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R Bruns

Publications and source records attributed to R Bruns.

At least 37 records · Page 2Linked to original sources

[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↗

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↗

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↗

[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↗

[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↗

[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↗