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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The spondyloarthropathies of childhood present a diagnostic and therapeutic challenge. It is important to differentiate this group of arthritides from JRA because the nature and frequency of extra-articular complications are quite different, as is the prognosis and the therapeutic approach. JAS is the prototype of the spondyloarthropathies and probably accounts for greater than 75 per cent of all children with diseases included in this category. Unlike adult-onset ankylosing spondylitis, axial skeleton disease (sacroiliac, lumbar spine) is infrequent at onset of JAS and may not develop for months or years after the onset of arthritis in peripheral joints (particularly those of the lower extremity). Enthesitis, the inflammation of the insertion of tendon, capsule, ligament, or fascia to bone, is an important clinical diagnostic feature of this group of diseases. Extra-articular disease, such as rash in psoriatic arthritis, erythema nodosum, weight loss of abdominal pain (in the arthropathies of inflammatory bowel disease), urethritis, conjunctivitis, or Reiter's syndrome help to differentiate these spondyloarthropathies from JAS. Laboratory studies are of little assistance in differentiating JRA from the spondyloarthropathies except that in the latter group, RF is absent and HLA-B27 is frequently present. The high frequency of ANA in JRA contrasts with its corresponding low frequency in JAS. The long-term follow-up of chronic arthritis in childhood has demonstrated the variable and evolving nature of these conditions, and stresses the importance of continually questioning the accuracy of the diagnosis.
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PMID:Spondyloarthropathies of childhood. 376 52

Yersinia pseudotuberculosis infection was diagnosed in 12 children on the basis of recovery of the organism from stool cultures and a 4-fold or greater titer change in agglutinating antibody. Eight of the 12 Yersinia isolates were recovered from stool cultures only after cold enrichment. Clinical findings in 50% or more of patients were fever, rash, diarrhea, desquamation, strawberry tongue, vomiting, red and cracked lips, abdominal pain, arthralgias, hepatomegaly and conjunctivitis. The patients' clinical manifestations and courses of illness resembled those of Izumi fever, an illness that occurs epidemically in Japan. Additionally the finding in two children fulfilled the strict criteria for Kawasaki syndrome, and signs in the other 10 children were consistent with that diagnosis.
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PMID:Yersinia pseudotuberculosis infection in children, resembling Izumi fever and Kawasaki syndrome. 634 44

We describe 2 patients who presented with yersinia arthritis within a period of 5 months in Leicester. Both were HLA B27 positive. Arthritis followed 2 to 3 weeks after pneumonia, abdominal pain, dysuria, and evidence of hepatic involvement in the first case, and dysuria and conjunctivitis in the second. Immunological studies showed the presence of IgM, IgG, and IgA antibodies at a significant level against Yersinia enterocolitica serotype O:3 in serum and synovial fluid, and immune complexes in the serum of the first case and synovial fluid of both. Arthropathy resolved after 16 weeks in the first case and 12 weeks in the second, the latter requiring systemic corticosteroids. Family studies revealed psoriatic spondylarthritis in the brother, and bilateral sacroiliitis in the mother of the second case. Both were HLA B27 positive. These are the fourth and fifth reported cases of yersinia arthritis in Britain. We believe the condition is probably underdiagnosed and that yersiniosis should be considered as a possibility in otherwise unexplained arthritis.
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PMID:Yersinia arthritis: a clinical, immunological, and family study of 2 cases. 697 85

Neonatal Chlamydia trachomatis infection is thought to be acquired as a result of contact with infected cervical secretions during vaginal delivery. An infant, delivered by cesarean section, who was infected with C trachomatis has been described. At 31 days of age he had conjunctivitis and respiratory distress. Nasopharyngeal aspirate grew C trachomatis and serum IgM antibody titer was 1:32 for serotype J. The patient's mother had serum IgG antibody against C trachomatis serotype J. Her cervical culture was negative for Chlamydia; however, cultures were not taken until two months after delivery and she had received antibiotics for postpartum fever and abdominal pain. The literature has been reviewed and possible modes of transmission have been discussed.
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PMID:Chlamydia trachomatis infection in infant delivered by cesarean section. 727 71

We studied characteristics of ocular inflammation associated with Yersinia infection in 23 patients. After an acute onset with fever, diarrhea, and abdominal pain, 22 patients developed arthritis, 11 patients developed myalgia, 11 patients developed Reiter's syndrome, 17 patients developed acute anterior uveitis, and nine patients developed conjunctivitis. Sacroiliitis was found in 12 patients. The patients had high erythrocyte sedimentation rates, leukocytosis, and lack of antinuclear antibodies and rheumatoid factor. All 17 patients tested had HLA-B27 antigen. The patients with acute anterior uveitis showed aqueous flare, cells, fine keratic precipitates, and often exudates, posterior synechiae, vitritis, and macular edema. Acute anterior uveitis was mostly unilateral and resolved during corticosteroids on the average during the first six weeks; recurrences were seen in about half of the cases. Conjunctivitis was generally mild with no chemosis, follicles, or keratitis; and it resolved in one week without treatment. Our results indicate that in HLA-B27 positive patients infective agents can trigger acute anterior uveitis or conjunctivitis, which often occur together with rheumatic diseases.
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PMID:Ocular inflammation associated with Yersinia infection. 735 91

Infection with rickettsiae of the spotted fever group was clinically and serologically diagnosed in four dogs from two households on Long Island. In two dogs, clinical signs included high fever (to 40.5 C), abdominal pain, lethargy, depression, anorexia, and nystagmus. One of these dogs had conjunctivitis and petechial hemorrhages in the oral mucous membranes. The third dog initially had high fever, evidence of abdominal pain, anorexia, and depression. The fourth dog appeared clinically normal. Clinical signs disappeared following treatment with tetracycline given orally.
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PMID:Rocky Mountain spotted fever in dogs. 738 Jul 21

In order to obtain data about clinical manifestations of symptomatic leptospiral infection in children, the authors reviewed 188 microscopic agglutination tests performed on sera of patients aged 0 to 12 years, made at the National Reference Laboratory of Leptospirosis (FIOCRUZ-RJ) from January 1983 to June 1991. Fifty two (27.6%) sera were positive. Twenty three (12.2%) children had serological evidence of acute infection. The most frequent signs and symptoms of these 23 cases were: fever (100%); myalgia (69.5%); headache (52.1%); jaundice (47.8%); vomit (34.8%); abdominal pain, hemorrhagic manifestations and impaired renal function (17.4%); conjunctivitis (13%); hepatomegaly (4.3%).
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PMID:[Leptospirosis in children in Rio do Janeiro]. 800 21

A 6-year-old Doberman bitch was presented for an acute onset of circling, hemiparesis and depression. Clinical examination revealed conjunctivitis, abdominal pain, anaemia, decreased facial sensation, decreased jaw, tongue and pharyngeal tone, decreased conscious proprioception, decreased flexor withdrawal reflexes, and abnormal hemiwalking and hemistanding. Pancytopaenia was evident on haematological evaluation. Bone marrow cytology revealed a bacterial infection. Cerebrospinal fluid analysis was normal. Despite antibiotic treatment, the dog died. On autopsy, widespread multifocal inflammatory lesions were found to be present in the lungs, liver, spleen, meninges, lymph nodes, adrenal glands and kidneys. Listeria monocytogenes was isolated in pure culture from these organs and tissues. Histopathological examination showed numerous gram-positive intracellular rod-shaped bacteria seen in all the above-mentioned organs.
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PMID:Generalised Listeria monocytogenes infection in a dog. 817 88

91 patients with trichinosis were treated at the Clinic of Infectious and Dermatovenereology Diseases in Novi Sad during a one-year period. In 64% of patients the onset was intestinal, while in 36% it was invasive. Diarrhea (in 28.89%) and abdominal pain (in 22.22%) are the most common symptoms of the intestinal stage. Nausea, vomiting and opstipation are less common. The main symptoms of the invasive stage are myalgia (65.54%), high temperature and eyelid edema (57.78%). Facial edema (38.89%), general weakness (24.44%), conjunctivitis (15.56%) and rash (8.89%) are somewhat less common. Heavy sweating, headache, nervousness, psychic instability and fast forgetting occur in a small number of treated patients. Myocarditis and encephalitis occurred in 3.33% of patients. There were 43.33% of patients with mild clinical picture, 40% with mild-to-severe and 16.66% with severe clinical picture. 54.44% of patients were males and 45.56% were females, and it can be said that sex did not influence the severeness of the clinical picture. The youngest patient was 5 years of age, the oldest 72. Most patients were 21-50 years of age but we did not establish statistical importance between clinical picture severeness in regard to age. The shortest period of incubation was 5 days, the longest 40 days. Average incubation period was 18.05 days (x = 18.05). Studying period of incubation and severeness of the clinical picture we established the following (x2 = 28.535). The shorter the incubation period, the severer the disease.
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PMID:[Clinical characteristics of trichinosis]. 901 31

Cetirizine (once daily), a highly selective H1-antagonist, is efficacious for treating seasonal allergic rhinitis (SAR), perennial allergic rhinitis, and chronic idiopathic urticaria. A 4-week, randomized, double-blind, placebo-controlled trial investigated the safety and efficacy of cetirizine syrup (5 or 10 mg daily) in 209 children ages 6 to 11 years with SAR. Parents assisted patients in recording symptom severity (sneezing, nasal discharge, itchy eyes, itchy nose or mouth, conjunctivitis, nasal congestion) daily. A total symptom severity (TSS) score was derived from all symptoms, excluding nasal congestion. At baseline, TSS was comparable for all groups (range 6.8-7.0). Cetirizine 10 mg produced a significantly greater mean TSS reduction (3.2) than placebo (P < 0.05) over the treatment period. Cetirizine 5 mg once daily produced mean reductions in weekly symptom scores of 2.4; this did not differ statistically from placebo. Furthermore, cetirizine 10 mg significantly improved symptoms of itchy eyes, nose, or mouth. The most commonly reported adverse reactions to both cetirizine and placebo were headache, pharyngitis, and abdominal pain, which did not occur with an incidence statistically different from that of placebo. Once-daily cetirizine is safe for treating SAR in children ages 6-11 years. Once-daily cetirizine 10 mg provides effective improvement in symptoms and is well tolerated.
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PMID:Once-daily cetirizine effective in the treatment of seasonal allergic rhinitis in children aged 6 to 11 years: a randomized, double-blind, placebo-controlled study. 911 92


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