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Biomedical subjects

H Wiersbitzky

Publications and source records attributed to H Wiersbitzky.

At least 19 recordsLinked to original sources
PubMed2003

Chlamydia pneumoniae carriage and infection in hospitalized children with respiratory tract diseases.

BACKGROUND: The importance of Chlamydia pneumoniae respiratory tract infection in childhood is under discussion. PATIENTS AND METHODS: 798 hospitalized children with respiratory tract diseases were prospectively studied during a 2-year period by polymerase chain reaction and enzyme immunoassay (PCR-EIA) detection from throat swabs. Paired serum samples were used to screen for Chlamydia antibodies. RESULTS: C. pneumoniae was detected by PCR-EIA in 74 children. Prevalence was 11% in lower and 4% in upper respiratory tract disease (p = 0.049) without age dependency. From November to February prevalence was elevated (42/277 vs. 32/521; p < 0.001). Using serology, prevalence of acute Chlamydia infection increased with age (p < 0.001) and the number of coinfections (p < 0.001), without seasonal variation. CONCLUSION: Characteristics of C. pneumoniae carriage in the respiratory tract in childhood differ from those in systemic infection.

Adolescent↗
PubMed2000

Ectopic cervical thymus in a 12-year-old boy: a case report.

The case of a 12-year-old boy with ectopic cervical thymus is reported. This is a rare differential diagnosis in cervical tumors in childhood. The clinical symptoms might present as complications; in rare cases malignant transformations have been reported. The diagnosis ectopic cervical thymus can be achieved only histologically. Due to possible malignant transformation, it is mandatory to excise this thymus tumor totally.

Child↗
PubMed1993

[Suspected vaccination complications or atypical vaccination course. Diagnostic assessment of 58 vaccine recipients].

The "list of recommended vaccinations" of the regional Ministries of Health is the legal basis for routine vaccination programmes in each region of Germany; the recommendations of the Federal Commission on Vaccinations, "STIKO", are not legally binding. These programmes of the different regions provide legal grounds for determining claims for damage against a vaccinating doctor. In cases of damage, the Ministry of Health is liable for the damage to a patient caused by a recommended vaccination. Irrespective of these clear and comprehensive legal provisions, in case of an atypical course the patient is entitled to careful diagnosis of the complaint and appropriate medical treatment. However, later claims by the patient for damage can only be decided correctly if the necessary diagnostic data have been carefully collected at the acute stage of the disease. In our 58 patients suffering from atypical vaccination courses or suspected complications, we were able to show in each case that the symptoms are the result of interference by infectious diseases or that there was some other clear diagnosis; in no case did we find that the vaccination had caused disease or permanent damage.

Adolescent↗
PubMed1993

Acute obstructive respiratory diseases (ARD) and bacterial complications of ARD (pneumonia, sinusitis) in infants and children associated with human herpesvirus-6 infection.

The existence of catharreal respiratory symptoms (such as pharyngitis, tracheitis, bronchitis etc.) is established as the usual manifestation of "exanthema subitum" due to acute human herpesvirus-6 (HHV-6) infection. But so far pneumonia, purulent sinusitis, purulent otitis media and/or acute obstructive bronchitis (bronchiolitis) in infants and children have not been described. Here we report the results of observations of 2 children with bronchopneumonia/sinusitis maxillaris and severe bronchiolitis associated with an acute HHV-6 infection. Other respiratory viruses were excluded as agents causing the ARD.

Antibodies, Viral↗
PubMed1993

Pre- and perinatal infections due to human herpesvirus-6 and Epstein-Barr-virus with lethal outcome or severe residual encephalopathy.

The Human Herpesvirus-6 (HHV-6) infection causes exanthem subitum (in typical cases) and a wide range of other symptoms. So far no prenatal or perinatal infections have been reported. For HHV-6 the prenatal infection should be extremely rare, because more than 95% of adults are immune in Germany. Two own cases reported here document that pre- and perinatal HHV-6 infection does occur and can provoke dramatic clinical symptoms of illness with death or cerebral defects like other prenatal herpesvirus infections (HSV, VZV, CMV etc.).

Antibodies, Bacterial↗
PubMed1993

Reactivation in children of juvenile chronic arthritis and chronic iridocyclitis associated with human herpesvirus-6 infection.

The human herpesvirus-6 (HHV-6) causes exanthem subitum. Moreover it can provoke a large scale of different other clinical symptoms. The life-long persistence of human herpes viruses is well known (HSV 1 and 2, VZV, CMV, EBV). For the HHV-6 we have described here for the first time the onset/reactivation of juvenile chronic arthritis (jcA) and chronic iridocyclitis as chronically active and persistent infection in two children of school age.

Antibodies, Viral↗
PubMed1992

[Infections with herpesvirus 6--really only "exanthema subitum"? Part 2: Rare or unknown disease pictures].

The human herpes virus 6 (HHV 6) may induce not only the wellknown condition of exanthem subitum, but also a number of more common (cf. Part 1) or rare, even previously unknown, clinical manifestations. Part 2 of this paper deals with the more rarely observed manifestations. These include complications of ARD (sinusitis, otitis media, bronchial pneumonia) hepatitis, encephalitis or Pfeiffer's disease (mononucleosis-like syndrome). In individuals with a relevant disposition (genetic HLA/DR type?) initiation or (re-)activation of rheumatoid arthritis (JCA = juvenile chronic arthritis) or chronic iridocyclitis may occur. Although, on account of the high prevalence of vaccination in our population (approximately 95%), prenatal infections are extremely rare, they may manifest in a severe "septic" form (fatalities have occurred) or may lead to neurological deficits (comparable with cytomegalovirus infection). To date, no specific therapy (e.g. gammaglobulin, virostatics) or reliable preventive measures (e.g. vaccination) are available.

Child↗
PubMed1992

[Infections with herpesvirus 6--really only "exanthema subitum"? Part 1: More frequent disease pictures].

The human herpes virus 6 (HHV6) is the causal agent of exanthem subitum (rose rash of infants). In addition, however, a wide range of other clinical manifestations are possible, the more common of these include: Untypical exanthem or uncharacteristic rash (with and without fever), acute respiratory disease (ARD) acute gastroenteritis and febrile convulsions (with and without exanthem). More uncommon, and in part unknown, clinical manifestations associated with HHV6 infection are discussed in Part 2 of this paper. In common with other herpes viruses, HHV6 also tends to show persistence and intermittent or chronic shedding in the normal population, making the unusually early infection of children (seroconversion in the first year of life in up to 80% of all children) understandable. This means that HHV6 infections manifesting in close temporal association with recommended vaccinations may be misinterpreted as complications of the vaccination. Today, the situation can be clarified by employing special virological-serological laboratory tests, which are available throughout the country.

Diagnosis, Differential↗
PubMed1992

[Complications of acute respiratory tract infection (pneumonia, sinusitis) in young children associated with acute HHV 6 infection].

The human herpesvirus-6 (HHV-6) causes exanthema subitum ("e.s."). "E.s." is characterized by fever, exanthem (rash), in many cases gastroenteritis, occasionally cerebral convulsions (but more frequently general cerebral irritability) and enlargement of all lymph nodes; usually there are mild catarrhal respiratory symptoms of the upper airways (ARD). So-called "complications" of an ARD (pneumonia, acute purulent otitis media, acute sinusitis) due to bacterial infections are very unusual as sequelae of a HHV-6 infection. Here we report the case of 2 small children (toddlers) suffering from bronchopneumonia or pneumonia and acute sinusitis maxillaris associated with an acute HHV-6 infection. It seems that HHV-6 (like other respiratory tract viral pathogens) also can lead to secondary bacterial infections of the lower respiratory tract. So far it is not known, why such complications are so rare, although the extreme granulocytopenia accompanying "e.s." suggests a transient disturbance of the antibacterial defence mechanisms.

Antibodies, Viral↗
PubMed1991

[The blood picture in exanthema subitum (Zahorsky)/ critical 3-day fever-exanthema in young children].

Exanthema subitum was described in 1910 by John Zahorsky/USA; in 1986 and 1988 the human herpesvirus 6 (HHV 6) was discovered as the causative agent of the disease and serologic tests were established for diagnostics (specific IgM and IgG antibodies). Up to this time the diagnosis was based on the typical clinical course: the prodromal febrile stage (3 days) followed by the onset of a (more or less characteristic) rash closely connected with the normalisation of the body temperature. Usually a typical white blood cell count was described for diagnostics on the first day of exanthema: leukocytopenia with eosino- and granulocytopenia associated with consequent lymphocytosis. We analysed the hematologic data for children with a serologically documented HHV6 infection including exanthema (group 1: n = 9), without exanthema (group 2: n = 11) or with a serologically unexplained febrile rash (group 3: n = 13). In children with exanthematous HHV6 infection (exanthema subitum) granulocytopenia and a decreased thrombocyte count (mean values) is the rule. But the total white blood cell count and the mean values for eosinophils did not differ between the groups studied.

Agranulocytosis↗
PubMed1991

[Obstructive respiratory tract diseases in children and Parvovirus B19 infections].

Acute respiratory diseases (ARD) due to parvovirus B 19 infection can be observed relative frequently in children. In 21 children (infants, toddlers and school children) we have seen acute or prolonged obstructive bronchitis/bronchiolitis (15 infants), acute subglottic laryngitis (3 toddlers) and acute asthmatic attacks (3 children of school age) in connection with parvovirus B 19 infection. Other respiratory viruses (adeno-, influenza, parainfluenza and RS-virus) could be excluded as agents causing the ARD. We suggest that parvovirus B 19 can provoke ARD with obstructive ventilatory disturbances of the upper or lower airways in children with a specific endogenous predisposition (small or unstable bronchial walls, or bronchial or tracheal mucosal hyperreactivity).

Airway Obstruction↗
PubMed1991

Serum prolactin concentration and hypothalamic-pituitary hormone release in CF-children.

Some experimental data from animals suggest that prolactin (PROL) is involved in sweat production and modulates the chloride concentration of sweat. We determined the serum PROL level by RIA in 38 CF-patients (age: 3-24 years) and 48 patients with bronchial asthma (age: 2-18 years) and found no concentration differences between the two groups each taken as a whole; the TSH level was increased in CF (p less than 0.05). Separate analysis showed a significantly higher PROL level in CF-females and in CF-children (male and female) under 12 years old (p less than 0.05). To assess the hypothalamic-pituitary system we performed the metoclopramide test (by Cerucal) on 30 children suffering from CF (n = 10), bronchial asthma (n = 10) or pyelonephritis (n = 10) for PROL, LH, FSH, TSH and HGH. The hormone release was normal for all kinds checked in all groups of patients. Hence it follows that the neurohormonal system of prolactin is normal in CF-patients and the increased serum PROL and TSH concentrations in CF should be seen as a regulatory phenomenon but not as a mechanism associated with the basic defect of the CF-disease.

Adolescent↗