Severe suppurative otitis media due to Streptococcus pneumoniae serotype 19A in a fully vaccinated infant by age

The routine use of pneumococcal conjugated vaccines (PCVs) in childhood has significantly reduced the frequency of invasive pneumococcal diseases (IPDs). Serotype replacement has occurred, resulting in an increase in nonvaccine serotypes. Despite this changing profile, both invasive and noninvasive cases continue to be seen with strains within the scope of PCV coverage. Although older children with comorbid disease are described as a risky group for vaccine insufficiency, vaccine failure patterns should be described in detail

A case of glandular tularemia presenting with prolonged fever and mesenteric lymphadenopathy

Tularemia is a zoonotic disease caused by Francisella tularensis, a gramnegative coccobacillus that is transmitted to humans by direct contact with or ingestion of infected animal tissues, through the bite of infected arthropods, by consumption of contaminated food or water, or from inhalation of aerosolized bacteria. Presented herein is a case of a four-year-old girl who was diagnosed with glandular tularemia after presenting with prolonged fever and mesenteric lymphadenopathy. A history of contact with a rabbit was a valuable clue for the diagnosis

An Important Finding of Systemic Aspergillosis: Skin Involvement and Amphotericin B Resistance in an Adolescent

Invasive aspergillosis is a life-threatening infectious complication in immunocompromised patients, especially with malignancy, and in some cases, it causes extensive tissue destruction and subsequent systemic illness, leading to multiorgan failure and death. Skin involvement and amphotericin B resistance are very rare findings of aspergillosis. Herein, we report the case of a primary hemophagocytic syndrome patient who developed subcutaneous nodules in the 3rd month of bone marrow transplantation from which Aspergillus fumigatus was cultivated despite the fact that she was under antifungal therapy. In immunocompromised patients with prolonged fever, atypical presentations of invasive mycosis should be kept in mind, and early appropriate therapy should be initiated promptly to decrease morbidity and mortality. Copyright (C) 2013, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC.WoSScopu

Brucellosis in childhood: Hacettepe University experience Çocukluk çaǧinda bruselloz: Hacettepe Üniversitesi deneyimi

In the present study, 24 cases with brucellosis followed up from 1 January 2000 to 30 April 2010 in the Infectious Diseases Unit of Hacettepe University İhsan Doǧramaci Children's Hospital were retrospectively reviewed. Brucellosis was diagnosed by an increased brucella agglutination titer of 1:160 or greater and/or isolation of the organism by culture in the presence of clinical findings. The 24 patients (13 males, 11 females) were aged 11.2±3.5 years. File records were obtained, and the most common symptoms on admission were fever (93.3%), malaise (86.6%), lack of appetite (80%), sweating (66.6%), and joint pain and swelling (53.3%). On physical examination, the findings and percentages were as follows: fever (93.3%), arthritis (46.6%), lymphadenopathy (26.6%), splenomegaly (6.6%), and maculopapular rash (6.6%). Seventeen percent of the patients had high aminotransferase levels, 63% had high erythrocyte sedimentation rate and 72% had increased levels of positivity of C-reactive protein (CRP). In 30.7% of the cases, blood cultures were positive. All of the cases received combined antibiotic therapy. One of the cases (6.6%) had relapse during the follow-up period

Brain abscess in childhood: A 28-year experience

Brain abscess is an uncommon intracranial suppurative infectious disease, especially in children. The clinical presentation, treatment and outcome of 75 children with brain abscesses admitted to the Department of Pediatric Infectious Diseases at Hacettepe University Faculty of Medicine were retrospectively analyzed. Seventy-five cases of brain abscess within a 28-year period were included in this study. Fever and headache were the most common presenting symptoms. Cyanotic congenital heart disease was the most common predisposing factor. The most common pathogen was Streptococcus spp. Although congenital heart disease remained the most common predisposing factor for development of intracerebral abscess, the rate of immunocompromised diseases as a predisposing factor of brain abscess has increased in recent years, and better management of otogenic infections also influences the prevalence of the disease

Partial Hepatectomy for the Resistant Fasciola Hepatica Infection in a Child.

Fascioliasis is an emerging and important chronic parasitic disease caused by two trematode liver fluke species: Fasciola hepatica (F. hepatica) and Fasciola gigantica (F. gigantica) infecting several herbivorous mammals including cattle, goats, sheep, and humans. We report a 9-year-old girl who suffered from F. hepatica infection and underwent right hepatectomy because of increasing abdominal pain resistant to anthelmintic chemotherapy. When anthelmintic drug treatment is not effective and abdominal pain persists, surgical resection including hepatectomy should be kept in mind for resistant F. hepatica infection