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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty children all aged over 2 years and eutrophic were treated with the combination amoxycillin and clavulanic acid for various infections (twenty-three with meningitis, eleven with bronchial pneumonia, three with typhoid fever, two with lower urinary tract infections and one with ear infection of moderate severity). Nine of these patients had sickness during treatment which was mild and transient in the majority of cases and caused treatment to be stopped in only one case (2.5%). This low level of gastric tolerance should not concern the paediatrician faced with an infection due to (or most likely to be) a beta-lactamase producing micro-organism.
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PMID:[Tolerance of amoxicillin-clavulanic acid combination in the child]. 372 Oct 56

37 episodes of Staphylococcus aureus bacteremia (SAB) in children and adolescents with acute lymphoblastic leukemia (ALL) were analyzed. 25 were associated with an identifiable source of infection: pneumonia (9), cellulitis (11), osteomyelitis (2), ear infection (2), urinary tract infection (1). The absolute neutrophil count was less than 1,000/mm3 at the onset of 29 episodes. 6 patients had a bacterial re-infection after the treatment for SAB was stopped. 5 patients had fungal infection discovered at autopsy. 7 patients died within 4 days of admission. Gram-negative superinfection occurred in 6 patients treated with multiple antibiotics whereas no patient among those treated with a single antibiotic developed superinfection. This was not a statistically different difference.
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PMID:Staphylococcus aureus bacteremia in children and adolescents with acute lymphoblastic leukemia. 657 69

This review describes the microbiology and management of meningitis and shunt infections caused by anaerobic bacteria in children. The predominant anaerobes recovered in meningitis are Bacteriodes spp., Bacteriodes fragilis, Fusobacterium spp., and Clostridium spp. Peptostreptococcus, Veillonella, Actinomyces, Propionibacterium acnes, and Eubacterium are less commonly isolated. The predisposing conditions for meningitis are acute or chronic middle-ear infection, sinusitis, pharyngitis, and pulmonary infections. In newborn and preterm infants the predisposing conditions are rupture of membranes, amnionitis, fetal distress, necrotizing enterocolitis, gastric perforation and subsequent ileus followed by bacteremia, aspiration pneumonitis and septicemia, infected ventriculoperitoneal or ventriculoatrial shunt, and complicating dermal sinus tract infections. Shunt infection with Propionibacterium spp. has been reported in children, especially in association with ventriculoauricular and ventriculoperitoneal shunts. Clostridium perfringens has been recovered from infants with a ventriculoperitoneal shunt. Multiple-organism meningitis was reported as a complication of ventriculoperitoneal and lumboperitoneal shunts that perforated the gastrointestinal tract. Early recognition and effective therapy are essential to recovery. Management of meningitis includes the use of antimicrobials effective against anaerobes that penetrate the blood-brain barrier. These include metronidazole, chloramphenicol, the combination of a penicillin and a beta-lactamase inhibitor, and carbapenems. The treatment of shunt infection includes antimicrobial therapy and removal of the shunt.
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PMID:Meningitis and shunt infection caused by anaerobic bacteria in children. 1189 73

Each year, at least 4 million African children die before they reach their fifth birthday, and 70% of the deaths are caused by pneumonia, diarrhea, malaria, measles, malnutrition, or, more commonly, a combination of these. Despite the fact that sick children often have more than one condition, busy clinics tend to treat only the one that is most obvious. With much of the effort of the past two decades directed to diarrhea, health workers have been taught their clinical skills in a piecemeal, rather than an integrated, fashion. In response to this problem, the World Health Organization and the UN Children's Fund developed a training course for the integrated management of childhood illnesses (IMCI) in 1993. IMCI is now being used in Uganda, Tanzania, and Zambia, and other African countries are preparing to institute it. IMCI relies on a straightforward clinical assessment and classification of illness that does not require the use of a laboratory. IMCI identifies general danger signs that may call for hospitalization of the child and then bases its assessment on the presence of 1) cough and difficulty breathing, 2) diarrhea, 3) fever, 4) measles, 5) ear infection, and 6) malnutrition. All sick children are screened for all of these conditions because IMCI capitalizes on the presence of the child in the clinic (vaccinations are also given if necessary). Training for IMCI involves 11 days, half of which are spent in clinical practice and demonstration and half in the classroom. Each country must adapt the IMCI guidelines and training course to meet its specific needs. Such adaptation provides an opportunity for collaboration among disease-specific programs; it stimulates a review of technical and clinical guidelines; and it provides an opportunity for the health system to focus on its essential drug needs, referral care, and supervisory system.
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PMID:The integrated management of childhood illness. 1229 34

Each year, measles kills more than 1 million children in developing countries, especially malnourished children and children with complications. Prompt hospital admission is required to prevent measles-associated deaths if children with measles exhibit a general danger sign (lethargy or unconsciousness, convulsions, inability to eat or drink, or vomiting), signs of xerophthalmia, deep or extensive mouth ulcers, severe pneumonia, severe dehydration, or severe malnutrition. No drug can treat this viral infection; measles management consists of treating complications. Health workers must insert a nasogastric tube to administer liquid foods and fluids in children with severe measles who cannot eat. They should clean both eyes with a clean cloth and water 3 times a day. They should apply tetracycline eye ointment 3 times a day for 7 days. They should give a child with signs of xerophthalmia a treatment dose of vitamin A and another dose 3 weeks later. Health workers need to clean the mouth with clean water and a pinch of salt at least 4 times a day and put 1% gentian violet on mouth sores after cleaning. They should treat an anaerobic mouth infection, indicated by a foul smelling discharge, with metronidazole. Measles patients with an acute ear infection should receive paracetamol for pain and fever and an antibiotic for the infection. In the case of ear discharge, the health worker must clean the ears at least twice a day with cotton wool or a clean cloth. They should encourage mothers of measles patients with diarrhea to continue breast feeding. Health workers must administer more fluids than usual. They need to monitor hospitalized children to detect any additional complications. They need to look for danger signs; record the child's temperature, pulse, and respiratory rate twice a day; and weigh the child daily. Children with measles must be isolated for 4 days after onset of the rash. Any child in contact with the ill child should receive a dose of measles vaccine if he/she has not already been vaccinated or had measles. A vaccine coverage rate of at least 90% is the best way to prevent measles and measles-associated deaths.
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PMID:Preventing measles deaths. 1229 69

Streptococcus pneumoniae is the most frequent pathogen in young children's acute otitis media. It also plays a significant role in nosocomial ear infection in children, while it causes pneumonia with or without bacteremia in hospitalized elderly people. Multiple antibiotic resistant strains are prevalent among S. pneumoniae isolates from the respiratory tract of hospitalized patients in Hungary. This fact makes therapeutic reconsiderations concerning the use of oral beta-lactams mandatory. In this retrospective study two nosocomial outbreaks caused by multiresistant S. pneumoniae in two pediatric hospitals are described. The patients admitted with a chronic underlying disease (milk intolerance and gastro-oesophageal reflux were predominant) or respiratory tract infection acquired acute otitis media. Therapy with oral beta-lactams (first and second generation cephalosporins and amoxicillin), macrolides and co-trimoxazole was ineffective in most of the cases or resulted in transient improvement. In some cases acute otitis media resolved with the improvement of the underlying condition, in two cases administration of cefotaxime resulted in recovery and in one case mastoidectomy became necessary.
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PMID:Nosocomial Streptococcus pneumoniae infection causing children's acute otitis media. 1861 82

We examined the frequency of iron and iodine deficiencies and associations of iron and iodine deficiencies with common diseases among under-2 children, adolescent girls, and pregnant women of Bangladesh. We assayed the blood hemoglobin concentration in 395 under-2 children, 355 adolescent girls, and 263 pregnant women, the urinary iodine concentration of those adolescent girls and pregnant women, and the iodine level of all household salt specimens. The history of common diseases within their previous 2 weeks were also obtained from recall to explore the associations of iron and iodine deficiencies with common diseases. Anemia was found in 49.1% of children, 24.8% of adolescent girls, and 44.4% of pregnant women using defined cut-off values (Hb < 11.0 g/dL for under-2 children and pregnant women; <12.0 g/dL for adolescent girls). Prevalence of iodine deficiencies (urinary iodine <100 microg/L) was 38.4% in adolescent girls and 39.4% in pregnant women, and 39.4% of salt specimens had inadequate iodine (<15 ppm). The relative risk (RR) and 95% confidence intervals (CI) were estimated and adjusted for age, sex, and gestational age to explore the associations of iron and iodine deficiencies with common diseases. The RR of anemia was increased for fever (RR = 1.7, 95% CI = 1.3-2.3), ear infection (RR = 3.4, 95% CI = 1.3-8.5), skin disease (RR = 1.4, 95% CI = 0.9-2.2), and pneumonia (RR = 3.7, 95% CI = 0.7-19.5). The RR of iodine deficiency was elevated for diarrhea/dysentery (RR = 2.2, 95% CI = 1.1l-4.4) and eye infection (RR = 2.1, 95% CI = 0.5-9.4). We concluded that iron and iodine deficiencies are quite high among the Bangladeshi population. Observed associations of iron and iodine deficiencies with common diseases indicated the necessity of eliminating iron and iodine deficiencies from this vulnerable population through strengthening of iron and iodine supplementation, in order to prevent diseases and promote health conditions.
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PMID:Iron and iodine deficiencies among under-2 children, adolescent girls, and pregnant women of Bangladesh: association with common diseases. 1935 74

Although there is evidence that oral antibiotic prescriptions for children have decreased since the 1990s, antibiotic resistance continues to be a problem. This study evaluated the caregivers' understanding of antibiotic use for their children and identified demographic characteristics that may contribute to inappropriate antibiotic-seeking behavior. Caregivers were asked how often the child should receive antibiotics for common medical conditions and about factors to improve patient compliance. This study found that caregivers overexpected antibiotic use with upper respiratory infection, ear infection, and pneumonia. Caretakers with lower incomes and on Medicaid comprised the higher percentage of overusers. The most important factors to improve patient compliance were explanation of the name and indication for antibiotic use. This study showed that demographic variables play a role in caregivers' expectations of antibiotic use. Effective communication of physicians with caregivers on antibiotic use can be an important strategy to improve patient compliance.
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PMID:Caregivers' baseline understanding and expectations of antibiotic use for their children. 2239 68

Children spend most of their indoors time at home, which may have substantial influence on their health. We conducted a cross-sectional study in the Tianjin area, China to quantify the incidence of respiratory infections among children, and its association with home environments and lifestyles. The lifetime-ever incidences of croup, pneumonia and ear infection among children aged 0-8 in Tianjin area was 9.2%, 28.7% and 11.6%, respectively. The incidence of common cold infections more than twice per year was 31.3%. Home environments and lifestyles included strong risk factors for childhood respiratory infections. Perceived dry air had the greatest association with childhood common colds (population attributable fraction (PAF = 15.0%). Modern floor covering had the greatest association with croup (PAF = 14.7%) and ear infection (PAF = 34.5%), while infrequent bedding sun-curing had the greatest association with pneumonia (PAF = 18.7%). Condensation (a proxy of poor ventilation) accounted for 12.2% of the incidence of croup (PAF = 12.2%) and frequent common colds (PAF = 8.4%). Our findings indicate that factors related to "modern" home environments and lifestyles are risks for childhood respiratory infections. Modifying such factors might reduce the incidence of respiratory infections among children.
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PMID:Children's Respiratory Infections in Tianjin Area, China: Associations with Home Environments and Lifestyles. 3251 60