Pneumonia in inborn errors of immunity

Pneumonia este o inflamație acută a sistemului respirator inferior și este una dintre principalele cauze de deces în rândul copiilor din întreaga lume. Când un copil se confruntă cu pneumonie recurentă, e necesar de luat în considerare inclusive imunodeficiențele primare ca o posibilă cauză. Vom exemplifica prin prezentarea unui caz clinic de plumonie recurentă.Pneumonia is an acute inflammation of the lower respiratory system and is one of the leading causes of death among children worldwide. When a child experiences recurrent pneumonia, it is necessary to consider primary immunodeficiencies as a possible cause. We will exemplify this by presenting a clinical case of recurrent pneumonia

Легочные поражения пост-COVID-19 у младенцев

COVID-19 infection affects any age and gender. Among the pediatric population, the most vulnerable are children up to 3-5 years old. Infants are especially affected, they present the most complications following post-COVID19 lung damage. The article presents the case of an infant who suffered severe SARS-CoV-2 infection. With the help of high-precision imaging investigations, such as Computed Tomography, it was possible to detect the bronchopulmonary changes that occurred after enduring the infection.Infecția COVID-19 afectează orice vârstă și sex. În rândul populației pediatrice cei mai vulnerabili sunt copii până la 3-5 ani. În special sunt afectați sugarii, aceștea prezintă cele mai multe complicații în urma afectării pulmonare post-COVID19. În articol este prezentat cazul unui copil sugar care a suportat infecția cu virusul SARS-CoV-2 în formă gravă. Cu ajutorul investigațiilor imagistice de înaltă precizie, cum este Tomografia computerizată, a fost posibil să detectăm modificările bronhopulmonare apărute după suportarea infecției.Инфекция COVID-19 поражает людей любого возраста и пола. Среди педиатрического населения наиболее уязвимыми являются дети до 3-5 лет. Особенно страдают младенцы, у них возникает больше всего осложнений после повреждения легких после COVID-19. В статье представлен случай младенца, перенесшего тяжелую форму инфекции SARS-CoV-2. С помощью высокоточных визуализирующих исследований, таких как компьютерная томография, удалось обнаружить бронхолегочные изменения, возникшие после перенесения инфекции

Bronchiectasis In Children With Cystic Fibrosis

Departamentul Pediatrie, USMF „Nicolae Testemiţanu”Cystic fibrosis is the most common genetic disease with autosomal recessive way of transmission. It is characterised by exocrine glands dysfunction. Severe progressive pulmonary problems are noted in most patients with cystic fibrosis. In this work there were evaluated clinico-imagistic peculiarities of the bronchiectasis in 40 children with cystic fibrosis. The mean age of patients was 7.07±0.81 years and the mean age of diagnosis was 1.11±0.24 years. The frequency of bronchiectasis presented a significant (r2 =0.97, p<0.01) increase with the age of patients with cystic fibrosis. Fibroza chistică este cea mai frecventă maladie genetică cu transmitere autozomal recesivă, care se caracterizează prin disfuncţie generalizată a glandelor exocrine. Majoritatea pacientilor cu fibroza chistica dezvolta patologie pulmonară progresivă. A fost realizat un studiu clinicoimagistic a bronşiectaziilor la 40 copii cu fibroză chistică. Pacienţii au prezentat o vârstă medie de 7,07±0,81 ani, iar vârsta medie de diagnostic al fibrozei chistice a constituit 1,11±0,24 ani. Frecvenţa dezvoltării bronşiectaziilor a prezentat un indice de corelaţie foarte înalt (r2 =0,97, p<0,01) cu vârsta pacienţilor

Бронхобструктивный синдром у детей с бронхолегочной дисплазией

Bronchopulmonary dysplasia (BPD) is a chronic lung disease, developing in premature infants with morphofunctional immaturity of the lungs, subjected to oxygen therapy, which is manifested by lung damage with the development of emphysema, fibrosis, broncho-obstructive changes. Aim. This article aims to provide an overview of the obstructive syndrome in children with bronchopulmonary dysplasia. Material and methods.This study is a prospective analysis of a cohort of 90 premature children hospitalized in the pneumology clinic of the Mother and Child Institute. In 51 children, the diagnosis of bronchopulmonary dysplasia was established and the study group was compiled. While the other 39, who did not develop BPD, were the control group. Analyzed variables included anamnestic data, general clinical manifestations, results of laboratory and imaging studies. Results. According to the anamnestic data, in the neonatal period the children received O2 therapy for respiratory distress syndrome. All children included in the study, had signs of obstructive syndrome during hospitalization, which were clinically manifested by shortness of breath, wheezing and tachypnea. Conclusions. BPD in premature newborns with a history of oxygen therapy is clinically manifested by severe respiratory syndromes, which are confirmed by signs of bronchopulmonary disease.Бронхолегочная дисплазия (БЛД) - хроническое заболевание легких, развивающееся у недоношенных детей с морфофункциональной незрелостью легких, подвергшихся кислородной терапии, что проявляется поражением легких с развитием эмфиземы, фиброза, бронхобструктивным синдромом. Цель исследования. Цель данной статьи - анализировать обструктивный синдром у детей с бронхолегочной дисплазией. Материалы и методы.Это исследование представляет собой проспективный анализ 90недоношенных детей,госпитализированных в клиникe пневмологии Института Матери и Ребенка. У 51 детей диагноз бронхолегочной дисплазии был установлен, они составили основную группу исследования, 39 детей без БЛД составили контрольную группу. Анализ включил анамнестические данные, клинические проявления, результаты лабораторных исследований. Результаты. Анамнестически в неонатальном периоде дети получали О2-терапию по поводу респираторного дистресс-синдрома. У всех детей, при госпитализации выявлялись признаки обструктивного синдрома, которые клинически проявлялись одышкой, хрипами, тахипноэ. Выводы: БЛД у недоношенных детей с кислородной терапией в анамнезе клинически проявляется выраженными респираторными синдромами, что подтверждается признаками бронхолегочной болезни

Modern approach to pediatric asthma

Background: The article reviews aims to promote the communication between scientists engaged in basic research and clinicians working with children, in order to better understand the mechanism and work together towards an optimal management of this prominent pediatric condition. We reviewed the recent advancements in regards to pediatric asthma related to pathogenesis, diagnostic criteria and differential diagnosis, and peer-reviewed evidence for efficiency of pharmacological and non- pharmacological/alternative/adjuvant treatment; we also emphasize the importance of education of all parties involved in care, outpatient management, age-appropriate involvement of children in their own care, and asthma prevention measures in children. Clinically asthma is characterized by recurrent episodes of wheezing, dyspnea, and cough; at the pathophysiological level the airway wall thickness is increased and involves both smooth muscle and collagen tissue, the mucous glands and mucus production are increased, and the vascularity of the airways is increased, all leading to chronic inflammatory remodeling of the airways and resulting in reduction of lung function. Conclusions: Asthma among children has been on the rise for decades. With an estimated prevalence of 10-30%, asthma is the most prevalent chronic disease of pediatric population worldwide and one with a large health care burden. The approach to diagnosis and treatment of asthma in children is distinct from adults; so is the management, prevention and the education of parties involved in care. Recently there has been a significant progress in mechanistic understanding of asthma; further, asthma management in children is becoming a top priority

Легочный гемосидероз у ребенка

Idiopathic pulmonary hemosiderosis is a rare respiratory disease that often beginning before the age of 10 years. In the pediatric population, it can be manifested only by isolated iron deficiency anemia, without association of other symptoms, sometimes with late diagnosis. We will present a clinical case of pulmonary hemosiderosis with metabolic damage, characterized by the accumulation of hemosiderin in alveolar macrophages and increased levels of ferritin. The progression of lung dysfunction is evaluated imaging by lung CT.Hemosideroza pulmonară idiopatică este o boală respiratorie rară, care debutează preponderent în copilărie, sub vârsta de 10 ani. La populația pediatrică poate fi manifestată doar prin anemie izolată cu deficit de fier, fără asocierea altor simptome, uneori cu diagnosticare tardivă. Este prezentat un caz clinic de hemosideroză pulmonară cu afectare metabolică, cu acumularea hemosiderinei în macrofagele alveolare și nivele sporite de feritină. Caracteristicele afect[rii pulmonare sunt evaluate imagistic prin CT pulmonară.Идиопатический гемосидероз легких — редкое респираторное заболевание, которое чаще всего начинается в детстве, в возрасте до 10 лет. В детской популяции он может проявляться только изолированной железодефицитной анемией, без ассоциации других симптомов, иногда при поздней диагностике. Приведем клинический случай легочного гемосидероза с метаболическим поражением, с накоплением гемосидерина в альвеолярных макрофагах и повышение уровня ферритина. Прогрессирование легочной дисфункции оценивают при помощи КТ легких

Clinical and imaging interrelationships in the diagnosis of foreign body aspiration in children

Department of Pediatrics, Nicolae Testemitanu State University of Medicine and Pharmacy Chisinau, the Republic of MoldovaBackground: Foreign body aspiration (FBA) is a typical occurrence in children. The clinical signs are influenced by various causes, and the differential diagnosis is important, especially when the suffocation crisis is not recognized. The aim of this study was to evaluate the clinical and imaging symptoms in children with FBA. Material and methods: A retrospective study is provided of 156 children who were hospitalized and examined (clinical and paraclinical tests) in the Pneumology Clinic between 2011 and 2020 after having a foreign body removed from their airways, using rigid tube bronchoscopy or fibrobronchoscopy. Results: The most affected age group was 1-3 years, which constituted 77.6% (95% CI 70.2% -83.8%). The most common symptoms were: cough – 98.7% (95% CI 95.4%-99.8%), dyspnoea – 94.2% (95% CI 89.3%-97.3%), wheezing – 61.5% (95% CI 53.4%-69.2%). Chest radiography was relevant for foreign body aspirations in 55.8% of cases (95% CI 47.6%-63.7%). The foreign body was extracted from the right bronchus in 32.1%, from the left bronchus in 21.8% of cases, from the lobar / segmental bronchi – 22.5%, and in 21.2% – multiple locations. The etiological structure of the endobronchial foreign body was dominated by the organic ones – 96.8%. Conclusions: Cough, dyspnoea, and wheezing are suggestive of this pediatric emergency. Chest radiography provides diagnostic information only for every second child

Бронхолегочный врожденный порок - трахеальный бронх у детей

Imaging of the rib cage was analyzed by computed tomography (CT) in 14 children (mean age 3,5±1,25 years) with congenital malformation – tracheal bronchus. Tracheal bronchus was found in all children with an emergency on the right side. The malformed bronchus has a different origin: from the middle segment of the trachea, from the lower segment and in most children near the bifurcation of the trachea. This bronchial malformation is clinico-imaged by bronchopulmonary changes with pneumonic infiltration, fibrotic changes with matte glass imaging, segmental atelectasis and fibrotic changes, and some children are associated with other birth defects.Manifestările imagistice a cutiei toracice au fost analizate prin tomografie computerizata (TC) la 14 copii (vârsta me- die de 3,5±1,25 ani) cu malformație congenitală – bronh traheal. Bronhul traheal a fost depistat la toți copiii cu emergență pe partea dreaptă. Bronhul malformativ își are pornirea diferită: din segmentul mediu al traheii, din segmentul inferior și la majoritatea copiilor lângă bifurcația traheii. Această malformație de bronh se realizează clinico-imagistic prin mo- dificări bronhopulmonare cu caracter de infiltrație pneumonică, modificări fibrotice cu aspect imagistic de sticlă mată, atelectazii segmentare și modificări fibrotice, iar la unii copii se asociază și alte malformații congenitale.Изображении грудной клетки были проанализированы с помощью компьютерной томографии (КТ) у 14 детей (средний возраст 3,5±1,25 года) с врожденными пороками развития – трахеальный бронх. Выход трахеального бронха был обнаружен у всех детей с справа. Деформированный бронх имеет различное начало: от среднего сегмента трахеи, от нижнего сегмента и у большинства детей вблизи бифуркации трахеи. Бронхолегочные изменения при этой бронхиальной мальформации характеризуются пневмонической инфильтрацией, фиброзными изменениями с матовым изображением стекла, сегментарными ателектазами и фиброзными изменениями, а у некоторых детей сочетаются с другими врожденными дефектами

Particularitățile manifestărilor respiratorii ale infecției COVID-19 la copii

Introduction. COVID-19 infection is common in the pediatric population, presenting a variety of respiratory manifestations and complications. Material and methods. The study involved 64 children from the COVID-19 section, Institute of Mother and Child, with an average age of 2.04±0.4 years (variations 1 day-17 years), divided into 5 age groups: 0-1 month, 1-12 months, 1-3 years, 3-7 years, >7 years. The methodology of the study is directed to the assess the significance of clinical manifestations in the COVID-19 infection episode. Results. As a result of 21 cases, this study discovered a higher frequency of the disease in infants. The nosological expression of the infection was dominated by pneumonia and unique cases of infection in four children with upper respiratory infections. Eleven children showed severe evolution, the moderate form being the dominant one. An almost constant feature in children in the study was a febrile syndrome, which in 31 cases was > 38.0oC. Every second child showed catarrhal respiratory signs, cough, and cyanosis in 66.1% of the children, chest circulation in 32.1% of the cases, wheezing in 6 children. COVID-19 infection in hospitalized children resulted in respiratory complications in 81.3% of cases and toxic infections – 23.4%. Conclusions. Analyzing the age structure of children with COVID-19 infection, a higher frequency of the disease was found in infants. In hospitalized children with SARS-CoV-2 infection, the disease manifests primarily in a moderate form (70 .3%). Despite the predominance of moderate forms of the disease, children are susceptible to develop the complications and severe forms of the SARS-CoV-2 infection.Introducere. Infecția COVID-19 este frecventă la populația pediatrică, prezentând o varietate de manifestări respiratorii și evoluând cu multiple complicații.Material și metode. În studiu au fost implicaţi 64 de copii din secția COVID-19, a IMSP Institutul Mamei şi Copilului, cu vârsta medie de 2,04±0,4 ani (variații de la 1 zi la 17 ani), repartizați în 5 categorii de vârstă: 0-1 lună, 1-12 luni, 1-3 ani, 3-7 ani, >7 ani. Metodologia studiului a urmărit aprecierea semnificației manifestărilor clinice la episodul de infecție COVID-19. Rezultate. Studiul a constatat o frecvență mai mare a bolii la sugari – 21 copii. Expresia nosologică a infecției a fost dominată de pneumonie și, în cazuri unice (4 copii), infecții respiratorii superioare. Evoluție severă au prezentat 11 copii, forma moderată fiind dominantă. Un semn aproape constant la copiii din studiu a fost sindromul febril, care în 31 cazuri era >38.0°C Fiecare al doilea copil prezenta semne catarale respiratorii, tusea și cianoza la 66,1% dintre copii, tirajul toracic în 32,1% de cazuri şi wheezing-ul la 6 copii. Infecția COVID-19 la copiii spitalizați s-a soldat cu complicații respiratorii în 81,3% dintre copii și toxiinfecțioase – 23,4% de cazuri. Concluzii. Analizând structura de vârstă a copiilor cu infecție COVID-19, s-a constatat o frecvență mai mare a bolii la sugari. La copiii internați cu infecție SARS-CoV-2, boala se manifestă în primul rând într-o formă moderată (70,3%). În pofida predominanței formelor moderate ale bolii, copiii sunt susceptibili de a dezvolta complicații și forme severe de infecție cu SARS-CoV-2