Herpes zoster infection in early adolescence: two case reports and review of the treatment approach

Introduction: Herpes zoster is a skin infection caused by reactivation of the Varicella zoster virus that remains latent in the dorsal root ganglia, showing dermatomal spread on the skin, accompanied by a vesicular rash and itching. It is a disease of the adult age group. Although herpes zoster is more common in immunocompromised children, it is rarely seen in healthy children. Case Presentation: Two patients, 11 and 12 years old, presented with pain, itching, and rash. Patient histories indicated that they were previously healthy. Alanine aminotransferase, aspartate aminotransferase, urea, blood urea nitrogen, creatinine, and electrolyte values were within normal limits. Varicella-zoster virus (VZV) immunoglobulin (Ig) G and VZV Ig M were positive, while herpes zoster virus (HZV) Ig G and HZV Ig M were negative. Oral acyclovir treatment was started. Symptoms, treatment, and follow-up of the two cases were similar. In both patients, the lesions regressed within a week, and at the end of the second week, they recovered without complications.Conclusion: Herpes Zoster infection is rarely seen in healthy children. In this case report, we aimed to remind and discuss the clinical features during childhood

Rotavirus and Adenovirus Frequency in Children with Acute Gastroenteritis

Amaç: Çoğunlukla kontamine gıda ve suların tüketilmesiyle vücuda alınan bakteri, virus veya parazitlerin neden olduğu akut gastroenteritler (AGE) özellikle çocuklar için hayati tehlike oluşturabilmektedir. Bu çalışmada AGE'li çocuklarda adenovirus ve rotavirus sıklığının cinsiyete, yaşa ve mevsimlere göre dağılımının saptanması amaçlanmıştır.Yöntem: Bir yıl süreyle mikrobiyoloji laboratuvarına AGE'li çocuklardan gönderilen 1080 gaita örneği Rotavirus Adenovirus antijen kiti ile çalışılmıştır. Bulgular: Örneklerden 173 (% 16)'ünde rotavirus, 65 (% 6)'inde ise adenovirus pozitifliği saptanmıştır. Kızlar ve erkeklerde pozitiflik oranlarının benzer olduğu görülmüştür. Yaş gruplarından 7-12 ay, 13-24 ay, 37-48 ay, 49-60 ay dönemindeki hastalarda rotavirus sıklığının diğer yaş gruplarından daha yüksek olduğu bulunmuştur. Adenovirus sıklığının ise tüm yaş gruplarında benzer olduğu saptanmıştır. Yine rotavirusun kış ve ilkbaharda daha sık saptandığı, adenovirusun ise sonbahar, kış ve ilkbaharda yaz mevsiminden daha sık görüldüğü tespit edilmiştir. Sonuç: Sonuç olarak her iki virusun da cinsiyet farkı olmaksızın çocukları enfekte edebildiği görülmüştür. Adenovirus sonbahar, ilkbahar ve kış aylarında daha sık görülürken, rotavirusun özellikle ilkbahar ve kış aylarında daha yüksek oranlarda saptanabildiği ve AGE'li çocuklarda özellikle bu mevsimlerde akla gelmesi gerektiği düşünülmüştür.Objective: Acute gastroenteritis (AGE), which is often caused by bacteria, viruses or parasites that are taken into the body by consuming contaminated food and water, can pose a life threat, especially for children. In this study, it was aimed to determine the distribution of adenovirus and rotavirus frequency according to sex, age and season in children with AGE. Methods: A sample of 1080 gaita sent from children with AGE to the microbiology laboratory for one year was tested with the Rotavirus Adenovirus antigen kit. Results: Among the samples, rotavirus was found in 173 (16%) and adenovirus was positive in 65 (6%). Positivity rates were found to be similar in girls and boys. It has been found that the frequency of rotavirus is higher in the age group of 7-12 months, 13-24 months, 37-48 months, 49-60 months than the other age groups. Adenovirus frequency was found to be similar in all age groups. Rotavirus was more common in winter and spring. Adenovirus was detected more frequently in autumn, winter and spring than in summer. Conclusion: As a result, both viruses were able to infect children without gender difference. While adenovirus is more common in autumn, spring and winter months, it is thought that rotavirus can be detected at higher rates especially in spring and winter, and children with AGE should especially come to mind in these seasons

The evaluation of the children who admitted to hospital after mad honey intake

WOS: 000445436900006Objective: The aim of this study is to analyze the demographic characteristics, illness and healing process of mad honey intoxications in Duzce University Medicine Faculty Hospital Pediatric Emergency Department. Method: Patients admitted to Duzce University Medicine Faculty Hospital Pediatric Emergency Department, because of honey poisoning, between June 2012 and February 2015 were included in this retrospective study. It was planned to evaluate the effects of grayanotoxin intoxication in the pediatric age group. The demographic characteristics of patients, clinical findings and laboratory test results were collected from hospital records. We retrospectively examined records of the vital signs of patients and treatment they receive. Age, sex, toxicologic characteristics, heart rates, systolic and diastolic blood pressures of patients were analyzed. Results: Four cases were included in this study. The oldest patient was 16, the youngest patient was 2 years old. It was determined that patients had ingested mad honey, the average duration was 1.5 hours, before admitting to the emergency service. Patients'minimum heart rates were 41 to 63 bpm, systolic blood pressures ranged from 71 to 98 mmHg and diastolic blood pressures ranged from 27 to 41 mmHg. None of them had a chronic illness and drug use. Dizziness was observed in all patients. Two patients had bradycardia are quiring atropine were monitored. All patients received intravenous fluids support. Longest hospitalization duration was 4 days who had syncope, bradycardia with hypotension and oldest age of. Mortality and complication were not observed. Conclusion: Mad honey intoxication should be considered in cases without underlying disease, drug or substance abuse, trauma etc. history and presenting non-specific symptoms such as bradycardia, hypotension, gastrointestinal irritability, especially in the Black Sea region., The safe dose range is not certain so families should be advised to keep their children away from this honey

A Rare Cause of Acute Renal Failure and Thrombocytopenia in Child: A Case Due to Hantavirus Infection

On yedi yaşında erkek hasta 3 gündür devam eden ateş, halsizlik ve baş ağrısı şikayeti ile aile hekimliğine başvurmuş ve yapılan tetkiklerinde trombositopeni tespit edilmesi üzerine tarafımıza yönlendirilmiş. Hastanemize başvurduğunda orofarinkste hiperemi, 39C ateş, belirgin halsizlik, trombositopeni ve böbrek yetmezliği olduğu görüldü. Hastanın periferik kan yaymasında atipik hücre görülmedi. Hastadan parvovirüs, sitomegalovirüs (CMV), Epstein-Barr virüs (EBV), hepatit belirteçleri, brusella aglütinasyon ve Gruber Widal testleri istenildi ve sonuçlar negatif saptandı. Hastadan alınan ayrıntılı anamnezde ölmüş fareleri yaktığı öğrenildi. Hantavirüsün serolojik tetkikinde hem indirekt immünfluoresan assay (IFA) hem de Biot Analysis’de IgG ve IgM antikorları pozitif saptandı. Hastada kanamalı ateş ile seyreden akut renal sendroma yol açan hantavirüs enfeksiyonu düşünüldü ve sadece semptomatik tedavi uygulandı.Seventeen years old yo male patient had applied to the primary care center for his complaints; fever, malaise and headache, and was he was investigated for causes thrombocytopenia of after thrombocytopenia had been detected in the workup. He had hyperaemia in oropharynx, 39C fever, noticaable malaise, thrombocytopenia and renal failure at admittance to our clinic. No atypic cell was seen in peripheral blood smear of the patient. Laboratory tests for parvovirus, cytomegalovirus (CMV), Epstein-Barr virus (EBV), brucella agglutination and gruber widal test and markers for hepatitis were examined and the results were neg-ative. A detailed patient history showed that we had informed that the patient had burned dead mice bodies. Serolohical investigation showed that IgG and IgM antibodies were positive in both Biot Analysis and in-direct immunofluorescence assay (IFA). We observed a hantavirus infec-tion causing haemorrhagic fever with renal syndrome (HFRS) and corre-spondingly applied symptomatic treatment

Çocuk acil serviste supraventriküler taşikardi yönetimi: Bir olgu sunumu

Supraventriküler taşikardi, çocukluk yaş grubunda görülebilen önemli kardiyak sorunlardan biridir ve sıklığı 1/250 - 1/1000 arasında değişir. Huzursuzluk, emme bozukluğu, taşipne, taşikardi ve kalp yetersizliği ile bulgu verebilir. Genellikle supraventriküler taşikardili hastalarda eşlik eden bir doğumsal kalp hastalığı yoktur, antiaritmikler ile kontrol altına alınabilir. Kontrol altına alınamayan vakalar ağır seyretmektedir ve kalp yetmezliği bulguları ile ortaya çıkabilir. Tedavide acil yaklaşım çok önemlidir ve tedavide kullanılan farklı ilaçlar acil servislerde hazır bulundurulmalıdır. Bu makalede huzursuzluk şikayetiyle çocuk acil servise başvuran 55 günlük bebek tartışılıp adenozin ile taşikardisi kontrol altına alınan supraventriküler taşikardi vakası sunularak, tedavi yaklaşımı literatür bilgileri eşliğinde gözden geçirilmiştirSupraventricular tachycardia is one of the major cardiac problems that can be seen in childhood and its frequency ranges from 1/250 - 1/1000. It may present with symptoms of restlessness, sucking disorder, tachypnea, tachycardia and heart failure. Generally, patients with supraventricular tachycardia do not have a concomitant congenital heart disease, they can be controlled by antiarrhythmics. Uncontrolled cases may be severe and may present with signs of heart failure. An urgent approach to treatment is very important, and different drugs used in treatment should be available in the emergency department. In this article, a 55-day-old baby who was admitted to the emergency department with the complaint of restlessness was presented and a case of supraventricular tachycardia with adenosine and tachycardia was presented. © 2019, Duzce University Medical School. All rights reserved

Bir Tıp Fakültesi Hastanesinin Çocuk Acil Servisine Başvuran Hastaların Özellikleri

Amaç: Acil servisler hastanelerin her tür acil hasta ve yaralıya kesintisiz hizmet veren en önemlibirimlerindendir. Bu çalışmada Düzce Üniversitesi Tıp Fakültesi Çocuk Acil Servisi’ne belli birdönemde başvuran hastaların çeşitli özelliklerini ve dağılımlarını ortaya koymak ve elde edilenbulgular doğrultusunda performansı yüksek, iş gücü kaybı en aza indirilmiş, kaliteli hizmet verenve hasta memnuniyetini önemseyen bir acil servis modeli çizmek amaçlanmıştır.Gereç ve Yöntemler: 1.01.2012—31.12.2016 döneminde başvuran toplam 116.172 hastanınkayıtları elektronik ortamda retrospektif olarak incelendi. Kayıtlarda hastaların yıl içinde kaç kezacil polikliniğine başvurduğuna, başvuru zamanına ve nedenlerine, aldığı tanıya ve hizmet çeşidine, ve yaş, cinsiyet ve sosyoekonomik özellerine dair bilgiler yer almakta idi.Bulgular: Çocuk Acil Servisi’ne başvuran hasta sayısının 2012–2016 yıllarında sırasıyla 11.336(%9,75), 15.453 (%13,3), 23.944 (%20,6), 28.695 (%24,7) ve 36.744 (%31,6) olduğu ve yıllar içindebaşvuran hasta sayısında anlamlı bir artış kaydedildiği görüldü.Tartışma ve Sonuç: Çocuk acil servislerine gelen hastaların sosyodemografik ve klinik özellikleritespit edilerek bir veri tabanı oluşturulması, bu servisler için yapılacak çalışma ve gelecek planları açısından çok önemlidirAim: Emergency departments are among vital units of hospitals, providing non-stop care in all cases of emergency and injury. This study aimed to present various characteristics and distributions of the patients visiting the Pediatric Emergency Department of the Düzce University Medical Faculty within a specified period and, based on the data obtained, define an emergency service model with high performance, minimized labor loss, high service quality, and prioritized patient satisfaction. Materials and Methods: Records of a total of 116,172 patients admitted between 1.1.2012 and 31.12.2016 were electronically reviewed retrospectively. The records included information as to how many times the patients visited the emergency polyclinic in a single year, admission time and indication, type of the diagnosis and medical care received, and patient age, sex and socioeconomic characteristics. Results: We found that the number of the patients visiting the Pediatric Emergency Department in the years 2012 to 2016 was 11,336 (9.75%), 15,453 (13.3%), 23,944 (20.6%), 28,695 (24.7%) and 36,744 (31.6%), respectively, and that there was a significant increase in the visiting patient number over the years. Discussion and Conclusion: Creating a database by determining the sociodemographic and clinical characteristics of patients visiting pediatric emergency services is crucial for the work and future planning for these services

Acute myocarditis that confounded by acute myocardial infarction in adolescent patients who applied Pediatric emergency room with chest pain

In children patients with chest pain, ST segment elevation and increase in cardiac markers, myocarditis must be the first diagnosis to consider if there is no cardiac disease history. Sometimes myocarditis can be confounded by some diseases like acute myocardial infarction. Although the electrocardiographic (ECG) signs are different, acute myocardial infarction and acute myocarditis can be duplicate occasionally. Treatments and prognosis of these two diseases are totally different. Differential diagnosis is life saver in these situations. Therefore, if ST-T changes in ECG and increased cardiac markers are assessed in patients with chest pain; differential diagnosis, treatment and referring the patient to a pediatric cardiology department for observation are mandatory. We introduce two patients aged 14 and 16, who have chestpain, spesific ST-T changes and increase in cardiac markers

Herpes zoster infection in early adolescence: two case reports and review of the treatment approach

Introduction: Herpes zoster is a skin infection caused by reactivation of the Varicella zoster virus that remains latent in the dorsal root ganglia, showing dermatomal spread on the skin, accompanied by a vesicular rash and itching. It is a disease of the adult age group. Although herpes zoster is more common in immunocompromised children, it is rarely seen in healthy children. Case Presentation: Two patients, 11 and 12 years old, presented with pain, itching, and rash. Patient histories indicated that they were previously healthy. Alanine aminotransferase, aspartate aminotransferase, urea, blood urea nitrogen, creatinine, and electrolyte values were within normal limits. Varicella-zoster virus (VZV) immunoglobulin (Ig) G and VZV Ig M were positive, while herpes zoster virus (HZV) Ig G and HZV Ig M were negative. Oral acyclovir treatment was started. Symptoms, treatment, and follow-up of the two cases were similar. In both patients, the lesions regressed within a week, and at the end of the second week, they recovered without complications.Conclusion: Herpes Zoster infection is rarely seen in healthy children. In this case report, we aimed to remind and discuss the clinical features during childhood

Parapleji ile Bulgu Veren Konversiyon Bozukluğu

Parapleji iki bacakta hareket ve/veya his yeteneğinin kaybıdır, etiyolojisinde organik ve psikiyatrik nedenler rol alır. Bu makalede alt ekstremitedeani gelişen güç kaybı, his kaybı ve buna bağlı yürüyememe şikayetleri ile acil servise getirilen ve organik etiyoloji açısından takip edilen, yapılanfizik muayene, tetkik ve görüntüleme sonuçlarında herhangi bir organik patoloji saptanmayan ve bu süreçte çocuk ergen ruh sağlığı birimincedeğerlendirilerek yaygın anksiyete bozukluğu ve konversiyon bozukluğu (KB) tanısı konulan 14 yaşında bir kız hasta sunularak, nörolojikbozuklukları taklit eden ve KB’nin bir alt tipi olan paraplejinin çocuk ve adölesan hastalarda KB’nin nadir bir bulgusu olabileceği vurgulanmakistenmiştir. Ayrıca bu tür olguların değerlendirme ve takip süreçlerinin çocuk sağlığı ve çocuk ergen ruh sağlığı birimlerince multidisipliner biryaklaşımla ele alınmaları gerektiği göz önünde bulundurulmalıdır.Paraplegia is a loss of movement and/or sensation of the two legs, and organic and psychiatric causes are involved in its etiology. In this article, a 14-year-old girl with sudden loss of power in the lower extremity and loss of sensation and related complaints, who was admitted to the emergency department and followed up in terms of organic etiology, was presented. She was diagnosed with generalized anxiety disorder and conversion disorder (CD) by childhood mental health unit and she did not have any organic pathology in the results of physical examination. It is desirable to emphasize that CD may be a rare finding in children and adolescents with paraplegia. In addition, it should be considered that the evaluation and follow-up processes of such cases should be addressed in a multidisciplinary approach by child health and children’s mental health unit

Short Term Unscheduled Revisits to Paediatric Emergency Department - A Six Year Data

TURAN SONMEZ, Feruza/0000-0001-8817-8521WOS: 000397995000110PubMed: 28511472Introduction: Reviewing the reasons for return visits within 24 hours is a very important method of determining possible problems of emergency health care. Several causes stay behind unscheduled emergency return visits. Therefore, identifying these factors is crucial to set strategies in order to decrease the number of unnecessary visits. Aim: To define the characteristics of the patients returning to the Paediatric Emergency Department (PED) within 24 hours via determining rate, number and demographic data of patients. Materials and Methods: The present study design involves retrospective data collection of patients who returned to PED within 24 hours after being discharged. Data was included over six year period and was collected from July 1, 2010 to June 30, 2016. The data was analysed with SPSS17.0 statistical package for windows. Results: A total of 1994 patients returned to PED within 24 hours from July 1, 2010 to June 30, 2016. The most common group of revisiting patients were toddlers (aged 0-2-year old), n=1168 (58.5%), and the least number represented young adolescents (aged 15-18-year old), n=82 (4.1%). Number of patients returning to PED in 24 hours has significantly increased within years from approximately 90 patients to 720 (p0.05) for each age, but again, presented definite negative correlation with age (the older is the patient group, the less is the number of revisits). The most common time for revisits was 17-24 hours after first discharge from PED, n=1277 (64.04%). Conclusion: The number of return visits is increasing over the years. The younger the patient is, more likely is the risk of unscheduled revisit to PED. Most of the patients returned to PED in 17 to 24 hours after discharge