Childhood Meningitis Terrifying, Fortunately Very Rare
A recent case of fatal bacterial meningitis leads Dr. Paul Sax to reflect on the disease in his blog HIV and ID Observations .
MRSA Colonization in Severely Ill Children Is Associated with Subsequent Infection
Infectious Diseases
Summary and Comment
Free
Nearly 10% of children with MRSA colonization or infection on admission to the intensive care unit developed a later MRSA infection, most often after hospital discharge.
By Neil M. Ampel, MD
November 23, 2011
Covering:
Milstone AM et al., Clin Infect Dis 2011 Nov 1; 53:853
Home Care for Severe Childhood Pneumonia in the Developing World
Infectious Diseases
Summary and Comment
For young children with severe pneumonia diagnosed by a lay health worker, home treatment with amoxicillin yielded better results than TMP-SMX with referral to the nearest healthcare facility.
By Robert S. Baltimore, MD
November 23, 2011
Covering:
Bari A et al., Lancet 2011 Nov 19; 378:1796
Molyneux EM and Graham SM., Lancet 2011 Nov 19; 378:1762
Quick Uptake of New Adolescent Vaccines
Infectious Diseases
Summary and Comment
From 2006 through 2009, coverage for three new vaccines increased substantially but still fell short of what could have been accomplished.
Utility of Urinalysis in Evaluation of Adolescent Males for STIs
Emergency Medicine
Summary and Comment
Findings from a retrospective study support empirical treatment and testing for sexually transmitted infections in adolescent males with urinary complaints; urinalysis is unnecessary.
By Katherine Bakes, MD
November 18, 2011
Covering:
Timm N et al., Pediatr Emerg Care 2011 Nov; 27:1042
Critical Illness in Children with Pandemic H1N1 Influenza
Infectious Diseases
Summary and Comment
Children with pandemic H1N1 influenza were more likely to have severe illness or to die if they had a preexisting chronic medical condition or a methicillin-resistant staphylococcal lung coinfection.
Febrile Infants Aged 30 to 90 Days with Positive Urinalyses Require Lumbar Puncture
Emergency Medicine
Summary and Comment
Despite the authors' conclusion that lumbar puncture is not needed, this study failed to show lower risk for meningitis in febrile infants with urinary tract infections.
By Katherine Bakes, MD
November 10, 2011
Covering:
Paquette K et al., Pediatr Emerg Care 2011 Nov; 27:1057
Benefits from Rotavirus Vaccination Extend Beyond Infants
General Medicine
Summary and Comment
Even older unvaccinated people seem to acquire some protection.
By Abigail Zuger, MD
October 25, 2011
Covering:
Lopman BA et al., J Infect Dis 2011 Oct 1; 204:980
Glass RI., J Infect Dis 2011 Oct 1; 204:975
Updated Guidelines for Perinatal Antiretroviral Use
HIV/AIDS Clinical Care
Clinical Practice Guideline Watch
The revision includes several new clinical recommendations, as well as a provocative discussion on when to start antiretrovirals in pregnant women who do not require treatment for their own health.
By Sally Hodder, MD
October 24, 2011
Covering:
Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission., 2011 Sep 14
RTS,S/AS01 Vaccine Reduces Malaria Incidence by Half
Infectious Diseases
Summary and Comment
Free
Initial results from a phase III trial show protection against clinical and severe malaria during the 12 months after vaccination in children aged 5 to 17 months.
By Mary E. Wilson, MD
October 20, 2011
Covering:
The RTS,S Clinical Trials Partnership., N Engl J Med 2011 Oct 18
White NJ., N Engl J Med 2011 Oct 18
Say No to Adenoidectomy for Recurrent Upper Respiratory Infections
For children referred to surgeons because of frequent URIs, adenoidectomy conferred no clinical benefit over watchful waiting.
Adding Adjuvant Increases the Benefit of Influenza Vaccine in Young Children
Infectious Diseases
Summary and Comment
Free
Vaccine efficacy and immunogenicity were both improved when trivalent inactivated influenza vaccine was adjuvanted with an oil-in-water emulsion.
Mortality Related to Stevens-Johnson Syndrome and TEN Is Lower in Children than in Adults
Dermatology
Summary and Comment
Free
But long-term complications are common.
By Mary Wu Chang, MD
October 7, 2011
Covering:
Finkelstein Y et al., Pediatrics 2011 Oct; 128:723
Long-Term Acyclovir to Suppress Neonatal Herpes Simplex Virus Following Initial Therapy
Suppressive oral acyclovir therapy for 6 months improved neurodevelopmental outcomes in infants with central nervous system involvement.
By Peggy Sue Weintrub, MD
October 5, 2011
Covering:
Kimberlin DW et al., N Engl J Med 2011 Oct 6; 365:1284
Gershon AA., N Engl J Med 2011 Oct 6; 365:1338
Long-Awaited Guidelines for Management of CAP in Kids
Pediatrics and Adolescent Medicine
Clinical Practice Guideline Watch
Free
These comprehensive guidelines recommend a less aggressive approach that limits the use of lab tests, irradiation, and antibiotics in children who can be followed as outpatients.
Routine Rotavirus Vaccination Has Reduced Healthcare Use
Routine vaccination of infants has reduced rates of hospitalization for rotavirus-associated diarrhea in children younger than 5 years by 75%.
By Louis M. Bell, MD
September 28, 2011
Covering:
Cortes JE et al., N Engl J Med 2011 Sep 22; 365:1108
No Benefit from IV Immune Globulin in Neonatal Sepsis
This large randomized trial showed no benefit from adjuvant treatment with IVIG.
By Peggy Sue Weintrub, MD
September 28, 2011
Covering:
The INIS Collaborative Group., N Engl J Med 2011 Sep 29; 365:1201
New AAP Guidelines for Diagnosis and Management of Febrile UTI in Infants and Young Children
Pediatrics and Adolescent Medicine
Clinical Practice Guideline Watch
Free
These recommendations outline a systematic approach to diagnosis and management that minimizes harm, maximizes benefit, and optimizes use of labs and procedures.
By Peggy Sue Weintrub, MD
September 21, 2011
Covering:
Subcommittee on Urinary Tract Infection., Pediatrics 2011 Sep; 128:595
Efficacy of a Blood-Stage Malaria Vaccine
Infectious Diseases
Summary and Comment
The vaccine did not provide significant protection against clinical malaria but appeared to have strain-specific efficacy.
By Larry M. Baddour, MD
September 14, 2011
Covering:
Thera MA et al., N Engl J Med 2011 Sep 15; 365:1004
Early Pseudomonas Infections in Children with CF: Four Regimens Compared
Infectious Diseases
Summary and Comment
Although the regimens were equally efficacious in preventing exacerbations, culture-based therapy was most efficient; adding oral ciprofloxacin to inhaled tobramycin provided no benefit.
By Robert S. Baltimore, MD
September 14, 2011
Covering:
Treggiari MM et al., Arch Pediatr Adolesc Med 2011 Sep; 165:847
Swine-Origin Influenza Virus Is Among Us Again
Infectious Diseases
Summary and Comment
Two epidemiologically independent cases of flu-like illness in young children were caused by a swine-origin influenza A (H3N2) virus with a novel genotype.
By Stephen G. Baum, MD
September 14, 2011
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2011 Sep 9; 60:1213
Decision Rule Falls Short in Identifying Children at Low Risk for Pneumonia
Emergency Medicine
Summary and Comment
Free
Even the lowest-risk group had a 7.6% pneumonia rate.
By Katherine Bakes, MD
August 26, 2011
Covering:
Neuman MI et al., Pediatrics 2011 Aug; 128:246
Interferon Gamma Release Assay No Better Than Skin Test for TB Diagnosis in Children
The assay has higher specificity but similar sensitivity for detecting latent infection or active disease.
By Peggy Sue Weintrub, MD
August 24, 2011
Covering:
Machingaidze S et al., Pediatr Infect Dis J 2011 Aug; 30:694
A Look Back at the Effect of Varicella Vaccination on Varicella Deaths
Dermatology
Summary and Comment
In just over a decade, the average annual mortality rate for varicella-related deaths in the U.S. has declined 88%.
IV Volume Expansion Reduces Risk for Oliguria in Hemolytic Uremic Syndrome
Volume expansion during the first 4 days of diarrhea was renoprotective.