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Clin Pediatr (Phila) 2022 Jun 27:99228221106554. Epub 2022 Jun 27.

Division of Pediatric Infectious Diseases, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, NY, USA.

Data on pediatric antibiotic prescribing and utilization practices at urgent care centers (UCC) remain limited. In this study, an electronic medical record-based review of UCC encounters for respiratory tract infections (RTI) of patients belonging to one mid-sized pediatric practice was performed. Antibiotic prescribing and guideline adherence were compared between UCCs that were staffed exclusively by pediatric-trained providers to those staffed otherwise. Read More

S D Med 2022 May;75(5):212-215

Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.

A previously healthy 8-year-old Native American female presented with right-sided weakness and joint pain for two weeks. Following an initially unremarkable workup including negative brain and spine MRI she was noticed to have chorea and subsequently diagnosed with acute rheumatic fever (ARF). ARF is a group A streptococcus-related disease that most commonly is a sequelae of pharyngitis. Read More

Pediatrics 2022 Jul;150(1)

Division of Urgent Care, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.

Background: Urgent care (UC; a convenient site to receive care for ambulatory-sensitive) centers conditions; however, UC clinicians showed the highest rate of inappropriate antibiotic prescriptions among outpatient settings according to national billing data. Antibiotic prescribing practices in pediatric-specific UC centers were not known but assumed to require improvement. The aim of this multisite quality improvement project was to reduce inappropriate antibiotic prescribing practices for 3 target diagnoses in pediatric UC centers by a relative 20% by December 1, 2019. Read More

Int J Environ Res Public Health 2022 06 6;19(11). Epub 2022 Jun 6.

Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, 477-96 Owada-Shinden, Yachiyo 276-0046, Chiba, Japan.

The study tested the hypothesis that human mobility may be a potential factor affecting reductions in droplet-transmissible pediatric infectious diseases (PIDs) during the coronavirus disease-2019 (COVID-19) pandemic mitigation period in 2020. An ecological study was conducted using two publicly available datasets: surveillance on infectious diseases collected by the Japanese government and COVID-19 community mobility reports presented by Google. The COVID-19 community mobility reports demonstrated percentage reductions in the movement of people over time in groceries and pharmacies, parks, and transit stations. Read More

JAMA Netw Open 2022 05 2;5(5):e2214153. Epub 2022 May 2.

Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri.

Importance: Nonguideline antibiotic prescribing for the treatment of pediatric infections is common, but the consequences of inappropriate antibiotics are not well described.

Objective: To evaluate the comparative safety and health care expenditures of inappropriate vs appropriate oral antibiotic prescriptions for common outpatient pediatric infections.

Design, Setting, And Participants: This cohort study included children aged 6 months to 17 years diagnosed with a bacterial infection (suppurative otitis media [OM], pharyngitis, sinusitis) or viral infection (influenza, viral upper respiratory infection [URI], bronchiolitis, bronchitis, nonsuppurative OM) as an outpatient from April 1, 2016, to September 30, 2018, in the IBM MarketScan Commercial Database. Read More

J Multidiscip Healthc 2022 4;15:999-1010. Epub 2022 May 4.

Pediatric Rheumatology Unit, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.

Background: Systemic autoinflammatory diseases (SAID) are characterized by inappropriate activation of the innate immune system and include not only monogenic periodic fever syndromes but also multifactorial conditions. As SAID are rare and represent a diagnostic challenge, a multidisciplinary approach is important to ensure successful diagnosis and adequate follow-up of these patients.

Objective: To describe the organization of our multidisciplinary SAID clinic and to characterize our clinical experience, highlighting the benefits of multidisciplinary team management. Read More

Lancet Microbe 2021 07 15;2(7):e291-e299. Epub 2021 Apr 15.

Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia.

Background: Streptococcus pyogenes is a leading cause of infection-related morbidity and mortality. A reinvigorated vaccine development effort calls for new clinically relevant human S pyogenes experimental infection models to support proof of concept evaluation of candidate vaccines. We describe the initial Controlled Human Infection for Vaccination Against S pyogenes (CHIVAS-M75) study, in which we aimed to identify a dose of emm75 S pyogenes that causes acute pharyngitis in at least 60% of volunteers when applied to the pharynx by swab. Read More

Int J Pediatr Otorhinolaryngol 2022 07 25;158:111153. Epub 2022 Apr 25.

İzmir Katip Çelebi University, Faculty of Medicine, Department of Pediatric Rheumatology, İzmir, Turkey.

Front Pediatr 2022 14;10:868297. Epub 2022 Apr 14.

Centro de Estudios en Infectología Pediátrica, Cali, Colombia.

Background: Limited data is available from low-middle and upper-middle income countries of the factors associated with hospitalization or admission to pediatric intensive care unit (PICU) for children with COVID-19.

Objective: To describe the factors associated with hospitalization or PICU admission of children with COVID-19 in Latin America.

Method: Multicenter, analytical, retrospective study of children reported from 10 different Latin American countries to the Latin-American Society of Pediatric Infectious Diseases (SLIPE-COVID) research network from June 1, 2020, and February 28, 2021. Read More

CEN Case Rep 2022 Apr 10. Epub 2022 Apr 10.

Department of Pediatrics, Hokkaido University Hospital, Hokkaido University Graduate School of Medicine, Kita 15-jo Nishi 7-Chome, Kita Ward, Sapporo, Hokkaido, Japan.

It is clinically possible for patients with Alport syndrome (AS) to suffer from poststreptococcal acute glomerulonephritis (PSAGN). However, there is only one report of such a patient, and he had end-stage kidney disease. Here, we describe an 8-year-old male with X-linked AS and chronic kidney disease (CKD) stage G2. Read More

Arch Rheumatol 2021 Dec 10;36(4):493-498. Epub 2021 May 10.

Department of Medical Genetics, Çukurova University Faculty of Medicine, Adana, Turkey.

Objectives: In this study, we aimed to investigate the performance of Eurofever Registry and the Paediatric Rheumatology International Trials Organisation (PRINTO) classification criteria in pediatric patients with familial Mediterranean fever (FMF).

Patients And Methods: This retrospective, cross-sectional study included a total of 130 pediatric FMF patients (67 males, 63 females; mean age: 12.4±3. Read More

Front Pediatr 2021 3;9:800656. Epub 2022 Mar 3.

The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Introduction: Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis (PFAPA) is the most common periodic fever syndrome in the pediatric population, yet its pathogenesis is unknown. PFAPA was believed to be sporadic but family clustering has been widely observed.

Objective: To identify demographic and clinical differences between patients with PFAPA and a positive family history (FH+) as compared to those with no family history (FH-). Read More

J Pediatric Infect Dis Soc 2022 06;11(6):303-304

Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.

Cureus 2022 Jan 28;14(1):e21701. Epub 2022 Jan 28.

Pediatrics, University of Arizona College of Medicine - Tucson, Tucson, USA.

Although peritonsillar abscesses (PTAs) are a common presentation in pediatric patients, there are very few reports on a pediatric patient with both a PTA and uvular hydrops. Our patient presented to the emergency room after being unsuccessfully treated for pharyngitis, with odynophagia, dyspnea, muffled voice, drooling, and trismus. On physical examination, we observed a PTA as well as an edematous and erythematous uvula. Read More

Pediatr Infect Dis J 2022 05;41(5):405-410

Department of Pediatrics, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.

Background: Group A ß-hemolytic streptococcus (GABHS) is a leading pathogen worldwide and post-streptococcal sequelae is a major cause of morbidity and mortality in resource-limited countries. The M protein (coded by the emm gene) is a key virulence factor and a component of GABHS vaccine candidates. As data on BHS in Central Africa are scarce, antibiotic resistance, emm diversity and potential vaccine coverage were investigated. Read More

Arch Dis Child 2022 Jun 21;107(6):622-623. Epub 2022 Feb 21.

Pediatrics, NYU Langone Health, New York, New York, USA.

Glob Heart 2022 20;17(1). Epub 2022 Jan 20.

Division of General Internal Medicine, University of Washington, Seattle, WA, USA.

Background: Untreated streptococcal pharyngitis is a precursor to rheumatic heart disease (RHD) and remains a significant public health issue in many countries. Understanding local determinants of treatment-seeking behaviors can help tailor RHD prevention programs.

Objective: We sought to elicit perceptions of pharyngitis and related healthcare use in a range of communities in Uganda. Read More

Nat Commun 2022 02 9;13(1):769. Epub 2022 Feb 9.

Murdoch Children's Research Institute, Melbourne, Australia.

Streptococcus pyogenes causes at least 750 million infections and more than 500,000 deaths each year. No vaccine is currently available for S. pyogenes and the use of human challenge models offer unique and exciting opportunities to interrogate the immune response to infectious diseases. Read More

Anaerobe 2022 Jun 2;75:102532. Epub 2022 Feb 2.

Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

F. necrophorum, a gram-negative obligate anaerobe, causes pharyngotonsillitis, peritonsillar abscess and the Lemierre Syndrome as well as other significant infections. Clinical information on this bacterium has increased dramatically over the past 20 years, yet no standard guidance exists for treating these infections. Read More

Infect Control Hosp Epidemiol 2022 Jan 31:1-7. Epub 2022 Jan 31.

Dvision of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee.

Objective: To improve appropriate antibiotic prescribing for children in Tennessee.

Design: We performed a before-and-after intervention study with 3 comparison periods: period 1 (P1, baseline) May 2018-September 2019; period 2 (P2, intervention before the COVID-19 pandemic) November 11, 2019-March 20, 2020; and period 3 (P3, intervention during the coronavirus disease 2019 [COVID-19] pandemic) March 21, 2020-November 10, 2020. We additionally surveyed participating providers to assess acceptance of the intervention. Read More

Clin Infect Dis 2022 Jan 17. Epub 2022 Jan 17.

Department of Pediatrics, Columbia University Irving Medical Center New York, NY, United States.

Background: Acute respiratory infections (ARI) are the most common infectious diseases globally. Community surveillance may provide a more comprehensive picture of disease burden than medically-attended illness alone.

Methods: In this longitudinal study conducted from 2012-2017 in the Washington Heights/Inwood area of New York City, we enrolled 405 households with 1,915 individuals. Read More

Rheumatol Int 2022 07 7;42(7):1207-1211. Epub 2022 Jan 7.

Division of Rheumatology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, 06100, Ankara, Turkey.

Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is an autoinflammatory recurrent fever syndrome that mainly affects children. Probiotics are currently used to prevent upper respiratory tract infections and flares of diseases associated with immune dysregulation. We aimed to evaluate the response to probiotic treatment in PFAPA patients. Read More

JAMA Netw Open 2021 12 1;4(12):e2135184. Epub 2021 Dec 1.

Department of Pediatrics, Division of Hospital Medicine, Nicklaus Children's Hospital, Miami, Florida.

Importance: The scope of low-value care in children's hospitals is poorly understood.

Objective: To develop and apply a calculator of hospital-based pediatric low-value care to estimate prevalence and cost of low-value services.

Design, Setting, And Participants: This cross-sectional study developed and applied a calculator of hospital-based pediatric low-value care to estimate the prevalence and cost of low-value services among 1 011 950 encounters reported in 49 US children's hospitals contributing to the Pediatric Health Information System (PHIS) database. Read More

Arch Pediatr 2022 Feb 23;29(2):128-132. Epub 2021 Dec 23.

Department of Pediatrics, University Hospital Arnaud de Villeneuve, University of Montpellier, France; Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Montpellier, France.

Objectives: The aim of our study was to describe clinical presentations, bacteriological results, and therapeutic management in a pediatric population presenting with acute pharyngeal suppuration. A further aim was to identify clinical, bacteriological, and radiological predictors of success associated with exclusive medical treatment.

Method: A retrospective study was carried out including patients under 18 years of age hospitalized between January 1, 2015 and December 31, 2017 in our center for acute pharyngeal suppuration. Read More

Front Pediatr 2021 25;9:759664. Epub 2021 Nov 25.

Pediatric Rheumatology and Autoinflammatory Reference Center Tübingen, University Children's Hospital Tübingen, University of Tübingen, Tübingen, Germany.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) is the most common fever syndrome in childhood. High disease activity (DA) dramatically impacts the health-related quality of life. Thus, effective and safe treatment is crucial. Read More

PLoS One 2021 13;16(12):e0249980. Epub 2021 Dec 13.

Department of Pediatrics, Brown University Warren Alpert Medical School, Providence, RI, United States of America.

Purpose: To evaluate the diagnostic value of symptoms used by daycares and schools to screen children and adolescents for SARS-CoV-2 infection, we analyzed data from a primary care setting.

Methods: This cohort study included all patients ≤17 years old who were evaluated at Providence Community Health Centers (PCHC; Providence, U.S. Read More

BMJ Glob Health 2021 12;6(12)

Department of Public Health, University of Otago Wellington, Wellington, New Zealand.

Introduction: Acute rheumatic fever (ARF) is usually considered a consequence of group A streptococcus (GAS) pharyngitis, with GAS skin infections not considered a major trigger. The aim was to quantify the risk of ARF following a GAS-positive skin or throat swab.

Methods: This retrospective analysis used pre-existing administrative data. Read More

Medicine (Baltimore) 2021 Nov;100(44):e27616

Department of Mother and Child Medicine - Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.

Rationale: Tuberculosis is an entity that usually affects the lungs, although extrapulmonary sites can also be involved. Tonsils are rarely affected, especially in the absence of pulmonary disease, primary tonsillar tuberculosis being a diagnostic challenge for the clinician.

Patient Concerns: We present the case of a 14-year-old female teenager, presented to our Pediatric Service with a 14-day history of dysphagia, odynophagia and left reflex otalgia associated with a 5 kg weight loss. Read More

Postepy Dermatol Alergol 2021 Oct 25;38(5):740-745. Epub 2020 Feb 25.

Department of Paediatrics, The First People's Hospital of Xiaoshan, Hangzhou, Zhejiang Province, China.

Introduction: The influence of mometasone furoate for paediatric asthma remains controversial.

Aim: We conducted a systematic review and meta-analysis to explore the efficacy and safety of mometasone furoate for paediatric asthma.

Material And Methods: We have searched PubMed, Embase, Web of science, EBSCO, and Cochrane library databases through October 2019 for randomized controlled trials assessing the effect of mometasone furoate versus placebo for paediatric asthma. Read More

Pediatr Int 2021 Nov 7;64(1):e15052. Epub 2021 Nov 7.

Departments of Pediatric Rheumatology, Selcuk University Faculty of Medicine, Konya, Turkey.

Background: Familial Mediterranean fever (FMF) is a self-limiting, autoinflammatory disease characterized by inflammation of the serosal surfaces and recurrent episodes of fever. The aim of this study is to determine the effect of genetic mutations on clinical features in children with FMF.

Methods: A total of 303 patients aged 0-18 years, who were diagnosed with FMF, according to Yalcinkaya-Özen diagnostic criteria and whose Mediterranean fever gene (MEFV) analysis was studied, were evaluated retrospectively. Read More