Biomedical subjects

Maria João Brito

Publications and source records attributed to Maria João Brito.

4 recordsLinked to original sources

PubMed2006

[Unsuspected meningococcal disease].

INTRODUCTION: Meningococcal disease has a wide spectrum of clinical presentation. Occult bacteremia is not easily diagnosed and may have good prognostic. CLINIC REPORT: Three year-old African boy with fever, gonalgia and gait disorder with 24 hours of evolution. Observation was unremarkable. He presented leukocytosis (27,300/mL) with neutrophilia (21,000/mL) and elevated reactive C protein (10.8 mg/dl) with normal osteo-articular imagiologic exams. A blood culture was obtained and he was discharged with the probable diagnosis of hip synovitis. Two days later, he was asymptomatic without fever or blood infectious parameters although Neisseria meningitidis was identified in the blood culture. Ceftriaxone was given for seven days. Before starting this treatment a second blood culture was negative. There were no complications. DISCUSSION: Meningococcal disease may present with fever without toxic appearance--unsuspected meningococcal disease--causing difficulty in the diagnosis and delaying the treatment. Spontaneous resolution is rare and severe complications may occur.

Bacteremia↗

PubMed2006

[Microlithiasis and testicular tumour].

Testicular microlithiasis is a rare entity, usually asymptomatic and bilateral. There are however reports that until 40% of the cases may be related with testicular tumours. We report an 11-year-old boy, with a four-month history of left testicular mass. Sonography showed increased volume of left testis and bilateral microlithiasis. Testicular biopsy revealed Sertoli cell tumour and he was submitted to left radical orquidectomy. Testicular cancer is often curable, especially if diagnosed and treated early. The association of malignancy justifies long term clinical and ultrasound follow-up of testicular microlithiasis.

Calculi↗

PubMed2005

[Respiratory infection caused by Chlamydia pneumoniae].

INTRODUCTION: Chlamydia pneumoniae is a pathogen usually associated with respiratory pathology. It has been estimated that this agent causes 5 to 15% of all pneumonias but its incidence among hospitalised children with respiratory infections is unknown. OBJECTIVE: Characterization of the Chlamydia pneumoniae respiratory infections in hospitalised children. PATIENTS AND METHODS: Retrospective longitudinal study of the Chlamydia pneumoniae respiratory infections in children admitted between January 1999 and June 2001 in the Department of Pediatrics in the Fernando Fonseca Hospital-Portugal. Sex, age, race, socio-economic status, number of scholar siblings, frequency of nursery/school, parents smoking habits, familiar atopy, personal history, clinical presentation, diagnosis, treatment and follow-up were analysed for each child. RESULTS: 55 cases were documented, 60% males and 73% whites. The age on admission varied between 17 days and 14 years-old, with a higher incidence below 5 years-old (60%). Twenty-three (42%) of the children were in nursery or in school and 12 (44%) had siblings at school-ages. Parent smoking habits were documented in 21 (38%) and familiar atopy in 21 (38%) children. Respiratory atopy (6 children), gastroesophageal reflux (3), cerebral palsy (1), cleft palate (1) and prematurity (1). Pneumonia was the most frequent clinical presentation (63%), followed by bronchiolitis (20%). The clinical presentation was not specific, with cough (84%), respiratory distress (65%) and fever (58%) being the most frequent signs. The most prevalent radiological pattern was the interstitial (42%). Coinfection by other agents occurred in five cases: S. pneumoniae (2), H. influenzae tipo b (1), P. aeruginosa (1) and tuberculosis (1). Complications were documented in 32 (58%) children: hypoxemia (20), pleural effusion (8), atelectasis (2) e atelectasis and hypoxemia (2). Macrolides were prescribed in 44% cases. DISCUSSION: This study calls the attention to the fact that Chlamydia pneumoniae infection is an etiology to be considered in children with respiratory infection and hospitalisation criteria. This infection can occur in all ages. Because the clinical presentation is not specific and complications can occur, a high level of suspicion is necessary for its diagnosis.

Adolescent↗

PubMed2005

Kawasaki disease.

INTRODUCTION: Kawasaki disease (KD) is the leading cause of acquired heart disease among children in developed nations. Its incidence has risen in recent years and 20% of untreated patients develop coronary artery abnormalities. OBJECTIVES: To analyze the epidemiological, clinical, laboratory and echocardiographic data of cases diagnosed in Hospital Fernando Fonseca and to identify factors that may influence prognosis. POPULATION AND METHODS: A retrospective study was performed of all children admitted to Hospital Fernando Fonseca with Kawasaki disease between June 1996 and December 2003. Diagnosis was based on the presence of fever plus four of the classic criteria or three of them in association with coronary aneurysms. Demographic and clinical features, laboratory and imaging findings, therapeutic measures and evolution were analyzed. SPSS for Windows was used for statistical analysis, applying the Mann-Whitney and Fisher's exact tests. RESULTS: A total of 23 children were admitted. The incidence was 8.2 per 100 000 children under 5. Their ages ranged from 6 months to five years (median 20 months). Half of the patients were aged < 2 years, and 21 (91%) were under 5. Most were male (74%) and white (83%). Nine children lived in the same area and ten (43%) had a concomitant infectious disease (parvovirus, Chlamydia pneumoniae, respiratory syncytial virus, enterovirus and herpesvirus 6). Twenty children had typical Kawasaki disease. Twenty-two received combined therapy with aspirin and high dose immunoglobulin, which was administered, on average, on the seventh day of the disease. Coronary disease was diagnosed in seven (30%) children. The frequency of cardiac lesions was highest in the youngest age group (< 2 years). The mean follow-up was 16 months. There was no mortality and aneurysmal changes persisted in only one patient. CONCLUSIONS: Cardiac disorders were more frequent in the youngest age group, as has been reported elsewhere. The common geographic origin and the evidence of several infectious agents suggest that infection may trigger the immunopathogenesis of KD.

Child, Preschool↗