A Rare Cause of Hemoptysis in West Syndrome—Isolated Aortopulmonary Collaterals in Structurally Normal Heart

Major aortopulmonary collateral arteries (MAPCAs) are abnormal systemic to pulmonary collateral vessels originating from the persistent segmental arteries. The common conditions concomitant with MAPCA are congenital heart diseases with reduced pulmonary blood flow. Isolated MAPCAs represent occurrence of collaterals in the absence of underlying heart disease, which commonly present as heart failure, recurrent respiratory tract infection, and pulmonary artery hypertension. Here, we describe a case of West syndrome presenting with hemoptysis due to isolated MAPCAs and its causal relation and management.

Research Progress on the Effect of Massage on Immune System Function in Children

As a traditional Chinese medicine treatment, massage has significant clinical effect. In recent years, a large number of clinical studies have shown that the mechanism of massage in the treatment of diseases is related to the regulation of immune function. In this article, we review the existing problems and prospects of massage on children with diarrhea, asthma and recurrent respiratory tract infection in relation to its effect on the regulation of immune function.

Respiratory outcomes at five-year follow-up in children with MBL deficiency: a cohort study

Introduction Mannose-binding lectin (MBL) serum protein, is an important molecule of the innate immune system that is involved in antimicrobial recognition and clearing responses. There is no conclusive evidence that MBL deficiency is associated with adverse respiratory consequences. Aim We explored whether there is a difference in clinical, radiological and microbiological characteristics in children with MBL deficiency presenting with troublesome respiratory symptoms (frequent, recurrent, persistent or very severe), as compared to those who are MBL-sufficient. Methods We performed a retrospective study looking at MBL measurements in children over a period of 10 years in a large teaching hospital, with a minimum follow-up period of 5 years from the time of the MBL measurement to the year 2019. Results 32% of children with MBL deficiency and 30% of those with MBL sufficiency had positive microbiology. 23% of children with MBL deficiency and 24% of those with MBL sufficiency had radiological changes on plain radiographs. 28% of children with MBL deficiency and 33% of those with MBL sufficiency had suboptimal vaccine responses to primary immunisations. 67% of the MBL-deficient children had suboptimal vaccine responses to booster immunisations, compared to 40% of the MBL-sufficient group. Conclusion We conclude that there is no difference at five year follow-up in clinical, radiological and microbiological characteristics between children who are MBL-deficient as compared to those who have sufficient levels. These results add to the existing body of literature that shows no statistically significant association between MBL deficiency and susceptibility to recurrent respiratory tract infection in children.

Whether immunostimulants are effective in susceptible children suffering from recurrent respiratory tract infections: a modeling analysis based on literature aggregate data

Background: Immunostimulants are gradually being used in the prevention and treatment of recurrent respiratory tract infection (RRTIs) in susceptible children, but its drug effects have not been quantified. The purpose of this paper is to confirm the efficacy of immunostimulants in the prevention and treatment of RRTIs in susceptible children. Methods: Model-based meta-analysis (MBMA) was used to describe the time-course of placebo and immunostimulants in the prevention of RRTIs in children. The cumulative number of acute respiratory tract infections (ARTIs) was used as the indicator of efficacy. The single-arm meta-analysis was used to analyze the incidence of drug related adverse events. Results: A total of 14 articles with 2,400 pediatric subjects were finally included for analysis. The results showed that the cumulative number of ARTIs increased linearly with time, and the incidence of ARTIS in the placebo group was 0.65 (95% CI: 0.55 to 0.75) per month. OM-85 BV and pidotimod significantly reduced the incidence of ARTIs by 0.21 (95% CI: 0.16 to 0.26) and 0.19 (95% CI: 0.17 to 0.21) compared with placebo per month, respectively. The incidence of drug-related adverse events of pidotimod and OM-85 BV was comparable with that of placebo. Conclusions: Pidotimod and OM-85 BV can effectively reduce the incidence of ARTIs in susceptible children, and there is no significant increase in the incidence of drug-related adverse events. This study provides quantitative support for the application of immunostimulants for the prevention of recurrent respiratory tract infection in children.

Recurrent Respiratory Tract Infection in an infant: Early Diagnosis by Clinical and Radiological Pearls

Recurrent respiratory tract infections, a cause of concern for both parents and paediatricians, can have various etiologies entitled to different organ systems. Diagnosing the exact cause warrants both clinical acumen and timely investigations. Here, we are reporting an infant with recurrent respiratory tract infections, where adequate clinical examination prompted us to diagnose the extra-respiratory cause with simple investigations.

Recurrent Respiratory Tract Infection in a 24-Year-Old Female Secondary to a Foreign Body Aspiration

Foreign body aspiration (FBA) is a common problem necessitating prompt recognition and early treatment to minimize the potentially severe and sometimes fatal consequences. We presented a 24-year-old girl who was admitted for chronic cough and recurrent pneumonia associated with constitutional symptoms. She was feverish with a temperature of 39°C and had tachycardia and tachypnoea with an oxygen saturation of 98%. Investigations revealed leukocytosis. CXR showed right lower lobe consolidation, and CT thorax demonstrated collapse consolidation of the right middle and lower lobe, along with associated dilated segmental bronchioles and diffuse patch ground-glass opacity in both lung fields. Bronchoscopy revealed a pen cap at the entrance of the right lower lobe. Patient symptoms improved after removal of the foreign body. In patients with recurrent chest infection, the physician should check for the possibility of FBA and prompt for a referral to a tertiary center for further evaluation.