Infectious Diseases

Australian researchers say that children with type 1 diabetes mellitus are almost 10 times more likely to have enterovirus infection than children without the disease. The odds of infection also are higher in children diagnosed with prediabetes.

Five-year-old girl with redness and light sensitivity of the right eye of 2 days' duration. She denied any significant pain or decreased vision. She initially presented to an urgent care clinic, where application of polymyxin B/trimethoprim eye drops 4 times a day was prescribed.

Trivalent inactivated influenza vaccine may be associated with febrile seizures in infants and children aged 6 to 23 months who received the vaccine this current flu season, according to a vaccine safety update released by the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).

Pregnant women who get vaccinated against influenza appear to reduce the risk for their infants younger than 6 months old from being hospitalized for influenza.

Physicians should be on the alert for secondary bacterial infections in children with H1N1.

Among febrile infants 56 days old or younger, those with a positive CSF enterovirus polymerase chain reaction test result had a shorter hospital length of stay than febrile infants of the same age who did not undergo such testing.

This 14-month-old girl was brought for evaluation of marked swelling and erythema of the left eyelids (A) The mother had noticed a green discharge and mild swelling of the eye 2 nights earlier.

To identify parents' beliefs and barriers related to influenza immunization of school-aged children and to evaluate how accepting parents are of school-based influenza immunization, investigators surveyed parents of students at an elementary school in Salt Lake City, Utah.

Over the past decade, the United States has had tremendous success in achieving very high immunization compliance rates among children, sometimes as high as 91%.

The Centers for Disease Control and Prevention and FDA have noted an increase in reports of bloodborne infection transmission, primarily hepatitis B virus, resulting from shared use of fingerstick and point-of-care blood testing devices.

The H1N1 virus is expected to again be a major risk this flu season.

A 10-month-old boy with an asymptomatic rash is brought to your office by his mother. The rash, which began on the legs and spread to the arms, face, and buttocks, has been present for 3 days. Other than rhinorrhea and nasal congestion for the past 3 to 5 days, the infant has been well, although fussier than usual, especially at night. His appetite is normal. The rash has persisted despite the application of bacitracin, petroleum jelly, and cortisone. He has had no sick contacts with a similar rash or illness. His immunizations are up-to-date.

FDA has authorized for use a new test for the diagnosis of H1N1 influenza virus infections. This test was developed by the CDC.

“Drug rash” is a common pediatric complaint in both inpatient and outpatient settings. This term, however, denotes a clinical category and is not a precise diagnosis. Proper identification and classification of drug eruptions in children are important for determining the possibility of-and preventing progression to-internal involvement. Accurate identification is also important so that patients and their parents can be counseled to avoid future problematic drug exposures.

The precautionary list of things to avoid during pregnancy is a long one. In this issue, researchers from the CDC remind us that there is another pathogen of which pregnant women should be wary.

A 12-year-old girl presented to the emergency department with progressing generalized inflammatory symptoms (fever and malaise), visual difficulty, severe inspiratory dyspnea, and 2 painless lesions on the right upper lip that had persisted for a few days. She had been well until 2 days before presentation, when she noticed a small pimple-like lesion above the right upper lip that was followed rapidly by facial edema, erythema, and constitutional symptoms.

Most children who present with undifferentiated rash and fever-or fever and rash and nonspecific physical findings-have a benign viral illness. However, identifying those few who have an early or atypical presentation of a more serious disease is vitally important. Here-clues that can help.

On awakening in the morning, a 2-year-old girl was noted to have left-sided facial swelling and was brought to the emergency department. The child had had no fever, trauma to the area, pain, or difficulty in swallowing. Her medical history was unremarkable. Her immunizations were up-to-date; she had received both doses of the measles, mumps, and rubella (MMR) vaccine about 6 months before presentation. There were no sick contacts.

A 20-month-old boy brought to the emergency department with swelling on the right side of the neck and fever (temperature, 39.3°C [102.7°F]) of 1 day’s duration. The parents reported that the child had had intermittent fevers and poor weight gain for the past 3 months but no vomiting, diarrhea, rash, drooling, or difficulty in swallowing.

Identifying pandemic H1N1 flu in children may not be as easy as administering rapid influenza tests, according to 2 studies.

A 3-month-old African American boy was referred for evaluation of poor weight gain and vomiting. The infant had been evaluated by his primary care physician 15 times within the past 6 weeks; he had no change in symptoms despite various treatments.

Selective IgA deficiency (SIGAD) is the most common immunodeficiency disorder; it affects about 1 in 200 to 900 persons. Most affected children are asymptomatic.

For 3 months, a 9-year-old boy had swelling of the left upper arm. An MRI scan obtained at another facility 1 week after onset showed extensive edema of the soft tissue at the midhumeral level. Laboratory results, including complete blood cell (CBC) count and Lyme titer, were normal.

Among urban adolescent girls, sexually transmitted infections (STIs) often occur soon after the first occurrence of sexual intercourse.

A recent study demonstrated that long-term, low-dose trimethoprim-sulfamethoxazole (TMP-SMX) was associated with a modest decrease in urinary tract infections (UTIs) in children who had had at least 1 such symptomatic infection in the past.

The 39-practice physician hospital organization (PHO) related to the Cincinnati Children's Hospital Medical Center has increased its influenza immunization rate from 22% to 66% in 5 years.

One week earlier, a 14-month-old girl with a history of eczema was evaluated because of a diffuse rash of excoriated lesions, some of them purulent. She was afebrile. Worsening eczema with secondary infection was diagnosed. Treatment with oral clindamycin was prescribed. At follow-up, the lesions had worsened. The child had multiple excoriated papules, some of which had coalesced into plaques. She also had two 5-mm vesicles on her right shoulder. Eczema herpeticum was diagnosed clinically. Culture of the vesicles later grew herpes simplex virus (HSV).

The Food and Drug Administration (FDA) recently approved several agents for use in pediatric patients, including a new cervical cancer vaccine and a seasonal influenza vaccine.

A collection of links for the most current, comprehensive information on H1N1.

An editorial that examines the current status of H1N1 in the medical setting.