SARS-CoV-2 infection in children

SARS-CoV-2, a RNA virus that emerged in December 2019 in the city of Wuhan in China and took hold of the whole world, affects children as well as all age groups. In our country, we started to observe the first cases by March 2020. SARS-CoV-2, which is transmitted by droplets and by way of contact with surfaces contaminated by these droplets, is generally transmitted to children from adults through close contact. There is no proven information about other transmission routes such as fecal-oral transmission. Similar to adults, the primary symptoms at presentation include fever, cough, sore throat, malaise, nasal discharge, and rarely, vomiting and diarrhea in children. Although the majority of pediatric patients are asymptomatic or have a mild clinical course, severe cases have been reported in children with underlying chronic diseases. There is currently no specific antiviral treatment against the SARS-CoV-2 virus. Supportive treatment is recommended in children with a mild course, and some treatments are recommended in children with comorbidities or in children who are observed to have a more severe course. Asymptomatic pediatric patients or pediatric patients who have a mild course constitute an important group in terms of transmission of the infection to the advanced age group who carry high risk. Prevention of infection is very important in terms of reducing new cases and alleviating the load on the healthcare system. In order to prevent transmission of SARS-CoV-2, hygienic rules should be pursued in the community, social distancing should be observed, and the family members and contacts of patients who have been diagnosed should be screened and isolated

Factors associated with early complications in inpatients who were treated in our clinic between 1992 and 2011 with a diagnosis of acute bacterial meningitis

Aim: To evaluate factors associated with the development of early complications in acute bacterial meningitis

Clinical characteristics and genetic analysis of cystic fibrosis transmembrane conductance reseptor‐related disease

Background Cystic fibrosis (CF) transmembrane conductance receptor (CFTR)-related disease is diagnosed in patients affected by CFTR dysfunction who do not fully meet the CF diagnostic criteria. Only 2% of all CF patients have CFTR-related disease. We define the demographic characteristics of such patients, described the performance of mutational analyses, and describe the clinical findings

Clinical characteristics and genetic analysis of cystic fibrosis transmembrane conductance reseptor-related disease

Background Cystic fibrosis (CF) transmembrane conductance receptor (CFTR)-related disease is diagnosed in patients affected by CFTR dysfunction who do not fully meet the CF diagnostic criteria. Only 2% of all CF patients have CFTR-related disease. We define the demographic characteristics of such patients, described the performance of mutational analyses, and describe the clinical findings

Can Fecal Calprotectin Level Be Used as a Markers of Inflammation in the Diagnosis and Follow-Up of Cow's Milk Protein Allergy?

Purpose: Calprotectin is a cytosolic protein with immunomodulatory, antimicrobial, and antiproliferative actions. The concentration of calprotectin increases in infection, inflammation, and malignancy. We determined if calprotectin can be used as a marker for the diagnosis and follow-up of bowel inflammation in cow's milk protein allergy (CMPA). Methods: In total, 32 patients newly diagnosed with CMPA were included (24 IgE-mediated, 8 non-IgE-mediated). In all subjects, a complete blood count, total IgE, cow's milk-specific IgE, and fecal calprotectin (EC) were assessed before and after a cow's milk protein (CMP) elimination diet was started. The results were compared with those of 39 healthy children. Results: The mean EC value before the CMP elimination diet was 516 +/- 311 mu g/g in the 32 patients with CMPA and 296 +/- 94 mu g/g in the control group (P=0.011). The mean FC value after the diet in these patients was 254 +/- 169 mu g/g, which was significantly different from the mean value before the CMP elimination diet (P<0.001). When we compared EC levels before the CMP elimination diet in the IgE-mediated group with the control group, we found no significant statistical difference (P=0.142). The mean FC value before the CMP elimination diet was 886 278 pg/g in the non-IgE-mediated group and 296 +/- 94 pg/g in the control group; this difference was statistically significant (P<0.001). In the IgE-mediated and non-IgE-mediated groups, FC values after CMP elimination diet were 218 +/- 90 mu g/g and 359 +/- 288 mu g/g, respectively, and FC values before CMP elimination diet were 392 +/- 209 mu g/g and 886 +/- 278 mu g/g, respectively; these differences were statistically significant (P=0.001 and P=0.025, respectively). Conclusions: FC levels may be a useful marker for follow-up treatment and recurrence determination in CMPA

Clinical Manifestations and Diagnosis of Extrapulmonary Tuberculosis in Children

Objective:Tuberculosis (TB) is an important public health problem both in developing and developed countries due to migration with increasing incidence despite control strategies. Various clinical manifestations of extrapulmonary tuberculosis (EPTB) cause delay in diagnosis and treatment. In the present study, we aimed to evaluate the clinical and laboratory findings of extrapulmonary tuberculosis in childhood

Consensus statement on diagnosis, treatment and follow-up of cow's milk protein allergy among infants and children in Turkey

The present paper aims to provide experts' consensus on diagnosis and management of cow's milk protein allergy (CMPA) among infants and children in Turkey, based on review of available evidence-based guidelines, publications and experts' clinical experience. The experts agreed that CMPA diagnosis should be based on symptomatic evaluation and diagnostic elimination diet as followed by implementation of an open challenge test after disappearance of symptoms and confirmation of CMPA diagnosis in re-appearance of symptoms. For breastfed infants, differential diagnosis involves withdrawal of cow's milk-containing products from the mother's diet, while calcium supplements and appropriate dietary advice are given to mothers to prevent nutritional deficiency. For infants not breastfed exclusively, cow's milk-based formula and any complementary food containing cow's milk protein (CMP) should be avoided. The first line treatment should be extensively hydrolyzed formula (eHF) with use of amino acid-based formula (AAF) in severe cases such as anaphylaxis, enteropathy, eosinophilic esophagitis and food protein induced enterocolitis along with cases of multiple system involvement, multiple food allergies and intolerance to eHF. Introduction of supplementary foods should not be delayed in CMPA, while should be made one by one in small amounts and only after the infant is at least 17 weeks of age. Infants who are at-risk can be identified by family history of atopic disease. Exclusive breastfeeding for 4-6 months (17-27 weeks) is recommended as the best method of infant allergy prevention. There is no evidence that modifying the mother's diet during pregnancy and/or breast-feeding and delaying solid or even potentially allergic foods beyond 4-6 months in infants may be protective against allergy among at-risk infants. When exclusive breastfeeding is not possible, at-risk infants should get a partially or extensively hydrolyzed formula (pHF or eHF) to prevent allergy until risk evaluation by a health professional. In conclusion, the present consensus statement provides recommendations regarding diagnosis, prevention and management of CMPA in infants and children in Turkey, and thus expected to guide physicians to optimize their approach to CMPA and decrease burden of the disease on infants and their caregivers

Thyroid abscess due to Eikenella corrodens in a pediatric patient

Eikenella corrodens is one of the HACEK bacteria that is commensal microorganism of the oropharngeal flora. E. corrodens has been increasingly reported to cause pyogenic abscesses, especially in diabetic or immunocompromised adults. It is less frequently reported in immunocompotent children. Here, we report a deep neck infection, including the thyroid gland, in a previously healthy girl. E. corrodens was the only microorganism isolated in two different cultures. Antibiotic susceptibility is variable, in contrast to other oropharyngeal pathogens. Thus, to avoid delayed treatment, E. corrodens should always be considered in infections of the head and neck area