Obstructive bronchitis syndrome in acute viral respiratory diseases in young children

External respiratory function was explored in 39 children aged 1.5 months to 2 years presenting with the bronchoobstructive syndrome (BOS) in the presence of acute respiratory virus infection. The development of the BOS was accompanied by disorders of bronchial patency and alveolar ventilation. The maintenance of adequate ventilation is reached at the expense of hurried breathing with the respiratory volume being lowered. During convalescence, bronchial patency rises, hyperinflation drops and the respiratory volume increases. Uniformity of the ventilation-perfusion relations in the lungs declines. The use of total body plethysmography and oxycapnography makes it possible to objectively estimate respiratory function and to control the efficacy of the treatment in infants.     

Medium-weight molecules and their indicator role in young children with acute pneumonia]

As many as 63 infants with acute pneumonia, 7 children with ARVI (bronchiolitis) and 28 normal children were examined. At the height of the clinical manifestations there was an increase of the level of medium-weight molecules in blood serum, correlating well with the disease gravity determined by the intensity of the toxic syndrome. The highest concentration of serum medium-weight molecules was demonstrable in toxic and purulent complications due to acute pneumonia. Meanwhile the level of medium-weight molecules, equal to or exceeding 0.6 Units extinction may be viewed as an unfavourable predictor. No relationship was discovered between the concentration of serum medium-weight molecules and the type of virus causative agent and respiratory tract inflammation.     

The pivotal role of deep vein thrombophlebitis in the development of acute disseminated staphylococcal disease in children

Deep vein thrombophlebitis (DVT) and septic pulmonary emboli (PE) are rare in children. The association of DVT and acute disseminated staphylococcal disease (DSD) during childhood has not been previously reported. We report 3 children who developed a triad of DVT, septic PE, and acute osteomyelitis with Staphylococcus aureus cultured from blood and bone. One child succumbed, while 2 survived following prolonged, morbid hospitalizations. The rapid clinical deterioration observed in these patients might be caused by the aggressiveness of staphylococcal infection combined with an ongoing showering of septic emboli from the ileo-femoral DVT. We suggest that infected DVT with septic PE had a pivotal role in the development of DSD in these children. The presence of this triad should prompt aggressive treatment with the appropriate antibiotics, anticoagulation, surgical drainage, and assisted ventilation when indicated.     

The role of Chlamydia pneumoniae in acute respiratory tract infections in young children in The Gambia, West Africa

BACKGROUND: Little is known about the role of Chlamydia pneumoniae in the aetiology of acute respiratory tract infections (ARI) in children in developing countries. AIMS: To obtain better information, we studied the presence of C. pneumoniae and its association with clinical signs and symptoms of ARI in children under 5 years of age in The Gambia. METHODS: C. pneumoniae was sought by polymerase chain reaction in nasopharyngeal secretions and/or lung puncture aspirates from 324 infants under 3 months of age and 325 children between 3 months and 5 years of age with malnutrition, with or without pneumonia, and in control children. Clinical signs and symptoms for ARI and the spectrum of other viral and bacterial organisms were compared between those positive for C. pneumoniae and those negative. RESULTS: Of 324 young infants, ten (3.1%) showed the presence of C. pneumoniae whereas in the older children 50 of 325 (15%) were positive for C. pneumoniae. There was no significant association between clinical signs and symptoms of ARI and C. pneumoniae positivity in the young infants. Among older infants and children, there was a trend to more frequent lobar alveolar changes in those positive for C. pneumoniae. No bacterial pathogens were found to be significantly associated with C. pneumoniae infection. However, there was an association with measles in the malnutrition group and with RSV in the young infants group. CONCLUSIONS: In this study, C. pneumoniae was not associated with any particular clinical syndrome. We found no evidence that the organism plays a major role in ARI in young children in developing countries such as The Gambia.     

Lipomas of the mesentery in young children]

Lipomas of the small bowel and mesentery are exceedingly rare in young pediatric patients. This article reports a case which underlines the difficulty of establishing this diagnosis before exploratory laparotomy.