Clinical Features and Prognosis in Childhood Pneumococcal Meningitis

In this study, 50 children with pneumococcal meningitis were evaluated for the clinical manifestations and prognosis. The mean age was 44.9 months and 32% of the cases were 6 months old or younger. The most frequent physical findings were alteration in the level of consciousness (66%), fever (52%) and neck stiffness (in 50% of all the cases, and in 73.9% of the cases older than 2 years). Convulsions occured in 54% of the cases at home and/or at the hospital. Various neurologic sequelae were detected in 9 cases at discharge. Persistent hearing loss was detected in 28% of 25 cases who were evaluated. Six cases (12%) died. Cerebrospinal fluid (CSF) protein level > 200 mg/dL was a significant risk factor for mortality (p= 0.025). Besides, blood glucose level was significantly lower (p= 0.010) and CSF protein level was higher (p= 0.013) in the cases who died comparedto the cases who lived

A Case Report of Soft Tissue Necrosis Due to the Use of Topical Steroid During Varicella Infection

Systemic absorbtion of topical steroids increases the risk of severe or fatal varicella infection due to the surface applied and duration of application. Suppression of normal cutaneous immun response causes the spread of varicella infection and secondary bacterial infections. A previously healthy two years old boy was hospitalized because of the necrotic lesions on his right thigh and submandibular area during varicella infection. With a detailed history of the patient, we learned that his parents have applied a topical steroid (beclasone pamoat) on his itchy vesicular varicella lesions without informing a physician. This case is presented to attract attention to the complications due to the use of topical steroid during varicella infection

Differences in hepatitis A seroprevalence among geographical regions in Turkey: a need for regional vaccination recommendations

dikici, bunyamin/0000-0001-7572-6525WOS: 000258784400013PubMed: 18837839Hepatitis A is a worldwide vaccine-preventable infection. Recommendation of vaccination depends on the endemicity of the disease. The World Health Organization recommends universal hepatitis A vaccination in intermediate areas; however, there is no need of mass vaccination in high and low endemicity regions. Therefore, most of the countries are using a vaccination policy according to the endemicity characteristic representing the whole of the country. The endemicity of this infection varies due to sanitary and hygiene conditions and socioeconomic differences among the countries and in various regions of the same country. A sample of 1173 persons between the age of 0 and 91 years from nine randomly selected medical centres from five different geographical centres of Turkey were tested for the level of anti-hepatitis A virus (anti-HAV) immunoglobulin-G antibodies using an enzyme-linked immunosorbent assay. The overall prevalence of anti-HAV antibodies was 64.4% (1142/1173). While the rate of sero-positivity was over 80% in the 5-9 age group and more than 90% after 14 years of age in south-eastern and eastern regions, it was lower than 50% at the age of 5-9 years in central and western regions and remains under 80% in those areas. We conclude that the differences observed in HAV sero-positivity among various geographical regions in Turkey support a universal HAV immunization policy for children currently living in regions of intermediate endemicity.Clement Weinberger of Sanofi PasteurWriting support was provided by Clement Weinberger of Sanofi Pasteur