Tick paralysis is a relatively uncommon tick-borne illness that is often overlooked and misdiagnosed. Therefore, it is not unusual for cases to undergo unnecessary work-up and interventions that may delay correct diagnosis and treatment, placing the patient at risk for catastrophic consequences. We present the case of a four-year-old female who developed ascending flaccid paralysis, initially misdiagnosed with Guillain-Barré syndrome (GBS).
View Article and Find Full Text PDFIntroduction: (Hi) is subdivided into typeable (a-f) and non-typeable groups. Hi serotype b (Hib) has historically been one of the important pathogens responsible for invasive infection. However, after widespread Hib vaccination, the emergence of other Hi serotypes, specifically Hi serotype a (Hia), was noted during the last few decades, mostly in children younger than 5 years of age.
View Article and Find Full Text PDFIntroduction: Health care quality and patient safety remain one of the core areas of focus for the Accreditation Council for Graduate Medical Education. In addition to using the traditional approach to teaching patient safety, disclosure of a safety event and introduction to the concepts of just culture and safely doing less add a unique perspective to our module.
Methods: This 4-hour learning activity was conducted using a formal PowerPoint presentation, simulation, and interactive discussion/debriefing.
Chlamydia, gonorrhea, and syphilis continue to be significant burdens to the health of pregnant women and their children despite easy and effective guidance for screening and treatment. Specific guidelines exist for screening for these infections as well as treatment and follow-up. In this article, we review the epidemiology of chlamydia, gonorrhea, and syphilis.
View Article and Find Full Text PDFAs of late, the incidence of congenital syphilis in the United States is increasing. Each new case represents a failure of preventing, diagnosing, and treating syphilis in pregnant women. Pediatricians should confirm that all women have received adequate screening for and management of syphilis during pregnancy.
View Article and Find Full Text PDFDespite infection prevention efforts, neonatal intensive care unit (NICU) patients remain at risk of Methicillin-resistant Staphylococcus aureus (MRSA) infection. Modes of transmission for healthcare-associated (HA) and community-associated (CA) MRSA remain poorly understood and may vary by genotype, hindering the development of effective prevention and control strategies. From 2008-2010, all patients admitted to a level III NICU were screened for MRSA colonization, and all available isolates were spa-typed.
View Article and Find Full Text PDFSalmonella are gram-negative bacilli within the family Enterobacteriaceae. They are the cause of significant morbidity and mortality worldwide. Animals (pets) are an important reservoir for nontyphoidal Salmonella, whereas humans are the only natural host and reservoir for Salmonella Typhi.
View Article and Find Full Text PDFThis guideline is a revision of the clinical practice guideline, "Diagnosis and Management of Bronchiolitis," published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted.
View Article and Find Full Text PDFOverwhelmingly consistent evidence from observational studies has demonstrated that the pneumococcal conjugate vaccine has reduced the burden of pneumococcal disease but continues to affect the epidemiology of pneumococcal infections caused by nonvaccine serotypes and antibiotic-resistant pneumococci. On the basis of strong evidence, susceptible pneumococci causing uncomplicated, noninvasive childhood infections (eg, otitis or pneumonia) should be treated with a narrow-spectrum antimicrobial (eg, amoxicillin). Severely ill patients and those with infections caused by resistant pneumococci may be treated with parenteral antibiotic agents based on the isolate’s susceptibility and the site of the infection.
View Article and Find Full Text PDFWorld J Pediatr Congenit Heart Surg
October 2013
Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization has been recognized as a significant problem among hospitalized patients. Available data about prevalence of MRSA among children with congenital heart disease (CHD) are minimal. The aim of the study was to determine the prevalence of MRSA colonization and to identify risk factors for MRSA colonization among children <19 years old with CHD admitted to a pediatric intensive care unit (PICU).
View Article and Find Full Text PDFA 7-month old girl with GM1 gangliosidosis type 1 manifested with diffuse ecchymosis and Mongolian spots. The cutaneous lesions were present at birth before the appearance of the other features of the disease. We postulate that dermal pigmentation may be recognized as an early sign of GM1 gangliosidosis.
View Article and Find Full Text PDFBackground: Methicillin-resistant Staphylococcus aureus (MRSA) is a well-known nosocomial pathogen of neonatal intensive care unit (NICU) patients and can cause both serious infections in preterm neonates and prolonged MRSA outbreaks in NICUs.
Objectives: Our objectives were to determine the prevalence of and identify risk factors for MRSA colonization and infection in the NICU and the impact of an active surveillance program on MRSA in the NICU.
Methods: We collected weekly nasal MRSA surveillance cultures on 2,048 infants admitted to NICU over 3 years.
Propionic acidemia manifesting with hyperglycemia is rare. Few cases have been reported mainly of the neonatal-onset form associated with high mortality. We report a 9-month-old Palestinian boy who manifested with coma, severe hyperglycemia and ketoacidosis mimicking diabetic ketoacidosis.
View Article and Find Full Text PDFBackground: Neonatal scalp abscesses are a rare but potentially very serious condition.
Objectives: This report serves to demonstrate meningitis as a potential complication of neonatal scalp abscess. In addition, we review the current literature on the subject and comment on the most appropriate evaluation and treatment.
Photobacterium damsela (P damsela) is a common marine bacterium. Rare reports of P damsela causing septicemia and wound infection have been described in children. We report a case of Photobacterium damsela isolated from a wound culture taken from a 14-year-old male injured after a minor trauma while surfing.
View Article and Find Full Text PDFWe report on a female infant with congenital iron storage disease, facial dysmorphism, intractable diarrhea, and hair abnormalities. The intractable diarrhea failed to resolve despite total parenteral nutrition and complete bowel rest for more than 3 weeks. The patient also had elevated liver enzymes and failure to thrive.
View Article and Find Full Text PDFJ Pediatr Orthop
September 2002
There are few data on the use of outpatient parenteral antimicrobial therapy (OPAT) in the management of osteoarticular infections (OAIs) in childhood. The objective of this study was to determine if OPAT is safe and effective in the management of OAIs. Using their OPAT database, the authors evaluated the use of OPAT in children younger than 18 years old treated for OAIs between January 1, 1995, and December 31, 1999.
View Article and Find Full Text PDFThis study compared adverse drug reactions (ADRs) to oxacillin with those to nafcillin and other antibiotics. We reviewed the medical records of 222 children receiving outpatient parenteral antimicrobial therapy (OPAT) from February 1995 through June 1999. The diagnosis, antibiotics used, ADRs, action taken, and patient demographics were recorded.
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