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PubMed1988

The expanded spectrum of toxocaral disease.

Among 137 members of 30 families, 6% (and 8% of those aged under 15 years) were seropositive for toxocara antibodies. In these seropositive subjects and in 84 patients known to have raised toxocara titres the commonest clinical features were abdominal pain, hepatomegaly, anorexia, nausea, vomiting, lethargy, sleep and behaviour disturbances, pneumonia, cough, wheeze, pharyngitis, cervical adenitis, headache, limb pains, and fever. 61% of patients with raised toxocara titres had recurrent abdominal pain. Eosinophilia was in many cases associated with a raised toxocara titre, but 27% of patients with high titres had normal eosinophil counts. Toxocariasis is common, especially in children, and is associated with clinical features that are generally regarded as non-specific but together form a recognisable symptom complex. Toxocariasis should be considered in the differential diagnosis of such symptoms and especially in recurrent abdominal pain, which might otherwise be labelled as idiopathic. The absence of eosinophilia does not exclude toxocariasis.

Adolescent↗

PubMedDate not supplied

Use of Broncho-Vaxom in private practice: phase IV trial in 587 children.

We conducted a Phase IV, open-label clinical trial to test the efficacy and safety of the immunomodulating agent Broncho-Vaxom in private practice. The trial comprised 587 children younger than 12 years of age who had an acute respiratory tract infection at entry and a history of recurrent respiratory tract infections. The patients were given one capsule daily, 10 days per month, for 3 consecutive months. During the acute phase of the disease the patients also received antibiotic therapy. Comparing the infection present at entry with previous infections, the time to improvement (mean +/- SD) decreased from 6.77 +/- 4.42 days to 3.76 +/- 2.18 days, while the time to cure decreased from 11.86 +/- 8.41 days to 7.36 +/- 4.93 days. During the 3 months of therapy, the number of infections decreased from 1.79 +/- 0.96 1 month before treatment to 0.24 +/- 0.46 in the third month of treatment; absenteeism decreased from 3.17 +/- 3.07 days to 0.16 +/- 0.63 days; and the number of antibiotic treatments decreased from 1.71 +/- 1.06 to 0.16 +/- 0.51. In the patients who experienced a recurrent respiratory tract infection during the study, the time to improvement decreased from 5.46 +/- 3.28 days before treatment to 2.79 +/- 1.36 days after treatment, and the time to cure decreased from 8.71 +/- 3.96 days to 4.54 +/- 2.26 days. Adverse events included asthenia and adynamia in 3 patients, diarrhea in 3, rash in 2, fever in 2, exacerbation of symptoms in 2, adenitis in 1, and flulike syndrome in 1. We conclude that Broncho-Vaxom is effective and safe for the treatment of acute episodes of respiratory tract infections and for preventing recurrences.

Acute Disease↗

PubMed2001

Surgery required to verify atypical mycobacterial infections.

To estimate the incidence and distribution of nontuberculuous mycobacterial surgery, a retrospective case record study of 42 children operated for cervicofacial atypical mycobacterial infections in Oslo from 1990 to 2000 was performed. Mean age at diagnosis was 41 months and mean duration of the disease was 40 weeks from symptom onset to remission. All presented with localized and unilateral disease without increased hematological parameters. The majority of children had one lesion localized in the submandibular region characterized by changes in the overlying skin color, but without necrosis or fistula formation. Children below three significantly more often presented with only one lesion and the referring physician more frequently suspected neoplasm and bacterial adenitis than reactive adenopathy in this group. Compared to older children, there was a tendency for shorter symptom duration prior to outpatient treatment (mean 4 and 13 weeks for children up to 3 and above 3 years, respectively, t=-1.6, P=0.11). Furthermore, mycobacterial cultures and histopathology from surgical specimens was needed to diagnose the disease correctly. Fine-needle aspiration biopsy was unsuccessful in 27% (n=8) of the patients, due to non-cooperative patients (n=2) or inconclusive material (n=6), and mycobacterial growth was not obtained in any of the samples. Intradermal mycobacteria skin testing yielded 29% (n=10) false negatives. Although mycobacteria was correctly diagnosed in the remaining patients, correct specimen was found in only 31% (n=11) of the 25 cases.

Child↗

PubMed1986

Complication of acute epiglottitis.

Acute airway obstruction secondary to supraglottic inflammation is a regional manifestation of epiglottitis in children. Pneumonia, meningitis, cervical adenitis and septic shock are systemic manifestations which can complicate the course of acute epiglottitis. Prompt airway control and institution of appropriate high dose i.v. antibiotics are both important to continue to decrease the morbidity and mortality associated with the regional and systemic manifestations of acute epiglottitis in children.

Acute Disease↗

PubMed1990

Newly reported skin disease syndromes in the dog.

Several recently recognized canine dermatoses are described. Syndromes discussed include superficial necrolytic dermatitis, Malasezzia dermatitis, sebaceous adenitis, nodular dermatofibrosis in German shepherd dogs, solar-induced dermatitis, and acrodermatitis.

Animals↗

PubMed2002

The management of burns in a developing country: an experience from the republic of Yemen.

BACKGROUND: Burns management and mortality rates have improved in even developing countries including some Arab states. This paper describes an experience with burn victims in the Yemen to draw attention to the victims' plight, the challenge posed to bodies, such as the International Society of Burn Injury (ISBI), and, the basic required corrective measures. PATIENTS AND METHODS: Between 1996 and 1999, sponsored surgical teams paid four visits to four Yemen cities. The patients presented here are a consecutive series of the plastic surgery operations that the teams performed. No literature on burn care in the Yemen could be traced. RESULTS: The cities visited were Mokalla, Sayown, Taiz and Aden. Of 406 plastic procedures, 139 were for post-burn contracture release and are the focus of this paper. The victims were mostly children and the hand (49; 35%) was the most common site. Types of operation performed were release and split skin grafi, excision and full thickness skin grafi, release and local flap, and, multiple Z-plasty. CONCLUSIONS: This experience confirms the believe that, given initiative and efficient organization of available resources, developing countries such as the Yemen can also achieve better burn management. Solutions suggested are determining local health needs; onsite conferences, symposia and training programs; local personnel to visit burn centers overseas; burn research and prevention activities; and epidemiologic studies.

Adolescent↗

PubMed2002

Application of dynamic CT for various diseases in the oral and maxillofacial region.

OBJECTIVE: To investigate whether dynamic CT enables quantitative differentiation between inflammation, benign tumors, and malignant tumors in oral and maxillofacial regions. METHODS: Sixteen malignant tumors (14 squamous cell Ca, one adenoid cystic Ca, one mucoepidermoid Ca), six benign tumors (one Warthin tumor, two pleomorphic adenomas, one lipoma, one Schwanoma, one hemangioma), and seven inflammation cases (three submandibular adenitis, two osteomyelitis, two perimandibular inflammations) were examined. Contrast agent (0.8 ml/kg) was injected intravenously at 5 ml/s. CT (Toshiba TCT 900S) scanning was performed at the time of the beginning of contrast medium injection. Parameters from the time-density curve were investigated: peak height (PH), relative CT value from the base CT value when the curve reached peak point; peak time (PT), the time when the curve reaches the peak point from contrast medium infusion; transit time (TT), time between two transit points on the time-density curve; and peak time ratio (PR), the ratio of peak time from the lesion to the artery and peak time from the vein to the artery. RESULTS: PH was highest in inflammation, followed by malignant tumors and benign tumors. TT was significantly longer in benign tumor cases compared with malignant tumor and inflammation cases. PR for malignant tumor and inflammation were between the artery and vein phase, and that for benign tumor was beyond the vein phase. CONCLUSION: Parametrical analysis of a contrast enhanced dynamic CT study may serve to differentiate the lesions in the oral and maxillofacial region.

Adult↗

PubMed2003

PFAPA syndrome mimicking familial Mediterranean fever: report of a Turkish child.

The PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis, Adenitidis) syndrome is characterized by periodic fever, adenitis, pharyngitis, and aphthous stomatitis. Herein, we present a Turkish child with PFAPA syndrome mimicking familial Mediterranean fever because of a rare presentation. A 9-year-old boy was admitted with recurrent fever, aphthous stomatitis, sore throat, headache, and general body pains, lasting 2 to 3 days since 3.5 years of age. He was completely symptom-free between the attacks. He was diagnosed as having familial Mediterranean fever according to the clinical findings when he was 6 years of age and Colchicum tablet was administrated. Despite colchicines therapy for 8 months, his attacks did not subside; therefore, the drug was discontinued. He had high fever, a painful cervical lymphadenopathy, aphthous stomatitis, and tonsillo-pharyngitis. The patient was then diagnosed as having PFAPA syndrome. He was given a single dose of prednisolone (0.35 mg/kg/dose). His complaints dramatically and completely disappeared 3 h after administration of the drug. During the 8th month of follow-up, a similar febrile attack lasting only 1 day was noted and it was controlled with a single dose of prednisolone (0.5 mg/kg/day). At this writing the patient is in the 12th month of follow-up, and there have been no symptoms after the second attack. In conclusion, our patient shows that PFAPA syndrome can be confused with familial Mediterranean fever. We also would like to emphasize that the typical PFAPA syndrome can be easily diagnosed by detailed history-taking and physical findings.

Child↗

PubMed1997

[Severe streptococcal complications in varicella].

BACKGROUND: An increase in the incidence of group A beta hemolytic streptococcal (GABHS) infections in children has been recently noted with a frequent association with varicella. CASE REPORTS: Two children, 3 and 4.5 years old, developed varicella. The first one was febrile and presented a phlyctene on his left foot. Few hours after his admission, he presented a septic shock; GABHS was isolated from blood. Despite immediate adapted antibiotherapy, he developed a right tibial osteomyelitis with abscess. The second child also developed varicella and was hospitalized because of fever, bad general condition, right cervical adenitis and edema on the left wrist. Edema rapidly extended to the hand and upper arm. One purulent lesion was noted on the upper arm from whom Staphylococcus aureus and GABHS were isolated. Blood samples were sterile. The clinical course was favorable with adapted antibiotherapy. A cutaneous desquamation was observed on the 9th day and we concluded that it was a GABHS cellulitis. CONCLUSION: These two cases confirm the recent report of increase in GABHS infections associated with varicella. Such complications must be looked for in patients with varicella remaining abnormally febrile and/or presenting unusual manifestations.

Chickenpox↗

PubMed1998

[Foreign bodies in the ear; report of 40 cases].

BACKGROUND: Foreign bodies in the external ear canal present a frequent situation in pediatric practice. It is generally benign, but infectious complications may occur. POPULATION: Between January 1996 and March 1997, 35 children with a foreign body in the ear canal were treated in the ENT department of Robert-Debré hospital. RESULTS: Age ranged from 15 months to 14 years, with a mean of 6.5 years. The sex ratio was 1.2 (19 boys/16 girls). Five children had bilateral foreign bodies. The most frequent foreign bodies were pearls (8/40) and cockroaches (7/40). Eleven children had complications: ear canal laceration in five cases, otitis externa in five cases, cervical adenitis in three cases, general septic syndrome with fever in one case, and drum perforation in one case. CONCLUSION: The methods of extraction and the management of the complications are discussed.

Adolescent↗

PubMed1994

Myocardial oxygen supply-demand relations during isovolemic hemodilution.

The findings presented in this article pertain strictly to the specific conditions of the studies and should be extrapolated to human patients with caution for several reasons. First, the experimental model of a single acute coronary stenosis is a rare clinical occurrence, and it ignores the influence of the well-developed collateral circulation and impaired endothelial function which may accompany long-standing coronary artery disease (22). Second, the absolute hematocrit at which cardiac dysfunction arises would likely vary if a different anesthetic technique or diluent were used, or if the study were carried out in the absence of thoracotomy and positive-pressure ventilation or at a reduced body temperature. Nevertheless, the present findings provide broad guidelines for assessing when hemodilution may be used safely as a method of blood conservation. They suggest (1) that relatively severe hemodilution alone or moderate hemodilution combined with controlled hypotension with either SNP or ADEN may be used safely if cardiac function is normal and the coronary circulation is not obstructed, but (2) that even moderate hemodilution alone may be unsafe in patients in whom the coronary vasodilator reserve is exhausted or severely depleted by a proximal stenosis.

Animals↗

PubMed1997

Recurrent aphthous stomatitis: clinical characteristics and associated systemic disorders.

Recurrent aphthous stomatitis (RAS), commonly known as canker sores, has been reported as recurrent oral ulcers, recurrent aphthous ulcers, or simple or complex aphthosis. RAS is the most common inflammatory ulcerative condition of the oral mucosa in North American patients. One of its variants is the most painful condition of the oral mucosa. Recurrent aphthous stomatitis has been the subject of active investigation along multiple lines of research, including epidemiology, immunology, clinical correlations, and therapy. Clinical evaluation of the patient requires correct diagnosis of RAS and classification of the disease based on morphology (MiAU, MjAU, HU) and severity (simple versus complex). The natural history of individual lesions of RAS is important, because it is the bench mark against which treatment benefits are measured. The lesions of RAS are not caused by a single factor but occur in an environment that is permissive for development of lesions. These factors include trauma, smoking, stress, hormonal state, family history, food hypersensitivity and infectious or immunologic factors. The clinician should consider these elements of a multifactorial process leading to the development of lesions of RAS. To properly diagnose and treat a patient with lesions of RAS, the clinician must identify or exclude associated systemic disorders or "correctable causes." Behçet's disease and complex aphthosis variants, such as ulcus vulvae acutum, mouth and genital ulcers with inflamed cartilage (MAGIC) syndrome, fever, aphthosis, pharyngitis, and adenitis (FAPA) syndrome, and cyclic neutropenia, should be considered. The aphthous-like oral ulcerations of patients with human immunodeficiency virus (HIV) disease represent a challenging differential diagnosis. The association of lesions of RAS with hematinic deficiencies and gastrointestinal diseases provides an opportunity to identify a "correctable cause," which, with appropriate treatment, can result in a remission or substantial lessening of disease activity.

AIDS-Related Opportunistic Infections↗

PubMed2006

Mycobacterium abscessus cervical lymphadenitis: an immunocompetent child.

Nontuberculous mycobacterium (NTM) is one of the well-known causes of cervicofacial lymphadenopathy in children under 5 years of age. Children often present with a painless cervical mass that fails to respond to conventional antibiotics. They are often referred under the suspicion of a neoplasm or bacterial adenitis rather than NTM cervical lymphadenitis. The lack of systemic symptoms, modest or negative purified protein derivative test and absence of exposure to active tuberculosis are characteristics of NTM lymphadenitis. The diagnosis usually requires the isolation of pathogen or pathologic proof. Complete excision is the choice of treatment by the majority of authors in the literature. This not only enables rapid diagnosis but ensures the lowest recurrence rate. Medical management is sometimes successful when complete resection is impossible or refused. To our knowledge, the incidence of NTM cervical lymphadenitis in children is increasing throughout the world. However, such reports of children in Taiwan is lacking. Clinicians should suspect a possible nontuberculous mycobacterial infection when a cervical lump is found in a child.

Child↗

PubMed2005

[Terminal ileitis due to Yersinia enterocolitica in infants].

Yersinia enterocolitica infection presents a wide clinical spectrum; in infants and young children it usually presents as uncomplicated acute diarrhea, while in older children and adolescents it more frequently presents as terminal ileitis and/or mesenteric adenitis. We describe two infants who developed terminal ileitis complicating Y. enterocolitica infection, which is exceptionally rare. The clinical, laboratory and radiologic findings are described and ultrasound study is emphasized as a simple and reliable tool for investigation of terminal ileitis.

Crohn Disease↗

PubMed1975

Host-parasite relationship of Bulinus forskalii (Ehrenberg) and Schistosoma intercalatum Fisher 1934, from Cameroun.

The susceptibility of 13 different B. forskalii strains from Zaire, Cameroun, Gabon, Senegal, Rhodesia and Tanzania and B. reticulatus wrighti Aden has been tested to infection with Schistosoma intercalatum from Cameroun. The most common prepatent period was 23-28 days. B. forskalii from Zaire, Cameroun and Gabon were excellent intermediate hosts with infection rates varying from 59-0 to 97-4% and with very low death rates, 0-28-4%. The strains from Senegal and Rhodesia had infection rates from 50-0 to 58-4%. B forskalii from Tanzania was refractory. 53-0% of the exposed B. reticulatus wrighti was infected. The total cercariae production per snail varied from 1000-11000. The duration of the infection varied from 8 to 174 days.

Animals↗

PubMed1996

Cervical lymphadenopathy secondary to atypical mycobacteria in children.

Non-tuberculous mycobacterial (NTM) infections usually present as an enlarged lymph node in the neck of a non-immunocompromised child. The differential diagnosis includes bacterial adenitis, malignant disease and tuberculosis. The definitive diagnosis relies upon isolating the organisms in culture. The treatment is complete surgical excision with, or without, anti-tuberculous chemotherapy. Ten cases of NTM infections are presented with a discussion of the aetiology and treatment of this condition.

Child↗

PubMed2003

Prevalence of blood-borne viral hepatitis in different communities in Yemen.

It is generally believed that hepatitis B (HBV) and C (HCV) viruses are highly prevalent in the Republic of Yemen. This study investigated the prevalence of HBV and HCV markers in 494 blood donors from Aden, 493 blood donors from Sana'a, 97 residents from an African ethnic minority in Sana'a and 99 residents of Soqotra Island. There were significant differences in the prevalence of HBV carriage (HBsAg: 6.7, 15, 19.6 and 26.3% respectively; P < 0.001); past HBV infection (anti-HBc: 17.4, 18.5, 30.9 and 59.6% respectively; P < 0.001); susceptibility to HBV (absence of HBV markers: 73.3, 61.9, 38.1 and 9.1% respectively; P < 0.001), infectivity of HBV carriers (HBV DNA: 51.5, 33.8, 52.6 and 65.4% respectively; P = 0.028) and HCV antibodies (RIBA confirmed or indeterminate: 0.6, 0.2, 5.2 and 5.1% respectively; P < 0.001). A significant difference in HBV carrier rate and a borderline significant difference in the prevalence of natural infection was observed between males and females in the African community (P = 0.02 and 0.06 respectively). In contrast, in Soqotra Island, there was no significant sex difference in HBV carrier rate but susceptibility was significantly more prevalent in males (P = 0.03). This study illustrates that significant difference in prevalence and epidemiology exists among different communities within the same country, reflecting political, geographical and social differences. Control strategies should take these differences into account.

Adolescent↗

PubMed2006

[Recurrent febrile episodes--normal, periodic fever syndrome or immunodeficiency?].

Fever is one of the main symptoms leading to medical evaluation. Not only infections cause fever but also inflammatory disorders. To distinguish one from another, a thorough medical history and clinical evaluation are needed. Sometimes, only the clinical course will reveal the diagnosis. PFAPA-Syndrome (periodic fever, aphthous stomatitis, pharyngitis, adenitis) is the most frequent periodic fever syndrome in Switzerland. No diagnostic test is available to support the diagnosis. Some important diseases have to be ruled out, such as Immunodeficiency, cyclic neutropenia, chronic viral infections and rheumatologic disorders. To know the diagnosis of the PFAPA-Syndrome can help avoiding antibiotic courses for febrile episodes in infants. There is a clinical overlap to hereditary periodic fever syndromes as familial Mediterranean fever (FMF), Hyper-IgD and fever syndrome (HIDS), Tumor-necrosis factor receptor associated periodic syndrome (TRAPS) and others, in which a genetic basis for the disease has already been found.

Child↗