Chronic Epstein-Barr viral infection in children: a clinical case

The urgency of Epstein-Barr virus infection is explained by wide circulation of Epstein-Barr virus among children and adults, its tropism to immunocompetent cells with lifelong persistence after primary infection and polymorphism of clinical manifestations from subclinical forms, infectious mononucleosis to formation of oncological, autoimmune hematological diseases.Persistence of Epstein - Barr virus Leads to suppression of cellular immunity, decreased production of interferons and nonspecific protection factors, which contributes to reactivation of persistent infection, most often without mononucleosis-like syndrome, and the appearance of atypical mononuclears in blood with the formation of lymphoproliferative, intoxication, astheno-vegetative syndrome, long-term subfebrile condition, which dictates the need for immunocorrective therapy. This article presents a clinical case describing and analyzing the course of a chronic Epstein-Barr virus infection in a preschool child (5 years 8 months) with a pre-morbid background. Episodes of reactivation of chronic persistent infection occurred under the mask of acute respiratory infection with lymphoproliferative syndrome, purulent tonsillitis, purulent adenoiditis. Therapy, including antibiotics, short-course antiviral agents, bacterial lysates, and physiotherapy, had a temporary and short-lived effect. meglumine acridonacetate. The described clinical case demonstrates the effectiveness of the inclusion of meglumine acridonacetate, which has antiviral, immunomodulatory and anti-inflammatory effects, in the complex treatment of Epstein-Barr virus infection, This allowed to obtain fairly rapid positive clinical dynamics of relieving intoxication and febrile and lymphoproliferative syndromes in the acute period, and subsequently - astheno-vegetative syndrome and achieve the transition of active chronic Epstein - Barr virus infection into a latent form

ОПТИМИЗАЦИЯ ЭТИОТРОПНОЙ ТЕРАПИИ ОСТРЫХ РЕСПИРАТОРНЫХ ВИРУСНЫХ ИНФЕКЦИЙ У ДЕТЕЙ

The etiology and clinical manifestations of SARS in children in different epidemic seasons are studied. It is shown that influenza takes a leading role (91,2 %) in the etiological structure of SARS with flu-like syndrome in the epidemic season. In the absence of clinical flu-like syndrome SARS of other etiologies (64,7 %) predominate. In other epidemic influenza seasons probability of the presence of flu-like syndrome is 23,1%. the authors suggest differentiated approach to the choice of antiviral drugs. Presence of flu-like syndrome, epidemic season , age of the patient should be considered. Efficacy of Anaferon drug for children is studied.Изучена этиология и особенности клинических проявлений ОРВИ у детей в различные эпидемические сезоны. Показано, что в этиологической структуре ОРВИ с клиникой гриппоподобного синдрома (ГППС) в эпидемический сезон гриппа лидирует грипп (91,2%), при отсутствии в клинической картине ГППС в этот сезон преобладают ОРВИ другой этиологии (64,7%). В другие эпидемические сезоны вероятность гриппа при наличии ГППС 23,1%. Предложен дифференцированный подход к выбору противовирусных препаратов с учетом наличия клиники гриппоподобного синдрома, эпидемического сезона, возраста пациентов. Изучена эффективность препарата Анаферон детский в лечении детей с ОРВИ

Оптимизация лечения Эпштейна-Барр вирусного инфекционного мононуклеоза у детей

The paper presents the results of observation of 103 children aged from 10 months to 15 years with EBV-associated infectious mononucleosis (IM), determined in 32% by acute primary Epstein-Barr virus infection (AEBVI) and in 68% of cases by reactivation of chronic Epstein-Barr virus infection (CEBVI). Clinical and laboratory characteristics of the course, depending on the form of infection, were investigated. As a clinical outcome of infectious mononucleosis in patients with primary infection latent infection after a year is formed 5.8 times more often than in patients with chronic Epstein-Barr virus infection (CEBVI). The high efficiency of recombinant interferon monotherapy in patients with primary acute infection was recorded and the expediency of combined etiotropic therapy in the treatment of chronic Epstein-Barr virus infection was found out.В работе представлены результаты наблюдения за 103 детьми в возрасте от 10 месяцев до 15 лет с ВЭБ-ассоциированным инфекционным мононуклеозом (ИМ), обусловленным в 32% острой первичной Эпштейна-Барр вирусной инфекцией (ОЭБВИ) и в 68% случаев реактивацией хронической (ХЭБВИ). Выявлены клинико-лабораторные особенности течения ИМ в зависимости от формы инфекции. В исходе ИМ при первичном инфицировании в 5,8 раза чаще, чем при ХЭБВИ, через год после перенесенного заболевания формируется латентная инфекция. Показана высокая эффективность монотерапии рекомбинантными интерферонами при первичной инфекции и обоснована целесообразность комбинированной этиотропной терапии при лечении ХЭБВИ

Этиологическая структура острых респираторных заболеваний в 2009—2013 гг. у детей г. Воронежа

The analysis of the etiology of acute respiratory infections was carried out in 865 children hospitalized to a hospital infection in the ears 2009—2013. It was found that respiratory viruses dominated in the etiological structure of acute respiratory infections of children, with a leading position in the number of revised survey diagnoses in different years of observation occupied influenza, but in recent years there is a growth trend of respiratory syncytial virus infection. The most pronounced seasonality of hospitalized children to help in the verification of the diagnosis, there was just the influenza, and mycoplasma infection. Children of preschool and school age with influenza and micoplasma infections are hospitalized more often, while for respiratory diseases other etiology, especially with respiratory syncytial virus infection children up to 3 years are hospitalized.Проведен анализ этиологии острых респираторных заболеваний у 865 детей, госпитализированных в инфекционный стационар г. Воронежа (РФ) в 2009—2013 гг.. Установлено, что в этиологической структуре острых респираторных заболеваний у детей преобладали респираторные вирусы, причем лидирующую позицию в разные годы наблюдения занимал грипп, однако в последние годы имеется тенденция роста респираторно-синцитиальной инфекции. Наиболее выраженная сезонность при поступлении детей в стационар, помогающая в верификации диагноза, отмечалась только при гриппе и микоплазменной инфекции. При гриппе и микоплазменной инфекции чаще госпитализируются дети дошкольного и школьного возраста, в то время как при респираторных заболеваниях другой этиологии, особенно при респираторно-синцитиальной инфекции, это дети до 3 лет

СЛУЧАЙ ТЯЖЕЛОГО ОСЛОЖНЕННОГО ТЕЧЕНИЯ ТЕНИАРИНХОЗА С АТИПИЧНОЙ ЛОКАЛИЗАЦИЕЙ ГЕЛЬМИНТА

Documented case of the clinical observations of the complicatedcourse of beef tapeworm infection (Taenia saginata) have a child 17  years of age. Three years ago, the patient first noticed the active  isolation of the cuttings from the anus. Other clinical symptoms were absent and the disease was latent. At the end of may 2017,  symptoms of an acute abdomen developed and an appendectomy  was performed on 03.06.2017. Diagnosis after surgery: acute  gangrenous perforative appendicitis, periappendicular abscess,  diffuse purulent peritonitis. 07.06.2017 was a single vomiting. In the vomit seen the segments of the flat worm. 09.06.2017,  segments of worms found in the feces. They were identified as  arthropods of Taenia saginata. From 14.06.2017 the patient’s  condition worsened, the temperature increased, there were pains in  the left half of the chest. In the following days the condition remained grave. According to CT (from 19.06.2017) helminth was determined in the  lumen of the left lower salt bronchus. Bronchoscopy was performed  (21.06.2017), which reduced the presence of signs of inflammation  of the left lower salt bronchus. Worms are not detected. Sputum  sowing was performed, but sputum microscopy was not carried out.  Ultrasound (23.06.2017) showed the presence of fluid in the left  pleural cavity. Puncture was performed and 70 ml of serous fluid was obtained. In the future, double-prosodical puncture which was obtained 600 and 500 ml of a yellow viscous exudate. On  29.06.2017, teniid eggs were found in sputum. Praziquantelum is  prescribed 25 mg / kg once. On 04.07.2017, the fourth puncture of  the pleural cavity was performed, 200 ml of light yellow effusion was obtained. In the days following the symptoms of pleurisy had disappeared and 10.07.2018, came recovery. Lung damage, which  developed as a result of aspiration of the arthroplasty Taenia  saginata was accompanied by a  rare dry cough and moderate  severe intoxication syndrome. The severity of the patient’s condition  was determined by severe respiratory failure and pain. Auscultation  of the wheezing was not. Over the lesion was sharply pronounced  weakened breathing. In the peripheral blood was determined by high ESR, moderate leukocytosis and no eosinophilia.Подробно описан клинический случай осложненного течения тениаринхоза (Taenia saginata)  у ребенка 17 лет. Три года назад пациент впервые заметил активное выделение члеников  из анального отверстия. Другие клинические симптомы отсутствовали, и заболевание  протекало латентно. В конце мая 2017 г. развились симптомы острого живота, 03.06.2017 г.  выполнена аппендектомия. Диагноз после операции: острый гангренозный перфоративный  аппендицит, периаппендикулярный абсцесс, диффузный гнойный перитонит. 07.06.2017 г.  была однократная рвота. В рвотных массах замечены членики плоского червя. 09.06.2017 г. членики гельминта обнаружены в фекалиях. Они были идентифицированы как членики  Taenia saginata. С 14.06.2017 г. состояние больного ухудшилось, повысилась температура,  появились боли в левой половине грудной клетки. В последующие дни состояние оставалось тяжелым. По данным КТ (от 19.06.2017 г.) гельминт определялся в просвете левого  нижнедолевого бронха. Выполнена бронхоскопия (21.06.2017 г.), которая установила наличие признаков воспаления левого нижнедолевого бронха. Гельминт не обнаружен. Выполнен посев мокроты, но микроскопия мокроты не проводилась. УЗИ (23.06.2017 г.)  показало наличие жидкости в левой плевральной полости. Проведена пункция, получено 70 мл серозной жидкости. В дальнейшем дважды проводилась пункция, в результате чего было получено 600 и 500 мл желтого вязкого экссудата. 29.06.2017 г. в мокроте были  обнаружены яйца тениид. Назначен Praziquantelum 25 мг/кг однократно. 04.07.2017 г. проведена четвертая пункция плевральной полости, получено 200 мл светло-желтого  выпота. В последующие дни симптомы плеврита исчезли, 10.07.2017 г. наступило выздоровление.  Поражение легких, которое развилось в результате аспирации  членика Taenia saginata, сопровождалось редким сухим кашлем и умерено выраженным  синдромом интоксикации. При этом тяжесть состояния пациента определялась выраженной  дыхательной недостаточностью и болевым синдром. При аускультации хрипов не было. Над  очагом поражения было резко выраженное ослабленное дыхание. В периферической крови  определялась высокая СОЭ при умеренном лейкоцитозе и отсутствии эозинофилии

The evolution of clinical and laboratory features enteroviral meningitis in children

In recent years, enterovirus infection (EVI) retains its cyclical nature with an increase in the incidence rate in the Russian Federation in 2000, 2006, 2009, 2013 and 2017. Observation of 41 patients with laboratory-confirmed enteroviral meningitis (EVM) in 2000, 54 children in 2013, and 56 patients in 2018 revealed the clinical and laboratory features of this clinical form of the disease, mainly concerning changes in hemo- and liquorogram parameters, which allowed to trace the evolutionary changes during this infection in children

Clinical and laboratory features and risk factors of perinatal Epstein–Barr virus infection

Two hundred and twenty-four mother-neonate pairs were examined; of them 39 infants were diagnosed as having perinatal Epstein– Barr virus infection. Later on, two groups of infants (39 and 98 with and without this infection, respectively) were followed up during the first year of life. Epstein–Barr virus infection was shown to be widespread among fertile-age women and perinatal infection of this etiology. The risk of the perinatal infection is high in the active forms of Epstein–Barr virus infection in women who have complicated pregnancy, in those who are aged over 30 years in particular, in whose who suffer from chronic tonsillitis, who are urban dwellers and have bad habits (smoking). The signs of neonatal perinatal infections are nonspecific manifestations of TORCH syndrome. Acute respiratory viral infections show a complicated course in most cases of infants with perinatal Epstein–Barr virus infection during the first year of life

Оptimization of Treatment EBV Infectious Mononucleosis in Children

The paper presents the results of observation of 103 children aged from 10 months to 15 years with EBV-associated infectious mononucleosis (IM), determined in 32% by acute primary Epstein-Barr virus infection (AEBVI) and in 68% of cases by reactivation of chronic Epstein-Barr virus infection (CEBVI). Clinical and laboratory characteristics of the course, depending on the form of infection, were investigated. As a clinical outcome of infectious mononucleosis in patients with primary infection latent infection after a year is formed 5.8 times more often than in patients with chronic Epstein-Barr virus infection (CEBVI). The high efficiency of recombinant interferon monotherapy in patients with primary acute infection was recorded and the expediency of combined etiotropic therapy in the treatment of chronic Epstein-Barr virus infection was found out

The territory of advancing socio-economic development as a factor of development of the territory and attractions for the resident

The article provides analysis of the terminology of areas of advancing socio-economic development, legal support of creation and functioning of areas of advancing socio-economic development. The dynamics of the practical implementation of areas of advancing socio-economic development in the regions of Russia. The analysis highlighted the benefits of creating such zones for the activities of residents and for development of territories as a whole

OPTIMIZING OF ETIOTROPIC THERAPY OF ACUTE RESPIRATORY VIRAL INFECTIONS IN CHILDREN

The etiology and clinical manifestations of SARS in children in different epidemic seasons are studied. It is shown that influenza takes a leading role (91,2 %) in the etiological structure of SARS with flu-like syndrome in the epidemic season. In the absence of clinical flu-like syndrome SARS of other etiologies (64,7 %) predominate. In other epidemic influenza seasons probability of the presence of flu-like syndrome is 23,1%. the authors suggest differentiated approach to the choice of antiviral drugs. Presence of flu-like syndrome, epidemic season , age of the patient should be considered. Efficacy of Anaferon drug for children is studied