pediatric patients admitted with signs and symptoms suggestive of dengue fever to two hospitals in West Bengal and one in Bihar, during the period between January 2016 and December 2017. The data obtained were analyzed with correlative studies.Results: Total 200 patients of Dengue viral infected pediatric patients were included in the study. All these 200 children presented with fever. 126(63%) children had myalgia and arthralgia, 111 (55.5%) had headache, 58 (29%) presented with gastrointestinal infections, 51 (25.5%) had rash and 26 (13%) had hemorrhagic manifestations. Features of shock were present in 14 (7%) children, retro-orbital pain in 13 (6.5%) children and generalized swelling in 9 (4.5%) children.Conclusions: Increased awareness about the changing clinical features of dengue in pediatric cases in the present scenario as observed in recent epidemics, at least in eastern India is needed to further reduce mortality and complications of dengue cases. 

Clinical manifestations and diagnosis of keratoconus. Treatment of iatrogenic keratoconus

2020 ◽  
pp. 37-42
Author(s):  
Fedor Ermolyuk
Keyword(s):  
Research Methods ◽  
Contact Lenses ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Refractive Errors ◽  
Dry Eyes ◽  
Advanced Stages ◽  
Dystrophic Disease ◽  
Iatrogenic Origin ◽  
Binocular Diplopia

Keratoconus is a dystrophic disease of the cornea, when it is thinned with the formation of a conus-like protrusion (protrusion of the cornea). This disease belongs to the group of keratectasia, it has a multifactorial nature and occurs in approximately 25 % of all corneal pathologies. The disease can be either primary, which is based on dystrophic changes in the cornea, or secondary, which develops against the background of prenatal keratitis. Keratoconus of iatrogenic origin, which develops as a result of refractive eye microsurgery, has become widespread during the last 20 years. Most often primary keratoconus manifests during puberty, progresses to 30–40 years, after which its development slows down. An early clinical manifestation of this corneal pathology is a progressive decrease in visual acuity, development of double vision (binocular diplopia) with the development of a strong headache against this background. Monocular polyopia — images and symbols with multiple contours — develops subsequently. Severe dry eyes, itching, photophobia appear in advanced stages. Diagnosis of keratoconus in some cases can be a significant difficulty, since the use of conventional research methods only allow to suspect refractive errors in the form of myopia or astigmatism. It is necessary to take into account the impossibility of correcting visual impairment using conventional methods — glasses or contact lenses — to make correct diagnosis. As a rule, diagnosis of keratoconus requires use of expanded spectrum of instrumental research methods.

Multiple Myeloma or Brucellosis: A Case Report

2020 ◽  
Vol 20 (1) ◽  
pp. 102-105 ◽  
Author(s):  
Hossein A. Rahdar ◽  
Mansoor Kodori ◽  
Mohamad R. Salehi ◽  
Mahsa Doomanlou ◽  
Morteza Karami-Zarandi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Brucella Melitensis ◽  
Severe Disease ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Bone Marrow Aspiration ◽  
Major Health Problem ◽  
Brucella Infection ◽  
Wide Range ◽  
Parental Treatment

Background: Brucellosis, a major health problem in developing countries, is a multisystem infection with a broad spectrum of clinical manifestations. Hematological complications, ranging from an intravascular coagulopathy to mild homeostasis disorders (such as gammopathy), have been reported in brucella infection. These signs and symptoms may lead to misdiagnosis of brucellosis with other hematological diseases. Case: A 65-year-old male whose occupation was shepherding was referred to our hospital as a known case of multiple myeloma with continuous fever, muscle weakness, and night sweating after taking 2 courses of chemotherapy. The laboratory diagnosis of multiple myeloma had been based on the observation of a high percent of plasma cells in the bone marrow aspiration. At follow- up, the result of patient's fever workup, with 2 sets of blood cultures, was positive for Brucella melitensis. Isolated brucella was confirmed as B. melitensis by 16S rRNA sequencing. Brucellosis serologic test was performed by agglutination test and positive results were obtained. The patient was discharged with the cessation of fever and general improvement after the end of the parental treatment phase of brucella bacteremia. Conclusions: Brucella infection may cause a severe disease, mimicking a primary hematological disease, which could complicate the correct diagnosis. In brucellosis cases, due to the wide range of symptoms, in addition to cultivation and serological methods, molecular methods should also be used to prevent inappropriate diagnosis and additional costs.

Candida spp. In linear gingival erythema lesions in HIV- infeceted children: reports of six cases

2013 ◽  
Author(s):  
Maristela Barbosa Portela,
Keyword(s):  
Case Report ◽  
Hiv Infection ◽  
Pediatric Patients ◽  
Predictive Marker ◽  
Etiologic Agent ◽  
Candida Spp ◽  
Oral Manifestation ◽  
Oral Candidosis ◽  
Positive Growth ◽  
Microbiological Analyses

Linear gingival erythema (LGE), formally referred as HIV-gingivitis, is the most common form of HIV-associated periodontal disease in HIV-infection. These lesions were recently evaluated as a possible form of erythematous oral candidosis, mainly caused by Candida albicans. Other species are also being associated such as C. tropicalis, C. stellatoidea, C. krusei, C. parapsilosis, C. glabrata and C. dubliniensis, that was identified in some HIV-infected subjects. This case report demonstrates the presence of typical LGE lesions in six HIV-infected children, also investigates the etiologic agent by microbiological exams and correlates this oral manifestation with patients’ systemic conditions. Microbiological analyses showed positive growth for Candida spp in all patients, all of whom had severe imunessupression. After antifungal medication, the regression of lesions could be note. The presence of LGE in pediatric patients with AIDS may indicate its feature as a predictive marker in progression of HIV-infection in children.

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