Epidemiologic, clinical, and genetic characteristics of influenza C virus infections among outpatients and inpatients in Sendai, Japan from 2006 to 2020.

Background: Influenza C virus is a pathogen that causes acute respiratory illness in children. The clinical information about this virus is limited because of the small number of isolated viruses compared to influenza A or B viruses.

Methods: A total of 60 influenza C viruses were isolated by clinical tests using cell culture methods conducted in one hospital and one clinic during the 15 years from 2006 to 2020.

Onset of Hemophagocytic Lymphohistiocytosis during Piperacillin-Tazobactam Therapy in Three Children with Acute Focal Bacterial Nephritis.

Hemophagoytic lymphohistiocytosis (HLH) is a rare life-threatening disorder caused by overactivation of the immune system, associated with infections, autoimmune disorders, and malignancies. The pathological hallmark of HLH is phagocytosis of blood cells and platelets by activated macrophages and histiocytes. In this report, we describe the onset of HLH in three children, aged 2, 5 and 7 years old, during the treatment of acute focal bacterial nephritis (AFBN) with an antibiotic, piperacillin-tazobactam (PIPC-TAZ).

Concurrent Community Transmission of Enterovirus D68 With Human Rhinoviruses and Respiratory Syncytial Virus Among Children in Sendai, Japan.

Background: In the autumn of 2015, we experienced a surge in the number of pediatric cases of wheeze in our hospital, which was suspected to be caused by enterovirus (EV)-D68 transmission in the community. Thus, we implemented an ad hoc retrospective surveillance for EV-D68.

Methods: Patients <15 years of age with acute respiratory infection were eligible for inclusion in this study.

Efficient isolation of human metapneumovirus using MNT-1, a human malignant melanoma cell line with early and distinct cytopathic effects.

Isolation of human metapneumovirus (HMPV) from clinical specimens is currently inefficient because of the lack of a cell culture system in which a distinct cytopathic effect (CPE) occurs. The cell lines LLC-MK2, Vero and Vero E6 are used for isolation of HMPV; however, the CPE in these cell lines is subtle and usually requires a long observation period and sometimes blind passages. Thus, a cell line in which an early and distinct CPE occurs following HMPV inoculation is highly desired by clinical virology laboratories.

A Term Infant of Neonatal Toxic Shock Syndrome-Like Exanthematous Disease Complicated with Hemophagocytic Syndrome.

Neonatal toxic shock syndrome-like exanthematous disease (NTED) is a newly recognized neonatal infectious disease, caused by the superantigen toxic shock syndrome toxin-1 (TSST-1). TSST-1 is mainly produced by methicillin-resistant Staphylococcus aureus, and the immune responses to TSST-1 are known to cause toxic shock syndrome, a life-threatening infectious disease. The clinical symptoms of NTED are skin rash, fever, and thrombocytopenia, but severe thrombocytopenia is rare in term infants with NTED.

Perinatal Coxsackievirus B3 Infection with Transient Thrombocytopenia.

Coxsackievirus (Cox) B is the second common picornaviruses, after echovirus, detected from children younger than 2 months of age. Neonates who present with Cox B3 infection in the first week are known to have severe illness such as myocarditis or menigoencephalitis. Severity is commonly associated with perinatal vertical transmission.

Allergic reactions to milk appear sooner than reactions to hen's eggs: a retrospective study.

Background: Oral food challenge test doses are recommended to be performed at least 20 min apart; however, the times of symptom provocation from the start of the oral food challenge have never been compared between different foods. In this study, the durations from the start of the oral food challenge to symptom development in children with egg or milk allergy were compared.

Methods: Thirty-eight and 74 children who had previously passed oral food challenges to 96 g of yogurt and pumpkin cake containing ¼ whole egg underwent oral food challenges with 200 mL raw cow's milk and 1 whole scrambled egg, respectively; of these, 15/38 and 33/74 children had a reaction.

Transient Creatine Kinase Elevation Followed by Hypocomplementemia in a Case of Rotavirus Myositis.

We report an infant case of rotavirus myositis, a rare complication of rotavirus infection. Complement levels of the patient were normal when serum creatine kinase (CK) level was at its peak and then decreased when the CK level became normalized. In a previous case report of rotavirus myositis, transient decrease of serum albumin, immunoglobulin, and complement levels was reported.

Erratum: Butter Tolerance in Children Allergic to Cow's Milk.

[This corrects the article DOI: 10.4168/aair.2015.

Does Terminating the Avoidance of Cow's Milk Lead to Growth in Height.

Background: Cow's milk allergy is known to result in decreased body height; accordingly, the aim of this study was to investigate whether termination of milk avoidance leads to an increase in body height.

Methods: Between 2010 and 2011, 253 children with food allergies who were ≥2 years of age visited our outpatient department; 195 had height data available from approximately 1 year after their initial food allergy diagnosis and were included in the study. The height standard deviation scores (HtSDs) were calculated using data from the 2000 Japanese National Physical Growth Survey Report for Infants and Children, and changes in height were then retrospectively evaluated using clinical records.

Butter Tolerance in Children Allergic to Cow's Milk.

We performed an oral food challenge (OFC) with 10 g of butter (equivalent of 2.9 mL cow's milk) and 25-mL heated cow's milk for 68 children with cow's milk-allergy. Thirty-eight children reacted only to heated cow's milk.

Elevated serum levels of neutrophil elastase in patients with influenza virus-associated encephalopathy.

We examined serum levels of various cytokines, chemokines, growth factors, and adhesion molecules in patients with uncomplicated influenza (n=20) and influenza virus-associated encephalopathy (IE) (n=18) to understand the underlying mechanism of IE. We found that IL-1β, IL-2, IL-5, IL-6, IL-7, IL-8, IL-10, IL-13, G-CSF, GM-CSF, TNF-α, TIMP-1, MMP-9, sE-selectin, and neutrophil elastase were elevated significantly in sera from patients with uncomplicated influenza and those with IE, compared with normal controls (n=20). Of note, neutrophil elastase, sE-selectin, IL-8, and IL-13 were elevated significantly in IE as compared with uncomplicated influenza.

A case of acute cerebellitis with a unique sequential change on magnetic resonance imaging.

Background: Acute cerebellitis with unilateral onset is rare, and magnetic resonance imaging (MRI) is a useful method for demonstrating cerebellar involvement.

Patient: We report a 12-year-old girl with acute cerebellitis with a unique sequential change on her MRI.

Results: The patient's brain MRI first revealed cortical lesions mainly in the right cerebellar hemisphere.

Neonatal-onset brainstem reticular reflex myoclonus following a prenatal brain insult: generalized myoclonic jerk and a brainstem lesion.

Brainstem reticular reflex myoclonus (BRRM) is characterized by sudden, generalized, shock-like movements that can be elicited by sensory stimulation. We present a boy, born after 35 weeks gestation, who was diagnosed with neonatal-onset BRRM. Within 1 hr of birth, the patient showed spasticity and generalized clonic movements of all limbs elicited with tactile stimulation anywhere on the body.

Clinical features of influenza C virus infection in children.

Background: Seroepidemiological studies have revealed that influenza C virus is widely distributed globally. However, because the isolation of this virus is difficult, there have been few reports on its clinical features.

Methods: Between December 1990 and November 2004, 84,946 respiratory-tract specimens were obtained from patients < or = 15 years old.