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Allergy 2020 Jun 27. Epub 2020 Jun 27.

Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo.

CEN Case Rep 2020 Jun 26. Epub 2020 Jun 26.

Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo, Kobe, Hyogo, 650-0017, Japan.

Alport syndrome (AS) is a progressive kidney disease. Male cases with X-linked AS (XLAS) are reported to develop end-stage kidney disease (ESKD) at the age of around 20-30 years. One risk factor for developing ESKD at a young age is a genotype of having truncating variants in the COL4A5 gene. Read More

Proc Natl Acad Sci U S A 2020 Jun 9;117(25):14405-14411. Epub 2020 Jun 9.

National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892;

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome in children. The disease appears to cluster in families, but the pathogenesis is unknown. We queried two European-American cohorts and one Turkish cohort (total = 231) of individuals with PFAPA for common variants previously associated with two other oropharyngeal ulcerative disorders, Behçet's disease and recurrent aphthous stomatitis. Read More

Clin Pediatr (Phila) 2020 Jun 5:9922820927042. Epub 2020 Jun 5.

Children's Hospital Colorado, Aurora, CO, USA.

Pharyngitis is commonly diagnosed in the emergency department (ED) and accounts for substantial antibiotic burden in pediatrics. This study describes ED patterns of group A streptococcal (GAS) pharyngitis diagnosis and antibiotic prescribing patterns. This was a secondary data analysis of the National Hospital Ambulatory Medical Care Survey. Read More

Cochrane Database Syst Rev 2020 06 4;6:CD012431. Epub 2020 Jun 4.

Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker, Paris, France.

Background: Sore throat is a common condition caused by viruses or bacteria, and is a leading cause of antibiotic prescription in primary care. The most common bacterial species is group A streptococcus ('strep throat'). Between 50% to 70% of pharyngitis cases are treated with antibiotics, despite the majority of cases being viral in origin. Read More

Pak J Med Sci 2020 May-Jun;36(4):642-646

Masuma Anwar, MBBS. Department of Pediatrics, Shifa International Hospital Ltd, Shifa Tameer-e-Millat University, Islamabad, Pakistan.

Objective: The objective of the study was to assess the outcome of upper respiratory tract infections (URTI) in healthy children.

Methods: This descriptive study was conducted on 314 children aged 3-36 months in the paediatric outpatient clinic and emergency department with symptoms of URTI (fever, cough, rhinorrhoea) for ≤5 days. Patient's demographics, clinical features, laboratory data and outcome were recorded. Read More

Front Immunol 2020 14;11:877. Epub 2020 May 14.

Pediatric Rheumatology Unit of Western Switzerland, Pediatric Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland.

The inflammasome has been recognized as one of the key components of innate immunity. Gain-of-function mutations in the exon 3 of gene have been implicated in inflammatory diseases suggesting the presence of functionally important sites in this region. Q703K (c. Read More

J Antimicrob Chemother 2020 May 25. Epub 2020 May 25.

Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004 Paris, France.

Objectives: To assess recent community antibiotic prescribing for French children and identify areas of potential improvement.

Methods: We analysed 221 768 paediatric (<15 years) visits in a national sample of 680 French GPs and 70 community paediatricians (IQVIA's EPPM database), from March 2015 to February 2017, excluding well-child visits. We calculated antibiotic prescription rates per 100 visits, separately for GPs and paediatricians. Read More

Hawaii J Health Soc Welf 2020 May;79(5):149-152

Department of Pediatrics, John A Burns School of Medicine, University of Hawai'i, Honolulu, HI (BL-C, JM, RL, LN, DK).

Acute post-streptococcal glomerulonephritis (APSGN) is a disorder of inflammation in the glomeruli and vasculature of the kidneys that is caused by immune-complex formation after Streptococcus pyogenes infection. Most patients with APSGN present with macroscopic hematuria, edema, and hypertension, however presentation can vary from no symptoms to severe proteinuria, or even acute renal failure. This study sought to estimate the incidence of APSGN among children in Hawai'i, to identify populations at increased risk for APSGN, and to recognize risk factors correlated with the length of hospitalization by subtype of APSGN (eg, pyoderma-associated, pharyngitis-associated). Read More

Pediatr Infect Dis J 2020 06;39(6):469-477

Department of Paediatrics, The University of Melbourne, Parkville, Australia.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has spread rapidly across the globe. In contrast to initial reports, recent studies suggest that children are just as likely as adults to become infected with the virus but have fewer symptoms and less severe disease. In this review, we summarize the epidemiologic and clinical features of children infected with SARS-CoV-2 reported in pediatric case series to date. Read More

J Telemed Telecare 2020 May 11:1357633X20917497. Epub 2020 May 11.

Department of Pediatrics, Erlanger Medical Center, USA.

Aims: We report a novel pilot project that allows access to healthcare for children and staff at school via a mobile clinic or telemedicine portal connected to the mobile clinic. The objectives of this pilot project were (a) to perform physicals for children not attached to a primary care physician; (b) to provide medical consultations and treatment for acute illnesses of students and staff, and (c) to lower absenteeism rates among students and staff.

Methods: In 2013, Ronald McDonald House Charities, a non-profit organization, partnered with Children's Hospital of Erlanger to provide a mobile clinic trademarked Ronald McDonald Care Mobile utilising a large, box-style truck equipped with examination rooms and a telemedicine portal. Read More

JAMA Netw Open 2020 May 1;3(5):e204063. Epub 2020 May 1.

Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California.

Importance: Epidemiological studies indicate a link between obsessive-compulsive disorder and infections, particularly streptococcal pharyngitis. Pediatric acute-onset neuropsychiatric syndrome (PANS) manifests suddenly with obsessions, compulsions, and other behavioral disturbances, often after an infectious trigger. The current working model suggests a unifying inflammatory process involving the central nervous system, particularly the basal ganglia. Read More

Pediatr Rheumatol Online J 2020 Apr 15;18(1):31. Epub 2020 Apr 15.

Joseph M Sanzari Children's Hospital, Hackensack Meridian Health, Hackensack, NJ, USA.

Background: Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome in children. There is considerable heterogeneity in management strategies and a lack of evidence-based treatment guidelines. Consensus treatment plans (CTPs) are standardized treatment regimens that are derived based upon best available evidence and current treatment practices that are a way to enable comparative effectiveness studies to identify optimal therapy and are less costly to execute than randomized, double blind placebo controlled trials. Read More

Am J Emerg Med 2020 Feb 24. Epub 2020 Feb 24.

Department of The Ninth Pediatrics, Hunan Provincial People's Hospital (The First-Affiliated Hospital of Hunan Normal University), PR China.

Introduction: Mometasone furoate shows some potential in treating paediatric asthma. We conduct a systematic review and meta-analysis to explore the efficacy and safety of mometasone furoate for paediatric asthma.

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

J Korean Med Sci 2020 Apr 6;35(13):e142. Epub 2020 Apr 6.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea.

Methods: All of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Read More

IDCases 2020 15;19:e00659. Epub 2019 Oct 15.

Department of Pediatrics, Thriasio General Hospital, Athens, Greece.

Influenza virus primarily affects the respiratory system. It rarely causes extrapulmonary complications, with otitis media and febrile seizures being the most common in children. Acute glomerulonephritis as a complication of H1N1 influenza virus infection has been described only sporadically. Read More

BMC Fam Pract 2020 03 26;21(1):57. Epub 2020 Mar 26.

Tel Aviv University, Tel Aviv - Yafo, Israel.

Background: Throat pain is a common complaint in the ambulatory setting. Diagnosis of group A Streptococcus is made with a culture, molecular test or a rapid antigen detection test from the tonsils or the posterior pharyngeal wall, while other areas of the oral cavity are considered unacceptable. The purpose of the study is to compare cultures from the tonsils or posterior pharyngeal wall (throat) with cultures from the oral cavity (mouth). Read More

Arch Dis Child Educ Pract Ed 2020 Mar 20. Epub 2020 Mar 20.

Neonatal Unit, University Hospital Wishaw, NHS Lanarkshire, Lanarkshire, UK

Indian J Pediatr 2020 04 13;87(4):281-286. Epub 2020 Mar 13.

Department of Pediatrics and Infectious Disease, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India.

There is a new public health crises threatening the world with the emergence and spread of 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus originated in bats and was transmitted to humans through yet unknown intermediary animals in Wuhan, Hubei province, China in December 2019. There have been around 96,000 reported cases of coronavirus disease 2019 (COVID-2019) and 3300 reported deaths to date (05/03/2020). Read More

J Clin Microbiol 2020 May 26;58(6). Epub 2020 May 26.

Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA

Each year, there are an estimated 11 million visits to ambulatory care centers for pharyngitis in children between the ages of 3 and 18 years. While there are many causes of pediatric pharyngitis, group A streptococcal pharyngitis represents 15 to 30% of infections and is the only cause for which treatment is recommended. Unfortunately, clinical suspicion is insufficient for the accurate diagnosis of group A streptococcal pharyngitis, and laboratory testing for confirmation of infection is required to prevent complications of infection. Read More

Lancet 2020 03 12;395(10226):809-815. Epub 2020 Feb 12.

Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China. Electronic address:

Background: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. Limited data are available for pregnant women with COVID-19 pneumonia. This study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the intrauterine vertical transmission potential of COVID-19 infection. Read More

Rheumatology (Oxford) 2020 Mar 3. Epub 2020 Mar 3.

National Referral Centre of Auto-Inflammatory Diseases and Inflammatory Amyloidosis, - CEREMAIA, Department of Pediatrics, Versailles Hospital, Le Chesnay.

Objective: The new classification criteria for the hereditary recurrent fever (HRF) syndrome [cryopyrin-associated periodic syndrome (CAPS), TNF-α receptor-associated periodic syndrome (TRAPS), FMF and mevalonate kinase deficiency] have been published recently. These criteria define two core sets of criteria for each HRF: mixed criteria, including genetic and clinical variables, and clinical criteria, relying on clinical variables only. Our aim was to validate the criteria for HRF in an independent cohort, the JIR Cohort database, an international repository of systemic inflammatory diseases. Read More

Yonsei Med J 2020 Mar;61(3):243-250

School of Pharmacy, Sungkyunkwan University, Suwon, Korea.

Purpose: We aimed to analyze the surveillance reports of adverse events (AEs) due to different types of pneumococcal vaccines, in addition to detecting and validating signals of pneumococcal vaccines by comparing AEs with labels.

Materials And Methods: We analyzed the percentages of AEs according to vaccine type [pneumococcal polysaccharide vaccines (PPSVs) and pneumococcal conjugate vaccines (PCVs)] in children and adults using data from the Korea Adverse Event Reporting System (KAERS) database from 2005 to 2016. A signal was defined as an AE that met all three indices of data mining: proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). Read More

Infect Control Hosp Epidemiol 2020 Feb 24:1-3. Epub 2020 Feb 24.

Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah, Salt Lake City, Utah.

J Clin Rheumatol 2020 Mar;26(2):60-62

From the Institute of Rheumatology.

Objectives: This is a noncomparative study performed to determine if fever pattern is related to a diagnosis of autoinflammatory disease (AID) in pediatric- and adult-onset patients.

Methods: The final diagnosis of patients suspected to have AID was evaluated against gene polymorphisms known to be responsible for AID, clinical manifestations, and fever pattern, in our institute from 2005 to 2016. Genomic DNA was isolated from patients' peripheral blood, and polymerase chain reaction was used to amplify the indicated exons of 12 genes: MEFV, TNFRSF1A, MVK, NLRP3, NOD2, LI1RN, IL36RN, PSMB8, NALP12, PSTPIP1, TNFAIP3, and NLRC4. Read More

J Pediatr 2020 May 14;220:132-138.e2. Epub 2020 Feb 14.

Department of Pediatrics, Boston Children's Hospital, Boston, MA; Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.

Objectives: To determine the prevalence of features of viral illness in a national sample of visits involving children tested for group A Streptococcus pharyngitis. Additionally, we sought to derive a decision rule to identify patients with features of viral illness who were at low risk of having group A Streptococcus and for whom laboratory testing might be avoided.

Study Design: Retrospective validation study using data from electronic health records of patients 3-21 years old evaluated for sore throat in a national network of retail health clinics (n = 67 127). Read More

Pediatr Infect Dis J 2020 Jun;39(6):483-488

Department of Pediatrics, University of Pittsburgh School of Medicine.

Background: Among children with pharyngitis who test positive for group A Streptococcus (GAS), 10%-25% are GAS carriers. Current laboratory methods cannot distinguish acute infection from colonization.

Methods: We examined 2 separate longitudinal studies of children with symptomatic pharyngitis associated with a positive GAS throat culture (illness culture). Read More

Nutrients 2020 Jan 31;12(2). Epub 2020 Jan 31.

Department of Paediatrics at the Medical University of Warsaw, 02091 Warsaw, Poland.

Postbiotics have recently been tentatively defined as bioactive compounds produced during a fermentation process (including microbial cells, cell constituents and metabolites) that supports health and/or wellbeing. Postbiotics are currently available in some infant formulas and fermented foods. We systematically reviewed evidence on postbiotics for preventing and treating common infectious diseases among children younger than 5 years. Read More

J Med Microbiol 2020 Mar;69(3):443-450

Departments of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan.

Pharyngotonsillitis caused by (group A streptococci, or GAS) is among the most common infections treated with antibiotics in pediatric patients. This study aimed to analyse changes in molecular epidemiology and antibiotic susceptibility among GAS isolates in three study periods spanning 10 years.. Read More

J Nippon Med Sch 2020 Jan 31. Epub 2020 Jan 31.

Health Sciences Research Institute East Japan.

Streptococcus pyogenes, or Group A Streptococcus (GAS), is one of the most common pathogens of bacterial infection in children. GAS can cause such non-serious and non-invasive diseases as pharyngitis and skin infections, as well as serious and invasive diseases like streptococcal toxic shock syndrome. One of the factors that make GAS pathogenic is the type-specific M protein found on the cell surface. Read More

Eur J Clin Microbiol Infect Dis 2020 Jun 27;39(6):1103-1107. Epub 2020 Jan 27.

Department of Life, Health and Environmental Sciences, Epidemiology Unit, University of Aquila, L'Aquila, Italy.

Group A streptococcal (GAS) pharyngitis is responsible for 20-30% of pharyngitis cases in children (Shulman et al. Clin Infect Dis 55(10):e86-e102, 2012). Recommendations for the diagnosis and treatment of GAS pharyngitis have been published by the Italian National Institute of Health guidelines in 2012 (ESCMID Sore Throat Guideline Group et al. Read More

Clin Infect Dis 2020 Jan 19. Epub 2020 Jan 19.

Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

Background: Pharyngitis due to group A Streptococcus (GAS) represents a major cause of outpatient visits and antibiotic use in the United States. A leading vaccine candidate targets 30 of the >200 emm types of GAS. We aimed to assess natural protection conferred by GAS against respiratory symptoms. Read More

Cochrane Database Syst Rev 2019 12 30;12:CD008669. Epub 2019 Dec 30.

University Medical Center Utrecht, Utrecht University, Julius Center for Health Sciences and Primary Care & Department of Otorhinolaryngology, Heidelberglaan 100, Utrecht, Netherlands, 3508 GA.

Background: Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is a rare clinical syndrome of unknown cause usually identified in children. Tonsillectomy is considered a potential treatment option for this syndrome. This is an update of a Cochrane Review first published in 2010 and previously updated in 2014. Read More

Open Forum Infect Dis 2019 Dec 10;6(12):ofz524. Epub 2019 Dec 10.

Duke University, Durham, North Carolina, USA.

Background: Pharyngitis due to group A (GAS) is a common pediatric infection. Physicians might diagnose GAS pharyngitis more accurately when given biosurveillance information about GAS activity. The availability of geographic GAS testing data may be able to assist with real-time clinical decision-making for children with throat infections. Read More

Int J Pediatr Otorhinolaryngol 2020 03 17;130:109830. Epub 2019 Dec 17.

Università Cattolica Sacro Cuore, Rome, Italy; Unit of Otorhinolaryngology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

J Int Med Res 2019 Dec 18:300060519889442. Epub 2019 Dec 18.

Center of Diagnosis and Treatment of Breast Disease, The Affiliated Hospital of Qingdao University, Qingdao, China.

Objective: To evaluate the efficacy and safety of fluticasone propionate/formoterol (FP/FORM) versus fluticasone propionate/salmeterol (FP/SAL) in treating pediatric asthma during a 12-week treatment cycle.

Methods: Randomized controlled trials of FP/FORM compared with FP/SAL in treating pediatric asthma were searched systematically using Medline, Embase, and the Cochrane Controlled Trials Register.

Results: Two articles including 546 patients were evaluated. Read More

Am J Emerg Med 2020 Jul 18;38(7):1322-1326. Epub 2019 Nov 18.

Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, United States; Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, MA, United States.

Background: Clinicians use the Modified Centor Score (MCS) to estimate the risk of group A streptococcal (GAS) pharyngitis in children with sore throat. The Infectious Diseases Society of America (IDSA) recommends neither testing nor treating patients with specific viral symptoms. The goal of this study is to measure the impact of those symptoms on the yield of GAS testing predicted by the MCS. Read More

Vaccine 2020 02 13;38(6):1384-1392. Epub 2019 Dec 13.

Division of Infectious Diseases, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.

Background: Streptococcus pyogenes (group A Streptococcus, Strep A) is a widespread pathogen that continues to pose a significant threat to human health. The development of a Strep A vaccine remains an unmet global health need. One of the major vaccine strategies is the use of M protein, which is a primary virulence determinant and protective antigen. Read More

J Clin Immunol 2020 Jan 5;40(1):179-190. Epub 2019 Dec 5.

Department of Pediatrics, Division of Allergy, Immunology and Kawasaki Disease, University of California San Diego, La Jolla, CA, USA.

Periodic Fever, Aphthous stomatitis, Pharyngitis and Adenitis (PFAPA) syndrome is an inflammatory disorder of childhood classically characterized by recurrent fevers, pharyngitis, stomatitis, cervical adenitis, and leukocytosis. While the mechanism is unclear, previous studies have shown that tonsillectomy can be a therapeutic option with improvement in quality of life in many patients with PFAPA, but the mechanisms behind surgical success remain unknown. In addition, long-term clinical follow-up is lacking. Read More

Int J Pediatr Otorhinolaryngol 2020 Mar 25;130:109795. Epub 2019 Nov 25.

Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.

Objectives: Tonsillectomy (TE) or adenotonsillectomy (ATE) may have a beneficial effect on the clinical course in children with the periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome. However, an immunological reason for this effect remains unknown. This literature review summarizes the current knowledge regarding the immunological role of the tonsils in the PFAPA syndrome. Read More

JAAPA 2019 12;32(12):58

Brian T. Maurer has practiced general pediatrics for more than 30 years. He is the author of Patients Are a Virtue and blogs at http://briantmaurer.wordpress.com. The author has disclosed no potential conflicts of interest, financial or otherwise.

Microb Genom 2019 11;5(11)

Center for Antimicrobial Resistance and Microbial Genomics, University of Texas Health Sciences Center at Houston, Houston, TX, USA.

Despite universal susceptibility to β-lactams, resistance to second-line antimicrobials (e.g. erythromycin) is increasingly common among group A (GAS). Read More

J Family Med Prim Care 2019 Oct 31;8(10):3130-3135. Epub 2019 Oct 31.

Department of Pediatrics, Pt BD Sharma PGIMS, Shimla, Himachal Pradesh, India.

Background And Aims: Antibiotics are frequently prescribed for sore throat in developing countries, that in turn leads to huge healthcare expenditure and their irrational use may lead to antimicrobial resistance in the community. The aim of this study is to investigate the effect of environmental factors on the frequency of occurrence of group A beta hemolytic streptococcus (GABHS) sore throat and to work out enhancing effect on the sensitivity and specificity and positive predictive value of the signs and symptoms of GABHS sore throat for facilitation of rational antibiotic use.

Settings And Design: This was a prospective, cross sectional study conducted over period of one year in Pediatric Outpatient Department (OPD) of a Tertiary care teaching hospital. Read More

Rev Esp Salud Publica 2019 Nov 20;93. Epub 2019 Nov 20.

Hospital Católico Universitario Casa de Salud. Valencia. España.

Objective: There are two scales (Centor and McIsaac) that describe the frequent signs and symptoms in pharyngotonsillitis and determine the attitude to be followed for diagnosis and treatment; among them, the McIsaac criteria are one of the most widely used scales. The goal of the study was to determine the predictive value of the McIsaac criteria in the diagnosis of pharyngotonsillitis due to EbhGA in a Pediatric Emergency Service. The predictive value of these criteria is decisive in the adequate use of TDR test and antibiotics as a treatment. Read More

Iran J Child Neurol 2019 ;13(4):185-191

Physical Medicine and Rehabilitation Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Idiopathic neuralgic amyotrophy (INA) is a disorder presented with acute severe pain in the upper extremity, followed by muscle weakness, paralysis and atrophy. INA is rare in children and few reports are found in the literature. Here, we report a case of INA in an 8-yr old boy from Iran following pharyngitis. Read More

Clin Infect Dis 2020 Apr;70(8):1781-1787

Department of Pediatrics, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Improving antibiotic prescribing in outpatient settings is a public health priority. In the United States, urgent care (UC) encounters are increasing and have high rates of inappropriate antibiotic prescribing. Our objective was to characterize antibiotic prescribing practices during UC encounters, with a focus on respiratory tract conditions. Read More

Cureus 2019 Aug 21;11(8):e5447. Epub 2019 Aug 21.

Pediatrics, United Medical and Dental College/Creek General Hospital, Karachi, PAK.

Rheumatic chorea (RC) is a movement disorder seen in young children and adolescents with a recent history of incompletely treated group A beta-hemolytic streptococcal (GABHS) pharyngitis. Although, it rarely presents as the first manifestation of the disease, physicians should be aware of the disease, so that early diagnosis and prompt treatment may lead to elimination of the pathogen and prevent further disease progression. We present a case of a 13-year-old female child who presented with only RC as the first clinical sign. Read More

Clin Pediatr (Phila) 2020 01 14;59(1):21-30. Epub 2019 Oct 14.

John R. Oishei Children's Hospital, Buffalo, NY, USA.

Pediatric antibiotic prescriptions originate from an increasingly broad range of ambulatory settings. In this retrospective study, pharyngitis, otitis media, sinusitis, pneumonia, and upper respiratory infection cases, at 11 primary care offices, 2 independent urgent care centers (UCCs), and a pediatric emergency department in Western New York, were analyzed relative to medical society practice guidelines and antibiotic utilization. Of 2358 eligible visits across all sites, 25% were for study diagnoses, with 38% at UCC ( < . Read More

J Pediatr 2019 12 3;215:187-191. Epub 2019 Oct 3.

Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.

Objective: To describe clinical presentation, electrocardiographic, and echocardiographic characteristics of carditis at the time of diagnosis of acute rheumatic fever (ARF) over a 13-year period.

Study Design: A single-center retrospective chart analysis was conducted involving all consecutive patients diagnosed with ARF between 2003 and 2015. Patient age, sex, clinical characteristics, recent medical history for group A streptococcal pharyngotonsillitis and antibiotic treatment, and laboratory, echocardiographic, and electrocardiographic findings were recorded. Read More

J Pediatr 2020 01 24;216:208-212. Epub 2019 Sep 24.

Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL.