Infectious conditions of the infantile genitals are a diagnostic challenge. One of the rare differential diagnoses is lymphocytoma cutis benigna. We report a case of borrelial lymphocytoma of the glans penis in a 9 year old boy.
View Article and Find Full Text PDFFibroadenoma is the main cause of unilateral breast mass in teenagers and adolescents. 4% of these are a special form described as giant or juvenile fibroadenoma. For primary diagnosis, ultrasound is the method of choice.
View Article and Find Full Text PDFBackground: The clinical spectrum of pertussis ranges from mild cough illnesses of short duration to typical illness with paroxysmal cough, whooping and posttussive vomiting. We performed comparative genotyping of Bordetella pertussis isolates from children in Germany with severe or mild pertussis.
Methods: Pulsed field gel electrophoresis (PFGE) of genomic DNA, digested with the restriction endonucleases Xba I and Spe I, was used to determine the profiles of strains isolated from 31 unvaccinated children with severe symptoms of pertussis (with hospitalization and/or complications) compared with isolates from 32 matched children with mild symptoms.
Pertussis is a frequent and significant illness in adults. Because acellular pertussis vaccines for use in adolescents and adults have now been developed, it is important to compare serologic responses in adults after infection with serologic responses in adults after vaccination. We measured IgG and IgA antibodies to 4 Bordetella pertussis antigens at approximately 6-month intervals for 28 months in 11 adults with pertussis.
View Article and Find Full Text PDFThe reactogenicity and immunogenicity of three combined measles, mumps and rubella (MMR) vaccines and one administered with a varicella vaccine was studied in infants. The vaccines were Priorix (designated MeMuRu, Group 1), M-M-R II (Group 2), Triviraten (Group 3) and Priorix + a varicella vaccine, Varilrix (Group 4). Fever was greater in Group 2 (61.
View Article and Find Full Text PDFUnlabelled: The objective of this open study was to monitor the long-term effectiveness of the Lederle-Takeda diphtheria and tetanus toxoids and acellular pertussis antigen(s) (DTaP) vaccine and the Wyeth-Lederle diphtheria and tetanus toxoids and pertussis whole cell (DTP) vaccine in children who had received four doses of vaccine at 3, 4.5, 6 and 15 months of age during a pertussis vaccine efficacy trial from May 1991 to December 1994. After unblinding of the study code, follow-up information was obtained by use of standardised questionnaires twice a year from 1995 to 2000 to detect clinical pertussis and cough illnesses > or = 14 days duration.
View Article and Find Full Text PDFWe compared immunogenicity and reactogenicity of a single dose of DTaP vaccine (containing tetanus and diphtheria toxoids and four acellular pertussis antigens) with conventional Td- or d-vaccines in 180 German adults. Antibody values against diphtheria and tetanus toxin and against the pertussis antigens fimbriae (FIM), filamentous hemagglutinin (FHA) and pertussis toxin (PT) were measured in pre- and post-immunization sera. Reactogenicity was determined by a patient diary card.
View Article and Find Full Text PDFChildren aged 9-11, 12-14 or 15-17 months, respectively were vaccinated with a measles, mumps and rubella (MMR) vaccine and serum antibody responses and reactogenicity were compared. The data of 118 children could be analysed (group 1=9-11 months, n=46; group 2=12-14 months, n=29, group 3, 15-17 months, n=43). The only significant difference observed was for seroconversion against measles virus between group 1 and group 3 (84.
View Article and Find Full Text PDFObjective: To assess the diagnostic sensitivity and specificity of a Bordetella pertussis polymerase chain reaction (PCR) assay using nasopharyngeal (NP) specimens from subjects with cough illnesses participating in a large pertussis vaccine efficacy trial.
Design: From 1991 to 1994, we conducted a large pertussis vaccine efficacy trial in Germany to determine the efficacy of the Lederle/Takeda acellular pertussis component diphtheria-tetanus toxoids in comparison with the Lederle whole-cell component diphtheria-tetanus toxoids vaccine. In the final year of the follow-up period of this trial, a second NP specimen for PCR, in addition to a culture specimen and blood for specific serology (enzyme-linked immunosorbent assay), was collected by use of a Dacron swab in subjects or family members with cough illnesses >/=7 days duration or in subjects with exposure to a cough illness in a household member to establish a diagnosis of B pertussis infection.
A subanalysis of a recent cohort efficacy trial of a pertussis vaccine was performed to determine its efficacy against cough illnesses due to Bordetella parapertussis infections. Infants received four doses of either the Lederle/Takeda acellular pertussis component diphtheria and tetanus toxoids and pertussis (DTaP) vaccine or the Lederle whole-cell component diphtheria and tetanus toxoids and pertussis (DTP) vaccine at 3, 4.5, 6, and 15-18 months of age; controls received three doses of diphtheria and tetanus toxoids (DT) vaccine only.
View Article and Find Full Text PDFIn a pertussis vaccine efficacy trial in Germany we collected sera from vaccinees (DTaP or DTP) after the third and fourth doses of vaccine or at comparable time periods in DT vaccine recipients. In addition, sera were collected from a randomized sample of subjects in each vaccine group at approximately 3-month intervals from which antibody kinetic curves were constructed, which allowed us to estimate specific antibody values to pertussis toxin (PT), filamentous hemagglutinin (FHA), pertactin and fimbriae-2 at the time of exposure in the household setting. The imputed geometric mean antibody values to PT, pertactin and fimbriae-2 at the time of household exposure to Bordetella pertussis infection were higher (p < 0.
View Article and Find Full Text PDFBackground: In the course of a large pertussis vaccine efficacy trial we realized that investigator compliance could have a major impact on calculated vaccine efficacy.
Design: In our pertussis vaccine efficacy trial, the study investigators were to monitor illness in study families by telephone every 2 weeks. If a cough illness of >/=7 days duration was noted, the study child was to be evaluated.
Background: A household contact substudy was performed as part of a prospective, cohort pertussis vaccine efficacy trial in Germany.
Design: Infants received four doses of either the Lederle/Takeda acellular pertussis component diphtheria-tetanus toxoids (DTP) vaccine (DTaP) or Lederle whole-cell component DTP vaccine at 3, 4.5, 6, and 15 to 18 months of age (Wyeth-Lederle Vaccines and Pediatrics, Pearl River, NY).
Objective: To study the clinical presentation of culture-confirmed pertussis in children and their contacts with cough illnesses in an outpatient setting.
Methodology: In conjunction with a large pertussis vaccine efficacy trial in Germany, a central laboratory to isolate Bordetella species from nasopharyngeal specimens was established in Erlangen in October 1990. Pediatricians in private practices in southern Germany, the Saar region, and Berlin were encouraged to obtain nasopharyngeal specimens and clinical characteristics from patients with cough illnesses >/=7 days' duration.
Background: The goal of the trial was to determine the efficacy of a multicomponent acellular pertussis vaccine against Bordetella illnesses in comparison with a whole-cell product and DT.
Design: In a randomized, double-blind fashion, 2- to 4-month-old infants received 4 doses of either DTP or DTaP vaccine at 3, 4.5, 6, and 15 to 18 months of age.
Minor adverse events were evaluated in a comparative efficacy trial in Germany in infants who received either the Lederle/Takeda acellular pertussis component DTP (DTaP) vaccine, the Lederle whole-cell component DTP (DTP) or DT vaccine. Vaccinees received four doses (at three, four-and-a half, six and 15-18 months of age) of either DTP or DTaP vaccine or three doses (at three, four-and-a half and 15-18 months of age) of DT vaccine. The reactogenicity analysis included 4,273 DTaP, 4,259 DTP and 1739 DT vaccinees.
View Article and Find Full Text PDFSevere adverse events were evaluated in a comparative efficacy trial in Germany in infants who received either the Lederle/Takeda acellular pertussis component DTP (DTaP) vaccine, the Lederle whole-cell component DTP (DTP) or DT vaccine. Vaccinees received four doses (at three, four-and-a half, six and 15-18 months of age) of either DTP or DTaP vaccine or three doses at three, four-and-a half and 15-18 months of age) of DT vaccine. The analysis included 4,273 DTaP recipients, 4,259 DTP recipients and 1,739 DT vaccinees.
View Article and Find Full Text PDFUnlabelled: From December 1990 to November 1993 nasopharyngeal specimens were obtained for culture from 50 children (mean 4.9 +/- 3.3 months of age) who had died suddenly.
View Article and Find Full Text PDFIn modern medicine, infection is one of the most serious complications of implanted plastic devices. The host is not able to overcome this special type of opportunistic infection despite having a normal immune response and a low virulence of most of the bacteria involved. Antimicrobial therapy alone generally cannot cure the infection and the removal of catheters often remains the only choice of therapy.
View Article and Find Full Text PDFIn a large pertussis vaccine efficacy trial in Germany, vaccinees and/or their family members were seen if a cough illness of >14 days was reported. Evidence of recent Bordetella pertussis infection included a positive culture and/or polymerase chain reaction (PCR) and/or significant antibody values in agglutination and/or ELISA assay. From July 1991 through February 1994, 246 adults were evaluated and 64 had evidence of B.
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